| Objective Applications enhanced depth imaging(EDI) technology to research the change characteristics of retinal vein occlusion(RVO) complicated by m acular edema(ME) patients pre- and post-different treatment methods for subfo veal choroidal thickness(SFCT),macular retinal thickness, and best corrected v isual acuity(BCVA). To research choroidal thickness, retinal thickness of RV O patients related with visual acuity. To analysis the efficacy and safety of di fferent treatments for RVO concurrent ME. To investigate the development of RVO and the treatment outcome of the patients.Methods In this study, self-control to take a series of case studies designed f or retrospective analysis. Select diagnosed RVO patients. A total of 104 people and 104 eyes. The different types of disease were divided into branch retinal vein occlusion(BRVO) and central retinal vein occlusion(CRVO),each type w as grouped by different treatment. The healthy follow eyes of all patients as t he control group(n = 104). BRVO patients were divided into 2 groups, com bination group and laser group, respectively. Combination group: 18 cases, 18 eyes, receiving intravitreal ranibizumab(0.5mg 0.05ml) combined scatter 577 nm laser phtocoagulation at nonperfusion area.Treatment was laser phtocoagulatio n at nonperfusion area after intravitreal ranibizumab 3 days, photocoagulation t wice, interval 7 days. Laser group: 22 cases, 22 eyes, only 577 nm laser phtoc oagulation at nonperfusion area, photocoagulation twice, interval 7 days. CRVO patients were divided into 3 groups. the simple intravitreal ranibizumab gro up, combination group and laser group, respectively. Simple intravitreal ranibi zumab group: 23 cases, 23 eyes, and the group all patients were nonischemic type, fundus angiography(FFA) did not see the nonperfusion area, receiving i ntravitreal ranibizumab(0.5mg 0.05ml). Combination group: 23 cases, 23 eyes, r eceiving intravitreal ranibizumab(0.5mg 0.05ml) combined 577 nm laser pan-re tinal photocoagulation. Treatment was laser pan-retinal photocoagulation after intravitreal ranibizumab 3 days, photocoagulation 3-4 times, interval 7 days. laser group: 18 cases, 18 eyes, only 577 nm laser pan-retinal photocoagulation, pho tocoagulation 4 times, interval 7 days.The changes of BCVA, retina thickness and choroid thickness values were recorded during the follow-up in 1, 2, 3, 6 month. If the disease progression or recurrence in simple intravitreal ranibizu mab group or combination group, repeated injections were received in necessa ry. The shortest interval time was a month. Using SPSS 18.0 statistical softwar e for statistical analysis.Results1 The changes of observation indexes in pre- and post- treatment for CRVO p atientsSimple intravitreal ranibizumab group: during the follow-up in 1, 2, 3, 6 mon th,the SFCT value was significantly thinner than that before intravitreal ranibi zumab therapy, mean BCVA improved and mean CRT was significantly lower than that before treatment. The overall comparison difference was statistically significant(P < 0.05).Combination group: during the follow-up in 1, 2, 3, 6 month after treatmeat,t he SFCT value was significantly thinner than that before intravitreal ranibizuma b combined phtocoagulation therapy, mean BCVA improved and mean CRT w as significantly lower than that before treatment. The overall comparison differ ence was statistically significant(P < 0.05).Laser group: the SFCT in 1 month after treatment was higher than that the be fore treatment, in 2, 3 and 6 months after treatment was lower than that befo re treatment, the overall comparison difference was statistically significant(P < 0.05). The change of BCVA was not obvious, overall difference was no statis tical significance(P > 0.05). Mean CRT was slowly lower than that before tre atment. The overall comparison difference was statistically significant(P < 0.05).The overall difference of mean SFCT between the three groups before treatm ent and 1 month after treatment were statistically significant(all P <0.05). In CRVO patients, the mean SFCT of nonischemic type of simple intravitreal ranibizumab group was thinner than that ischemic type of combination group an d laser group before treatment and 1 month after treatment. The overall differe nce of mean SFCT between the three groups in 2,3,6 month after treatment w ere not statistical significance(all P > 0.05). The mean SFCT of the three gro ups in 6 month after treatment were significantly greater than that in fellow ey es, the comparison difference were statistically significant(all P < 0.05).The o verall difference of BCVA between the three groups before treatment were not statistically significant(P> 0.05). The BCVA of simple intravitreal ranibizum ab group in 2,3,6month was higher than that laser group, the comparison diffe rence were statistically significant(all P < 0.05). The difference of BCVA bet ween combination group and laser group only in 1 moth after