| Objective: To study the case-control clinical study of intravitreal injection of ranibizumab(IVR)combined with diclofenac sodium and intravitreal injection of IVR alone in the treatment of neovascular age-related macular degeneration.Participants and methods: A total of 55 patients with neovascular age-related macular degeneration who were admitted to our hospital from January 2017 to December 2017 were enrolled,including 27 patients in the ranibizumab-treated group(single-agent group),and ranibizumab(IVR).28 patients in the combined diclofenac sodium treatment group(combined group).All patients received a monthly intravitreal injection of 0.5 mg IVR for 3 months and then decided whether to continue the injection based on the retreatment criteria.Patients in the combined group were also given 0.5% diclofenac sodium eye drops,one drop each time,three times a day,and stopped for two weeks after each month of continuous application for 12 months.All patients were followed up for 12 months.The main observations in this study were best corrected visual acuity(BCVA)and central retinal thickness(CRT).Secondary observations were the number of injections of ranibizumab and the adverse reactions of the two groups.Results: The study included 53 patients in the study,including 26 patients in the single drug group and 27 patients in the combined group.The baseline levels of the two groups were BCVA: 0.12±0.02 for the single drug group and 0.12±0.02 for the combination group.CRT: 444±6.4 μm for the single drug group and 443±6.1 μm for the combination group.At the end of the 12-month treatment period,we found that the BCVA was 0.60±0.06 for the single-agent group and 321 ±6.6 μm for the CRT;the BCVA for the combined group was 0.66±0.08,and the CRT was 317±6.1 μm.There were significant differences in BCVA and CRT between the two treatment groups at each follow-up node(P < 0.05).The results suggest that both the singleagent group and the combined group can improve the patients’ BCVA and CRT.Further analysis found that BCVA and CRT in patients in the combined treatment group.Compared with the single drug treatment group,the improvement was better.When analyzing the IVR treatment doses of the two groups,the average number of IVR injections was 6.57±0.74(single drug group)and 5.96±0.58(combination group),the difference was statistically significant(P < 0.01).Conclusion: Compared with ranibizumab monotherapy,diclofenac sodium combined with ranibizumab significantly improved BCVA and CRT in patients with neovascular age-related macular degeneration.Moreover,the combined use of diclofenac sodium eye drops can significantly reduce the dose of IVR injection and improve the health economics effect. |
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