| Purpose:Comparison of the clinical effect and visual acuity prognosis related factors of ranibizumab for macular edema secondary to central retinal vein occlusion aged under 50 years old and over 50 years old.Method:A retrospective case-control study.We collected 39 patients with macular edema secondary to central retinal vein occlusion diagnosed by fluorescein fundus angiography(FFA)and optical coherence tomography(OCT)in our outpatient department from 2017.11-2019.11.According to the age of onset,the patients were divided into group A(<50 years old)17 patients(17 eyes)and group B(?50 years old)22 patients(22 eyes).All the patients were treated with 1+PRN by the same experienced fundus doctor who injected the drug(anti-vegf ranibizumab 0.05ml)into the vitreous cavity.(1).Cellected the patient's gender,age,weight,first onset duration,personal history of arteriosclerotic diseases(hypertension,diabetes,hyperlipidemia),best corrected visual acuity(BCVA),intraocular pressure(IOP),central macular thickness(CMT)and other examination data.(2).Contrasted the BCVA(logMAR),IOP,CMT,injection rate and complications before and after treatment at 7day,1month,2 month,3 month and 6 month.(3).Analyzed the effect of vision improvement and edema subsided after treatment and whether it is related to the times of vitreous cavity injection,sex,age,weight,atherosclerotic disease,ischemia state,duration,baseline BCVA,baseline CMT and atherosclerosis disease to the influencing factors related to vision prognosis evaluation.Result:1.Baseline data: The difference was a statistically significant in age betweenthe two groups(P < 0.05).There was no statistically significant in preoperative BCVA(logMAR),preoperative IOP,weight,preoperative CMT,preoperative ischemic status,presence or absence of arteriosclerotic disease(hypertension,diabetes mellitus,hyperlipidemia),gender,eye type and duration(P > 0.05).2.BCVA(logMAR)analysis:Between groups:there was no statistically significant in preoperative and postoperative 7day BCVA between group A and group B(P > 0.05),and the BCVA(logMAR)at 1,2,3 and 6 month after treatment with statistical difference(P <0.05).The follow-up time BCVA of group A was better than that of group B.In group A,BCVA(logMAR)at baseline was 0.98±0.50,the BCVA(logMAR)at 7day,1 month,2 month,3 month and 6 month after treatment were 0.71±0.43,0.64±0.30,0.58±0.24,0.56±0.27,and 0.53±0.26.Compared with before treatment,the postoperative BCVA was significantly increased at each follow-up time points,and the difference was statistically significant(P < 0.05).The preoperative BCVA(logMAR)of group B was 1.13±0.41,and BCVA(logMAR)after treatment at 7day,1 month,2 month,3 month and 6 month were0.91±0.36,0.88±0.37,0.85±0.39,0.84±0.32,and 0.83±0.34.Compared with before treatment,the postoperative BCVA was significantly increased at each follow-up time point,and the difference was statistically significant(P < 0.05).The difference in BCVA measured at different time was statistically significant(P=0.000).There is no interaction between age and time(P>0.05),with the change of time,the visual acuity of both groups was improved compared with that before treatment.3.CMT(?m)analysis:Between groups: there was no significant difference in preoperative and postoperative 7day CMT between group A and group B(P> 0.05).There were statistically significant differences in CMT at 1,2,3 and 6 month aftertreatment(P <0.05).The reduction effect of CMT thickness in group A was better than that in group B.In group A,the preoperative CMT was 452.12±148.62,and the mean CMT at7 day,1 month,2 month,3 month and 6 month were 238.65±65.39,227.71±33.41,225.24±28.53,223.29±26.38,and 213.18±19.92.The postoperative CMT was significantly increased at each follow-up time points,and the difference was statistically significant(P < 0.05).The average CMT in group B was 271.45±46.35 before treatment,the mean CMT at 7 day,1 month,2 month,3 month and 6 month were 283.32±76.67,253.91±29.40,245.36±21.93,247.95±47.07.The postoperative CMT was significantly increased at each follow-up time points,and the difference was statistically significant(P < 0.05).4.Times of injection and complications: The average times of drug injection in group A was 1.88±0.78,and the average times of drug injection in group B was3.59±1.09.The total amount of vitreous cavity injection in group A was less than that in group B,and the number of vitreous cavity injection was statistically significant(P < 0.05).There were 2 cases of bulbous conjunctival hemorrhage in group A and 2 cases of bulbous conjunctival hemorrhage in group B,but no other complications.5.Analysis of influencing factors of vision prognosis in patients:(1)Preoperative baseline BCVA of CRVO patients in group A and group B was positively correlated with BCVA at the 6th month after treatment,and the difference was statistically significant(group A: r=0.71,P<0.01;group B: r=0.62,P<0.01),(2)The ischemic status of CRVO in group A was correlated with BCVA at the 6th month after treatment,and the difference was statistically significant(r=0.66,P<0.01),the ischemic status of CRVO in group B was not correlated with BCVA at the 6th month after treatment,and the difference was not statistically significant(P>0.05),(3)The duration,weight,times of vitreous cavity injection,and the atherosclerotic disease of the two groups of patients were not correlated with BCVA at the 6th month after treatment(P>0.05).(4)The duration,baseline BCVA,weight,times of vitreous cavity injection,ischemic status and atherosclerotic disease of the patients in both groups were not correlated with CMT at the 6th month after treatment(P>0.05).(5)Multiple linear regression further analyzed that baseline BCVA was an independent risk factor for CRVO and could be used as an influencing factor for vision prognosis.Conclusion:1.The BCVA and CMT of CRVO patients under the age of 50 after treatment with ranibizumab were better than those over the age of 50,and the total times of injections was less.2.The treatment of CRVO-ME with ranibizumab can significantly reduce macular edema,effectively improve vision and good safety in different ages.3.Baseline BCVA is an influential factor for postoperative visual acuity recovery. |
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