treatment was s tatistically significant(P < 0.05). The BCVA of simple intravitreal ranibizumab group in each follow up after treatment was better than that laser group, the comparison difference was statistically significant(P < 0.05). The CRT of simp le intravitreal ranibizumab group before treatment was thinner than that com bination group and laser group, the comparison difference were statistically sig nificant(P < 0.05). The difference of CRT between combination group and las er group before treatment was not statistically significant(P> 0.05). The CRT of combination group in 1,3,6 month after treatment was thinner than that lase r group, the comparison difference were statistically significant(P < 0.05).2 The changes of observation indexes in pre- and post- treatment for BRVO p atientsCombination group: during the follow-up in 1, 2, 3, 6 month,the SFCT value was significantly thinner than that before intravitreal ranibizumab combined ph tocoagulation therapy, mean BCVA improved and mean CRT was significantly lower than before treatment. The overall comparison difference was statisticall y significant(P < 0.05).Laser group: during the follow-up in 1, 2, 3, 6 month after treatment,the SF CT value was lower than that before treatment, the overall comparison differen ce was statistically significant(P < 0.05). The change of BCVA was not obvio us, overall difference was not statistical significance(P > 0.05). Mean CRT was slowly lower than that before treatment. The overall comparison difference w as statistically significant(P < 0.05).The overall difference of mean SFCT between the two groups before treatme nt was not statistically significant(P> 0.05). During the follow-up in 1, 2, 3, 6 month after treatment,the SFCT of combination group was thinner than that laser group, but the comparison difference was not statistically significant(P> 0.05). The mean SFCT of the two groups in 6 month after treatment were sig nificantly greater than that fellow eyes, the comparison difference were statistic ally significant(all P < 0.05). The overall difference of BCVA between the tw o groups before and after treatment were not statistically significant(P> 0.05). The difference of CRT between combination group and laser group before tre atment was not statistically significant(P> 0.05). The CRT of combination gro up in 1,3,6 month after treatment was thinner than that laser group, the compa rison difference were statistically significant(all P < 0.05).3 The correlation between the visual acuity, SFCT and CRTSFCT and visual acuity with no correlation(rp =-0.020, P> 0.05); CRT and v isual acuity have negative correlation(rp =-0.275, P <0.05).4 The statistical analysis of SFCT of RVO eyes and follow eyesThe SFCT of RVO eyes before treatment significantly thicker than that follow eyes, the difference was statistically significant(t = 10.726, P <0.05); they ha ve positive correlation(r = 0.832, P <0.05).5 The comparison of IVR numberBRVO combination group: the number of injection was 1 ~ 3 times, average 1.83 ±0.67 times.CRVO simple intravitreal ranibizumab group: the number of injection was 2-5 times, average 3.76 ± 0.84. CRVO combination group: the number of injecti on was 1 ~ 4 times, average 2.89±0.72 times. The difference of the two gr oups was statistically significant(t=9.843,P=0.000).Conclusion1 In the RVO concurrented ME patients, SFCT of RVO eye was thicker than that follow eye, after 6 months of treatment, it was still thicker than the follow eye.2 Through the IVR treatment of the nonischemic RVO eye, can promoting ma cular edema absorption, improving patients’ eyesight, reducing submacular chor oid thickness and macular area retinal thickness. The SFCT of nonischemic RV O eye before treatment is thinner than that ischemic RVO eye,and the progno sis of visual acuity is better than ischemic RVO eye.3 For ischemic RVO eye with laser photocoagulation treatment in the early stag e, inhibiting retinal neovascularization, reducing submacular choroid thickness a nd macular area retinal thickness, but the extent was not as IVR and IVR co mbined laser photocoagulation.Retinal laser photocoagulation on the improveme nt of the vision effect is not obvious.Simple laser treatment for retinal thickeni ng obviously ME curative effect is limited.4 For ischemic RVO eye with IVR combined with retinal laser photocoagulatio n treatment, not only the best corrected vision acuity improved, but also avoi d the retinal neovascularization, and macular choroidal thickness and macular r etinal thickness decreased, no complications occurred. It is an effective and saf e treatment.5 The vision of RVO patients vision is no correlation whit SFCT, and negative correlation relationship with the CRT.6 in CRVO patients, the prognosis visual acuity of simple intravitreal ranibizu mab group is better than combination group, but the IVR times is more than t he combined group. |
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