Clinical Observation Of Different Treatments For Macular Edema Secondary To Retinal Vein Occlusion

Objective: To observe and compare the clinical effects of three different methods:Conbercept combined with Hexuemingmu tablets,laser combined with Hexuemingmu tablets,oral Hexuemingmu tablets in the treatment of macular edema secondary to branch retinal vein occlusion.Methods: From June 2018 to June 2021,58 patients(58 eyes)diagnosed as branch retinal vein occlusion in Laixi People’s Hospital were selected.According to the different treatment methods,the patients were divided into three groups: oral Hexuemingmu tablet treatment group(group A,16 cases,16 eyes),laser combined with Hexuemingmu tablet treatment group(group B,19 cases,19 eyes),Conbercept combined with Hexuemingmu tablet treatment group(group C,23 cases,23 eyes).The international standard visual acuity chart recorded the changes of best corrected visual acuity in the three groups,the changes of intraocular pressure in the patients were measured by non-contact tonometer,and the central macular thickness was measured by optical coherent tomography.Statistical comparisons were made between each group and within the same group before treatment and at the first,the second,and the third month after treatment.Fundus photography was used to observe the changes of fundus hemorrhage before treatment and three months after treatment in three groups.The treatment effect was comprehensively evaluated.The complications and adverse events after treatment were recorded as safety indicators.Results:1.BCVA(Log MAR)during treatment.Before treatment,the best corrected visual acuity of group A,group B and group C were 0.81±0.16,0.82±0.18 and 0.78±0.17,respectively.The third month after treatment,the best corrected visual acuity of group A,group B and group C increased to 0.64±0.15,0.52±0.15 and 0.33±0.13,respectively.There were significant differences compared with before treatment(P<0.05).There was no statistically significant difference in BCVA between group A and group B at the first month after treatment(P>0.05).BCVA in group B was better than that in group A at the second and the third month after treatment(P<0.05).BCVA in group C was superior to that in group A and group B at the first,the second,and the third month after treatment,with statistical significance(P<0.05).2.Comparison of IOP(mm Hg)during treatment.Before treatment,the intraocular pressure of group A,group B and group C were 14.55±2.01 mm Hg,14.90±2.20 mm Hg,14.55 ± 1.90 mm Hg,respectively.The third month after treatment,the intraocular pressure of group A,group B and group C were 14.90 ± 2.36 mm Hg,15.30 ± 1.89 mm Hg,15.10 ± 1.37 mm Hg,respectively.There was no significant difference in IOP between groups A,group B and group C before treatment and the first,the second,and the third month after treatment(P>0.05).There was no significant difference in the intraocular pressure within each group(P>0.05).3.Comparison of CMT(μm)during treatment.Before treatment,the central macular thickness of group A,group B and group C were 547.75±53.18 μm,548.31±45.04 μm and 554.91±47.11 μm,respectively.Three months after treatment,the central macular thickness of the three groups decreased to 410.81±54.31 μm,363.47±61.31 μm and258.52±35.89 μm,respectively,significantly lower than that before treatment,the difference was statistically significant(P<0.05).During the treatment period,the central macular thickness of group C at the first,the second,and the third month after treatment was significantly lower than that of group A and group B,and the difference was statistically significant(P<0.05).Compared with group A,the central macular thickness of group B was significantly decreased at the first,the second,and the third month,and the difference was statistically significant(P<0.05).4.Comparison of fundus hemorrhage.Three months after treatment,fundus photography was performed in all three groups,to observe the changes of retinal hemorrhage,and compared with that before treatment.The results showed that the effective rates of group A,group B and group C were 56.25%,68.42% and 95.65%,respectively.There was no significant difference between group A and group B(P>0.05).The difference between group A and group C was statistically significant(P<0.05).There was statistically significant difference between group B and group C(P<0.05).5.Comparison of curative effect after treatment.At three months after treatment,the effective rates of group A,group B and group C were 43.75%,63.16% and 91.30%,respectively.Among them,the effective rate of group C was significantly better than that of group A and group B,and the difference was statistically significant(P<0.05),while there was no statistically significant difference between group A and group B(P>0.05).6.During treatment,there were no serious ocular complications or systemic adverse reactions related to drugs and laser in group A,group B and group C.Conclusion:1.It is safe and effective to treat macular edema caused by branch retinal vein occlusion by oral Hexuemingmu table,laser combined with Hexuemingmu tablet,and Conbercept combined with Hexuemingmu tablet.2.The effect of Conbercept combined with Hexuemingmu tablets on macular edema caused by branch retinal vein occlusion was significantly better than that of oral Hexuemingmu tablets alone,or laser combined with Hexuemingmu tablets.