Effects Of Lucentis And Ozurdex Injections On Macular Blood Flow In RVO Patients With Macular Edema

Objective:To observe the changes of center macular thickness(CMT),Retinal macular vascular density(MVD),choroidal MVD and foveal avascular zone(FAZ)in patients with retinal vein occlusion macular edema(RVO-ME)after intraocular injections of Lucentis or Ozurdex,in order to guide clinical treatment and evaluate the curative effect.Methods:A prospective study was conducted in 67 eyes of patients with central retinal vein occlusion(CRVO)and branch retinal vein occlusion(BRVO)with ME in the Department of Ophthalmology,Zhejiang people’s Hospital from November 2019 to March 2021.All patients were randomly treated with intravitreous injection of Lucentis(Lucentis group)or Ozurdex(Ozurdex group),40 eyes in Lucentis group and 27 eyes in Ozurdex group.At the same time,40 normal eyes were included as the control group.The Spectralis OCT of Heidelberg company in Germany was used to measure the scanning range of optical coherence tomography angiography(OCTA)in 3mm×3mm scanning mode.The measured indexes included CMT,MVD of macular retina and choroid,and FAZ area.Results: 1.Compared with the control group,the indexes of BCVA,CMT and deep FAZ area in RVO group were significantly increased,and the MVD in macular of superficial vascular complex(SVC),deep vascular complex(DVC),choroidal capillary layer and choroidal layer were decreased(P < 0.05);2.Comparison of Lucentis group and Ozurdex group:(1)BCVA There was statistical difference at the first,second and third months after treatment in each group(P < 0.05);(2)CMT There was statistical difference at the first,second and third months after treatment in each group(P< 0.05);(3)FAZ area FAZ area of superficial layer decreased significantly in Lucentis group at the second and third months after treatment(P < 0.05).In Ozurdex group there were significant differences at the first,second and third months than before treatment(P <0.05),but there was no significant difference between the third and second months after treatment.(4)The MVD in macular retina and choroidal layers MVD of SVC layer between the two groups was significantly different at the second month of treatment(P< 0.05),and there were significant differences at the first,second and third month of treatment in each group(P < 0.05).There were significant differences in MVD of DVC layer between the two groups in the first and second months of treatment(P< 0.05),and there were significant differences in the first,second and third months of treatment in each group(P< 0.05);MVD of choroidal capillary layer was significantly higher than that before treatment in each groups(P < 0.05),while there was no significant difference between the third month and the second month of treatment in Ozurdex group;MVD of choroidal capillary layer has significant differences in the first,second and third months of treatment in each group(P < 0.05).(5)The BCVA before treatment was positively correlated with age and course of disease,and negatively correlated with MVD of SVC layer and DVC layer(P < 0.05).Conclusion:The MVD in macular retina and choroidal layers of RVO patients with ME was lower than that of normal subjects.Comparison of Lucentis group and Ozurdex group of RVO patients with ME,the MVD of DVC layer increased significantly in the first month of treatment,and there was significant difference in the MVD of SVC and DVC layer in the second month,and increased faster and more significantly in the Ozurdex group.The MVD of each layer of omentum improved in the each groups.Therefore,if RVO patients with ME want to be hospitalized as little as possible in the same treatment cycle and with the same curative effect,Ozurdex could be a better choice.