Influence Of Systemic Risk Factors On Short-term Efficacy Of Anti VEGF Therapy In Patients With Diabetic Macular Edema Of Qi And Yin Deficiency Type

Objective: This study statistically analyzed the systemic risk factors influencing the short-term efficacy of anti VEGF therapy in patients with diabetic macular edema of Qi and yin deficiency type.Methods:From August 2020 to February 2021,32 patients(40 eyes)with DME who underwent anti VEGF therapy in the Affiliated Hospital of Chengdu University of traditional Chinese medicine were collected.General data were collected: gender,age,eye type,smoking history,drinking history,hypertension history,diabetes course,DME course,retinal laser history,and laboratory indexes: systolic blood pressure,diastolic blood pressure,fasting blood glucose,glycosylated hemoglobin,total cholesterol,triglyceride,high density lipoprotein,low density lipoprotein,blood neutrophils,hemoglobin,creatinine,blood urea Nitrogen.The best corrected visual acuity(BCVA)and macular fovea thickness(CMT)at 1,2 and 3 months after anti VEGF therapy were compared with the baseline level before treatment.The BCVA was converted into Log MAR for convenient statistics,and the BCVA improvement value(Log MAR reduction value)and CMT reduction value were calculated.Then,CMT reduction≥20%was regarded as edema regression standard group,on the contrary,not standard group;Log MAR reduction ≥ 0.2 was regarded as vision improvement standard group,on the contrary,not standard group.The influencing factors of visual acuity improvement and edema regression were compared between the two groups.Results:1、1 month after anti VEGF therapy,diastolic blood pressure,course of DME,baseline BCVA,baseline CMT,smoking history and insulin use affected visual acuity improvement(P<0.05);baseline CMT affected edema regression P<0.05).2 months after anti VEGF therapy: the course of DME affected the improvement of visual acuity(P<0.05);fasting blood glucose and baseline CMT affected the regression of edema(P<0.05).3 months after anti VEGF therapy: the course of DME affected the improvement of visual acuity(P<0.05);the effect of creatinine on the regression of edema(P<0.05).2、Gender,drinking history,history of hypertension,retinal laser history,age,systolic blood pressure,pulse pressure difference,course of diabetes,glycosylated hemoglobin,total cholesterol,triglyceride,high density lipoprotein,low density lipoprotein,hemoglobin,blood neutrophils,blood urea nitrogen had no effect on visual acuity improvement and edema regression(P>0.05).Conclusions:1.Patients with diabetic macular edema with Qi and yin deficiency should stop smoking and regularly monitor their blood pressure,especially diastolic blood pressure.DME course,baseline BCVA,baseline CMT,insulin use,fasting blood glucose and creatinine are strong predictors of poor postoperative efficacy against VEGF.2.Gender,age,history of drinking,history of hypertension,history of retinal laser,systolic blood pressure,pulse pressure difference,course of diabetes,glycosylated hemoglobin,high density lipoprotein,low density lipoprotein,cholesterol,triglyceride,hemoglobin,blood neutrophils,blood urea nitrogen have no significant correlation with the efficacy of anti VEGF therapy in patients with diabetic macular edema of Qi and yin deficiency type.