| Objective:The purpose of this study was to observe and evaluate the short-term clinical efficacy and safety of intravitreal injection of Conbercept and Ranibizumab in the treatment of macular edema（ME）secondary to retinal vein occlusion（RVO）,analyze the relevant factors affecting visual prognosis,and analyze the pharmacoeconomics evaluation of the two treatment methods.Methods:A retrospective and prospective case-control study was conducted.Collection on January 1,2020 to December 31,2021 in Yunnan University Affiliated Hospital ophthalmology,diagnosis of retinal vein occlusion with macular edema（RVO-ME）and treated with anti-vascular endothelial growth factor（VEGF）.According to the different drugs selected by patients,they were divided into group A,Conbercept group（56 cases）and group B,Ranibizumab group（52 cases）.All patients were followed up for 6 months after the first injection.During the follow-up period,the patients were treated according to their conditions.The changes of best corrected visual acuity（BCVA）,central macular thickness（CMT）,intraocular pressure（IOP）and the occurrence of fundus laser remedial treatment or other ocular and systemic adverse events were recorded before and after treatment.Statistical analysis was performed on the collected patient data using SPSS 26.0 to evaluate the therapeutic effect and analyze the correlation factors affecting the prognosis of visual acuity.The average cost-effectiveness ratio（ACER）and incremental cost-effectiveness ratio（ICER）were used to analyze the pharmacoeconomics evaluation of the two treatment methods.Results:1.At 6 months after treatment,BCVA（Log MAR）of group A increased from0.98±0.41 to 0.69±0.38,CMT decreased from 748.43±241.98μm to 423.14±192.51μm.BCVA（Log MAR）of group B increased from 0.96±0.31 to 0.63±0.30,CMT decreased from 793.27±227.73μm to 409.62±142.09μm.BCVA in group A and group B increased by-0.29±0.30 Log MAR and-0.32±0.21 Log MAR from baseline,respectively,and CMT decreased by 325.29±242.80μm and 383.65±189.77μm,respectively,with no statistical significance（P>0.05）.There was no statistical significance in BCVA,CMT and IOP between the two groups at each time before and after treatment（P>0.05）.There was no statistically significant difference between BCVA on day 1 after treatment and BCVA at baseline in group B（P>0.05）,and there were statistically significant differences between BCVA and CMT at other follow-up time and BCVA and CMT at baseline（P<0.05）.There was no significant difference in IOP between the two groups at each time after treatment and baseline（P>0.05）.At the sixth month of follow-up period,BCVA≥0.5（Log MAR≤0.3）was found in 12 patients（21.4%）in group A and 9 patients（17.3%）in group B,with no statistical significance（X~2=0.292,P=0.589）.2.Compared the BCVA between the two groups of patients with branch retinal vein occlusion（BRVO）and central retinal vein occlusion（CRVO）,the patients with BRVO were better than those with CRVO at all time points after treatment,and the difference was statistically significant（P<0.05）.BCVA of BRVO patients in group A,CRVO patients in group A and BRVO patients in group B at each time point after treatment was improved compared with that before treatment,and the difference was statistically significant（P<0.05）.There was no significant difference between BCVA on the first day after treatment and BCVA before treatment in group B CRVO patients（P>0.05）.BCVA at other time points was improved compared with that before treatment,and the difference was statistically significant（P<0.05）.Comparing CMT between BRVO patients and CRVO patients in group A,BRVO patients were better than CRVO patients,but the difference was not statistically significant（P>0.05）.Comparing CMT between BRVO patients and CRVO patients in group B,BRVO patients were better than CRVO patients before treatment,and the difference was statistically significant（P<0.05）.Comparing CMT between BRVO patients and CRVO patients in group B,BRVO patients were better than CRVO patients before treatment,and the difference was statistically significant（P<0.05）.CMT of BRVO patients and CRVO patients in the two groups at each time point after treatment was improved compared with that before treatment,and the difference was statistically significant（P<0.05）.The average injection times of BRVO patients in group A were less than those of CRVO patients,but the difference was not statistically significant（P>0.05）.The average injection times of BRVO patients in group B were less than those of CRVO patients,and the difference was statistically significant（P<0.05）.There was no significant difference between the two groups in BCVA,CMT and injection times at each time point before and after treatment（P>0.05）.In the first month after treatment,the BCVA of CRVO patients in group A was better than that in group B,and the difference was statistically significant（P<0.05）.There was no statistically significant difference in BCVA at other time points（P>0.05）.There was no significant difference in CMT and injection times at each time point before and after treatment（P>0.05）.3.The average number of drug injections in group A was 3.70±0.180,and that in group B was 3.60±0.156.The difference was not statistically significant（P>0.05）.26patients（46.4%）in group A received remedial laser treatment,and 19 patients（36.5%）in group B received remedial laser treatment,with no statistical significance（P>0.05）.In the correlation analysis,RVO-ME patients with baseline BCVA≥0.1（Log MAR≤1.0）,baseline CMT≤770μm,and disease duration≤1.5 months had better visual outcomes after treatment.No serious complications or systemic adverse reactions occurred during the study.The pharmacoeconomic results showed that the cost of obtaining the benefit of BCVA or anatomy（CMT）was higher in the Conbercept group than in the Ranibizumab group.Ranibizumab group has more cost-effectiveness advantages in the treatment of RVO-ME.Conclusion:1.Conbercept and Ranibizumab in the treatment of non ischemic RVO-ME can reduce macular edema and improve visual acuity in a short time,and can obtain similar curative effects.2.Anti VEGF drugs have obvious effects on patients with BRVO and CRVO in the short term,and the prognosis visual acuity of patients with BRVO is better than that of patients with CRVO.3.RVO-ME patients with baseline BCVA≥0.1（Log MAR≤1.0）,baseline CMT≤770μm,and disease duration≤1.5 months had better visual outcomes after treatment.4.Ranibizumab has a more cost-effectiveness advantage in the treatment of RVO-ME than Conbercept. |
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