Spectral-domain Optical Coherence Tomography Patterns And Clinical Efficacy Of Conbercept Therapy Macular Edema Secondary To Branch Retinal Vein Occlusion

Objective: To observe the therapeutic efficacy of intravitreal injection of conbercept for treating of macular edema secondary to branch retinal vein occlusion;to analyze the relationship between the morphological changes of the outer retina in patient shown by Spectral-domain optical coherence tomographythat was done before treatment and the best corrective visual acuity before and after treatment.Methods: Our study is a prospective study.Strictly according to the inclusion criteria,a total of 20 eyes from 20 patients who were definitely diagnosed as ME secondary to BRVO by fundus fluorescein angiography,post-mydriasis indirect ophthalmoscope examination and SD-OCT were selected and performed with a treatment in the form of intravitreal injection of Conbercept.All patients were treated with 3 PRN,and they were followed up and observed for 6 months after the first injection.The changes in best corrected visual acuity,central macular thicknessand foveola volumewithin the range of 1mm from the foveola at the center of macula lutea were observed on month 1,2,3 and 6 after treatment,and compared with their counterpart before the treatment.The morphological changes of the outer retina was analyzed through the patients' SD-OCT image before treatment,that is,the completeness of the external limiting membrane and the ellipsoid Zone.The changes of BCVA in patients with complete ELM and the ones without it and the patients with complete EZ and the ones without it were respectively observed on month 1,2,3 and 6 after treatment,and were compared with BCVA analysis before treatment,and a comparative analysis was conducted between the two groups at each time point.Using spss19.0 statistic software for data analysis,measurement data was represented by mean ± standard deviation,the data difference analysis between the two groups was done by two independent-sample T-test,two paired sample T-test was used to conduct a difference analysis for the comparison at each time point before and after treatment,the difference was regarded as statistically significant when p<0.05.Results: The BCVA(logMAR)on month 1,2,3 and 6 after treatment was respectively 0.40±0.21,0.30±0.19,0.27±0.23 and 0.26±0.22,which all increased as compared to the BCVA before treatment,which was 0.64±0.34,the differences has statistically significant(t=6.413?8.673?8.867?9.411,p<0.05);the CMT on month 1,2,3 and 6 after treatment was respectively was(441.80±154.8)um,(345.05±100.55)um,(311.00 ±120.68)um and(274.60±73.79)um,which all decreased as compared to the CMT before treatment,which was(595.40±198.84)um,the differences has statistically significant(t=7.397?8.866?7.476?8.463,p<0.05);the FV on month 1,2,3 and 6 after treatment was respectively was(0.35±0.12)mm3?(0.28±0.07)mm3?(0.26 ±0.09)mm3 and(0.23±0.05)mm3,which all decreased as compared to the FV before treatment,which was(0.47±0.16)mm3,the differences has statistically significant(t=6.585?8.177?7.158?7.352,p<0.05).There were 9 case-eye of consecutive ELM(45%)and 11 case-eye of non-consecutive ELM(55%).The BCVA of patients with a complete ELM at each time point before treatment and on month 1,2,3 and 6 after treatment was respectively was 0.39±0.07?0.24±0.04?0.16±0.04?0.13±0.08and0.08±0.07,the differences has statistically significant(t=4.584?4.572?4.288?3.306?5.120,P<0.05)as compared to the BCVA of patients with incomplete ELM,which was respectively0.85±0.33?0.54±0.21?0.42±0.19?0.39±0.19 and 0.41±0.19;There were 7 case-eye of Consecutive EZ(35%)and 13 case-eye of non-consecutive EZ(65%).The BCVA of patients with a complete EZ at each time point before treatment and on month 1,2,3 and 6 after treatment was respectively0.36±0.05?0.23±0.04?0.15±0.04?0.13±0.08and0.06±0.05,the differences has statistically significant(t=4.506?4.352?4.018?3.019?5.538,P<0.05)as compared to the BCVA of patients with incomplete EZ,which was respectively0.79±0.34?0.50±0.21?0.38±0.20?0.35±0.24and0.37±0.19.No adverse systemic events due to treatment were recorded,as well no adverse ocular events.Conclusions:The intravitreal injection ofConbercept for treating BRVO-ME can reduce the central macular thickness and improve visual acuity,and it is safe and effective treatment method for BRVO-ME.The BCVA of the patients with complete ELM and EZ is better than that of the ones with incomplete ELM and EZ at each time point before and after treatment.