The Efficacy Of Anti-VEGF Drug Combined With Laser Treatment For Macular Edema Secondary To Branch Retinal Vein Occlusion

Objectives:To observe the efficacy and safety of intravitreal injection of anti-VEGF drug of Conbercept(1+PRN strategies)combined with single macular grid photocoagulation in the treatment of macular edema secondary to branch retinal vein occlusion.It is expected to provide an important evidence for clinical exploration of a more effective therapeutic method to macular edema secondary to branch retinal vein occlusion.Method:A retrospective study.44 patients(44eyes)who were treated in the ophthalmology department of the Second Affiliated Hospital of Kunming Medical University from January 2017 to January 2018 were diagnosed by optical coherence tomography(OCT)and fundus fluorescein angiography(FFA),diagnosed with macular edema secondary to branch retinal vein occlusion as the research objects.These patients were devided into two groups including the combine group and the simple drug injection group according to the therapeutic methods.The combine group(20eyes)received intravitreal injection of Conbercept(1+PRN strategies)combined with single macular grid photocoagulation treatment;the simple drug injection group(24eyes)received intravitreal injection of Conbercept(3+PRN strategies)treatment.Compare and analyze central macular thickness(CMT)and the best corrected visual acuity(BCVA)changes between the two groups of patients before and after treatment,pay attention to the the occurrence of complications.The preoperative and postoperative 1Mo,2Mo,3Mo,4mo,5Mo and 6Mo were followed up,and the opacity of lens,the best corrected visual acuity(BCVA),intraocular pressure and so on were measured.The thickness of central macula was measured and recorded.All statistical analyses were performed using version 21.0 SPSS statistical software.All data are presented as mean±standard error.Changes in BCVA and CMT before and after treatment were compared using paired sample t tests in each group.Differences between treatment groups were compared using independent sample t tests.A P value of<0.05 was considered statistically significant.Results:(1)Safety:No severe complications occurred in the combine group or the simple drug injection group during the treatment.(2)BCVA:The mean BCVA of the combine group was 0.70 + 0.421ogMAR at baseline.The mean BCVA was 0.42 + 0.31,0.59 + 0.31,0.59 + 0.33,0.57 +,0.49 + 0.32,0.43 + 0.221ogMAR after the treatment during the 6-month follow-up period,respectively,the difference was statistically significant at each month in BCVA compered with baseline(P<0.05).The mean BCVA in the simple drug injection group was 0.64 + 0.481ogMAR at baseline,and the mean BCVA was 0.30 + 0.18,0.45 + 0.27,0.49 + 0.28,0.52 +0.28,0.39 + 0.25,0.37 + 0.161ogMAR after the treatment during the 6-month follow-up period,respectively,the difference was statistically significant at each month in BCVA compered with baseline(P<0.05).There was no significant difference in BCVA between the two groups at each follow-up time point(P>0.05).(3)CMT:The CMT of the combine group was 562.45± 156.18um at baseline.The CMT was 235.50±28.90?426.60±107.05?435.75±106.91?411.75±109.34?386.90±141.61?282.15±43.23um after the treatment during the 6-month follow-up period,respectively,the difference was statistically significant at each month in CMT compered with baseline(P<0.05).The CMT in the simple drug injection group was 513.63±151.87um at baseline,and the CMT was 229.79±28.76?331.33±98.68?307.92±84.63?372.75±129.07?393.79±151.54?261.08±60.93um after the treatment during the 6-month follow-up period,respectively,the difference was statistically significant at each month in CMT compered with baseline(P<0.05).Comparison between the two groups at each follow-up time point,There were statistical significance and significant differences in CMT between the second and third months(P<0.05);there were no statistical significance and significant differences in CMT between the first,fourth,fifth and sixth months(P>0.05).(4)The number of intravitreal injection:At the end of 6-month follow-up,the number of intravitreal injection of Conbercept in the two groups was separately 2.7±0.66 times in the combine group and 3.8±0.68 times in the simple drug injection group,and there was a significant difference between the two groups(P<0.05).Conclusion:(1)Intravitreal injection of Conbercept(1+PRN strategies)combined with single macular grid photocoagulation for the treatment of BRVO secondary macular edema is safe and effective in a short period of time.(2)Combine treatment helps to reduce the number of Intravitreal injections and reduce the financial burden of patients.