| Objective:Through the clinical observation of polypoidal choroidal Vasculopathy(PCV)treated by the method of eliminating collaterals and removing blood stasis combined with anti-vascular PRN,the clinical efficacy of Guiyuan eliminating collaterals and removing blood stasis combined with anti-vascular PRN in the treatment of PCV was discussed.The pathogenesis of PCV was analyzed from collateral pathology theory in order to provide new ideas for the treatment of PCV.Methods:Thirty-three eyes(twenty seven cases)of outpatients in ophthalmology hospital of Chinese Academy of Chinese Medical Sciences were selected.According to the dialectical treatment of the whole and part of the Chinese medicine,the treatment of Gui Yuan Ti Luo Hua Yu(Eliminating collaterals and removing blood stasis)was carried out.When the thickness and detachment of pigmented epithelium were higher than before,anti-VEGF drugs were injected.The specific anti-vascular drugs were not limited.Observation was conducted for 6 months,every 3 months was a course of treatment,and OCTA was reviewed at the end of each course by prospective study.Results:1.Visual acuity:In the last follow-up,33 eyes were cured in 5 eyes,accounting for 15%of the total,3 eyes were markedly effective,accounting for 9%of the total,16 eyes were effective,accounting for 48%of the total,9 eyes were ineffective,accounting for 28%of the total,and the total effective rate was 72%.2.The visual acuity of 3 months after treatment and 6 months after treatment was compared with that before treatment,P<0.05.the difference was statistically significant.The visual acuity of 6 months after treatment was compared with that of 3 months after treatment,P<0.05,the difference was statistically significant,indicating that after treatment,the visual acuity was improved.3.PED height analysis:in the last follow-up,33 eyes were cured in 1 eye,accounting for 3%of the total,12 eyes were markedly effective,accounting for 37%of the total,10 eyes were effective.accounting for 30%of the total.10 eves were ineffective,accounting for 30%of the total.and the total effective rate was 70%.4.The height of PED at 3 months and 6 months after treatment was significantly higher than that before treatment(P<0.05).5.CMT analysis:Compared with before treatment,CMT at 3 months and 6 months after treatment had significant difference(P<0.05).Compared with 3 months after treatment,CMT at 6 months after treatment had significant difference(P<0.05).6.The average number of injections in 6 months was 0.79.Conclusion:1.The method of Ti Luo Hua Yu(eliminating collaterals and removing blood stasis)combined with anti-VEGF PRN in the treatment of PCV can effectively improve the central visual acuity and visual deformations of patients.2.The method of Ti Luo Hua Yu(eliminating collaterals and removing blood stasis)combined with anti-VEGF PRN in the treatment of PCV can effectively promote the absorption of fundus hemorrhage and exudation,thus improving the morphological structure of patients' fundus.and alleviating the degree of macular edema and pigment epithelial detachment.3.The method of Ti Luo Hua Yu(eliminating collaterals and removing blood stasis)combined with anti-VEGF PRN in the treatment of PCV can reduce the average number of injections of anti-VEGF,reduce the probability of complications caused by repeated injections of anti-VEGF,greatly alleviate patients' pain and economic burden,and improve patients' quality of life. |
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