Clinical Research Of Jian Pi Hua Zhuo Combined With Anti-VEGF 3+PRN On The Treatment Of Polypoidal Choroidal Vasculopathy

Research purpose:To observe the clinical effect of Polypsoidal Choroidal Vasculopathy(PCV)after 1 year of treatment with Jianpi Huazhuo Formula combined with monthly anti-vascular endothelial growth factor(VEGF)for 3 months.Research method:Retrospective cohort study.From March 2017 to December 2019,A collection of 55 PCV patients(57 eyes)attended the Ophthalmology Clinic of Jiangsu Provincial Hospital of Traditional Chinese Medicine.We divided them into 27 cases(28 eyes)in the control group and 28 cases(29 eyes)in the treatment group.Best corrected visual acuity(BCVA),fundus color photography,optical coherence tomography,fluorescein fundus angiography,and indocyanine green angiography were performed at baseline.After diagnosis,all patients received anti-VEGF(including conbercept,ranibizumab,aflibercept)injections once a month for 3 consecutive months,followed by treatment as needed(3+PRN).The treatment group was treated with Jianpi Huazhuo Decoction at the same time and followed up for 12 months.The BCVA,the thickness of macular fovea,the change of polyps after treatment,retinal hemorrhage,disease activity,and the number of injections of the two groups were compared.Research results:There is no significant difference in BCVA and CMT between the two groups before treatment(P>0.05).The BCVA of the two groups is no significant difference with before treatment in 4wk(P>0.05),but it is better than before treatment in 12wk,24wk,and 48wk and the difference is statistically significant(P<0.05).After treatment at 24wk and 48wk,The treatment group has significant differences with the control group about the BCVA(P<0.05),but at 4wk and 12wk,the BCVA between the two groups is not significantly different(P>0.05).The CMT of the two group is significantly smaller than that before treatment and the difference is statistically significant(P<0.05)after treatment at 4wk,12wk,24wk and 48wk.After treatment at 4wk and 12wk,the CMT between the two groups is not statistically significant different(P>0.05).The CMT of the treatment group is smaller than the control group after treatment at 24wk and 48wk,and the difference is statistically significant(P<0.05).After treatment at 24wk and 48wk,the difference of the complete polyps regression rate between the two group is not statistically significant(P>0.05).The proportion of patients with disease activity in the treatment group is lower than that in the control group,and the difference is statistically significant(P<0.05)after treatment at 24wk、28wk、36wk、40wk、44wk and 48wk.But the proportion of patients with disease activity between them is no significant difference(P>0.05)after treatment at 12wk、16wk、20wk、32wk.In the control group(n=28),3 eyes have submacular hemorrhage area>4 disc area during the follow-up process,and the treatment group(n=29)has no submacular hemorrhage area>4 disc area at 48 weeks.Within 48 weeks,the average injections in the control group is lower than that in the treatment group(control group:6.32± 1.517 times,treatment group:5.14± 1.125 times),and the difference is statistically significant(P<0.05).The average interval between the third and fourth injections in the control group is lower than that in the treatment group(control group:61.48±39.906 days,treatment group:84.35±38.234 days),and the difference is statistically significant(P<0.05).Research conclusions:Compared with the control group,the treatment group has a higher value of BCVA improving and CMT reduction,a higher proportion of patients with no disease activity and fewer injections,but there are no differences between the groups for the submacular hemorrhage and complete polyps regression rate.The self-made Jianpi Huazhuo Formula combined with anti-VEGF 3+PRN regimen is safe,effective,and cost-effective for the treatment of PCV.It is suitable for a treatment regimen with Chinese characteristics and is worthy of clinical application.