Clinical Effect Analysis Of Anti-VEGF Drug Therapy For Macular Edema Secondary To Retinal Vein Occlusion

Objective:To compare the short-term clinical efficacy of intravitreal injection of anti vascular endothelial growth factor(VEGF)3 + PRN(pro re nata,PRN)in the treatment of macular edema secondary to retinal vein occlusion.Methods:A retrospective analysis of 80 patients(80 eyes)with ME secondary to retinal vein occlusion who attended the First Hospital of Jilin University from April 2017 to July 2019 were included in the study.1、Among them,there were divided into40non-ischemic type(40 eyes)and 40 ischemic type(40 eyes)according to the degree of disease ischemia.Both groups of patients received intravitreal anti-VEGF drug3+PRN(pro re nata,PRN)injection treatment.The best corrected visual acuity(BCVA)and optical coherence tomography of 1,2,3,and 6month were performed,as well as regression analysis analysis of factors influencing the long-term vision of patients.The correlation of long-term vision and age,intraocular pressure before treatment,log MAR BCVA before treatment,CMT before treatment and CMT reduction at 1 month after treatment were analyzed by multiple regression analysis.All the examination results were compared with those before treatment.2.They were divided into central retinal vein occlusion group(n = 38)and branch retinal vein occlusion group(n = 42).Both groups of patients received intravitreal anti-VEGF drug 3+PRN injection treatment.The BCVA and CMT of 1,2,3,and 6month were performed,as well as regression analysis analysis of factors influencing the long-term vision of patients.The correlation of long-term vision and age,gender,preoperative intraocular pressure,before treatment,log MAR BCVA before treatment,CMT before treatment and CMT reduction,preoperative visual vision,preoperative CMT and CMT at 1 month after treatment were analyzed.Multiple regression analysis was used to analyze the relationship between long-term visual acuity and age,gender,preoperative intraocular pressure,preoperative visual acuity,preoperative CMT,CMT before treatment,integrity of ellipsoid band and hyperreflective foci.3.These patients were divided into the complete ellipsoid band group(n = 9)and the incomplete ellipsoid band(n = 21)according to whether the ellipsoidal band of central retinal vein occlusion was complete or not.The patients in both groups were treated with intravitreal anti VEGF drug 3+PRN injection treatment.To observe the therapeutic effects of BCVA after the treatment of 1,2,3 and 6mo.4.These patients were divided into 3+PRN group(n = 21)and 1+PRN group(n = 17)according to different treatment schemes of central retinal vein occlusion.The number of injections and BCVA changes at 1,2,3 and 6mo after treatment were compared between the two groups.Results:1.On 6 months after treatment,the BCVA of non ischemic group and ischemic group were increased significantly(0.30 ± 0.21,0.58 ± 0.47),and the fovea thickness of both groups decreased significantly(364.60 ± 139.85,412.92 ± 140.00).The baseline BCVA(r = 0.641,P = 0.000)and CMT1mo(r = 0.285,P = 0.010)were positively correlated with the long-term prognosis visual acuity.The results of multiple regression analysis showed that the long-term visual acuity of the two groups of patients was positively correlated with the preoperative visual acuity and the reduction of CMT1 mo after the operation(P<0.05),and was related to the patient’s age,preoperative intraocular pressure,preoperative HRD,and complete ellipsoid zone.There was no correlation between sex(P>0.05).2.On 6 months after treatment,the BCVA of central retinal vein occlusion group and branch retinal vein occlusion group were decreased significantly(0.57 ± 0.42,0.34 ± 0.32),and the foveal thickness of both groups were decreased significantly(420.68 ± 158.44,358.59 ± 117.14).Multiple regression results showed that long-term visual acuity was correlated with preoperative BCVA、postoperative CMT after one month treatment 、 age 、 gender and preoperative visual acuity(P <0.05).There was no correlation between intraocular pressure,preoperative CMT,integrity of ellipsoid band and hyperreflective foci(P >0.05).3.On 6 months of treatment,BCVA of macular edema secondary to central retinal vein occlusion was significantly increased in both ellipsoid band with complete and incomplete groups(0.46 ± 0.38,0.6 ± 0.46),but there was no significant difference between the two groups(P > 0.05).4、On 6 months of treatment,the number of injections of 1 + PRN group was less than that of 3 + PRN group(P < 0.05),and the anti VEGF treatment was effective in both groups.There was no significant difference in BCVA between the two groups after treatment(P > 0.05).Conclusion:1.Intravitreal injection of anti-VEGF for RVO-ME to ischemic and non-ischemic groups have obvious effects,and the visual prognosis of non-ischemic patients is better than that of ischemic patients.2.Intravitreal injection of anti VEGF for RVO-ME to CRVO and BRVO groups have obvious effects.The prognosis visual acuity of the BRVO group was better than that CRVO group.