Effect Of Ranibizumab Combined With Xuesaitong Soft Capsule In The Treatment Of Retinal Vein Occlusion With Macular Edema

Objective: to observe and evaluate the short-term efficacy of ranibizumab combined with Xuesaitong Soft Capsules in the treatment of retinal vein occlusion(RVO)with macular edema(me),including the recovery of visual function,the reduction of macular edema,foveal avascular area and non circularity index,choriocapillaris plexus blood flow area,superficial capillary plexus blood flow density,deep capillary plexus blood flow density,hard exudate area and retinal hemorrhage area Changes in RNP free rates,number of drug injections,and pharmacoeconomic studies.Methods: a total of 20 eyes of 20 patients with retinal vein occlusion combined with macular edema(rvo-me)were collected from a prospective randomized controlled study.After randomization to the experimental and control groups,all patients were followed up for 6 months after 1 intravitreal injection of anti VEGF drugs,during the follow-up period,according to the patients and on-demand anti VEGF drug therapy(PRN),the experimental group was again given Xuesaitong Soft capsules,2 pills / time,2 times / day,0.33 g / particle,for 3 months continuously.The best corrected visual acuity(BCVA),macular foveal thickness(CMT),choriocapillaris layer blood flow area(CFA),superficial capillary plexus blood flow density(SCPD),deep capillary plexus blood flow density(DCPD),foveal avascular zone(FAZ)area and non circularity index,hard exudate(he),retinal hemorrhage area,number of administrations were recorded in both groups at baseline and 1,2,3,and 6 months after treatment The number of laser sessions and the occurrence of adverse reactions were remedied.Pharmacohealth economics analysis of the two treatment options was performed by mean cost-effectiveness ratio(Acer)and incremental cost-effectiveness ratio(ICER).Results: at the 6th month after treatment,BCVA in the experimental group improved from 39.80 ± 26.67 ETDRS letters to 72.60 ± 17.79 ETDRS letters,and CMT from 563.00 ± 223.95 μ M decreased to 219.80 ± 31.85 μ m.DCPD increased from 41.8± 5.3% to 49.0 ± 3.7%,CFA increased from 1.531 ± 0.198 to 1.819 ± 0.150,FAZ noncircle index decreased from 1.27 ± 0.16 to 1.10 ± 0.08,and RNP free rate increased from 60% to 90%;The BCVA improved from 44.80 ± 24.49 ETDRS letters to 56.90 ±22.76 ETDRS letters in the control group and from 503.20 ± 154.79 in the CMT μ M decreased to 295.90 ± 90.47 μ m.DCPD increased from 41.9 ± 3.1% to 45.9 ± 3.3%,CFA increased from 1.543 ± 0.242 mm2 to 1.644 ± 0.214 mm2,FAZ noncircle index decreased from 1.23 ± 0.27 to 1.14 ± 0.08,and RNP free rate increased from 60% to70%.Months BCVA improved by 32.80 ± 19.83 letters and 12.10 ± 14.76 letters compared with baseline in the experimental and control groups,respectively,and CMT decreased by 343.20 ± 238.32 μ M and 207.30 ± 130.84 μ m.The difference was not statistically significant(P > 0.05),and the CFA increased by 0.287 ± 0.149 mm2 and0.101 ± 0.119 mm2,respectively(P = 0.006).The BCVA,CMT,and retinal hemorrhage area of the two groups at each time point were significantly different from baseline(P < 0.05).In contrast to BCVA between the two groups,there was no significant difference in the 1st and 2nd months(P > 0.05),and in the 3rd and 6th months(P < 0.05);In contrast to CMT,there were no significant differences in months1,2,and 3(P > 0.05),and in month 6(P < 0.05);However,there was no significant difference between the experimental group and the control group at 1 month,2 months,3 months after treatment(P > 0.05)and at 6 months(P < 0.05).No significant differences were found in FAZ area,SCPD,hard exudate area at each follow-up time point before and after treatment compared within the two groups(P > 0.05).There were no significant differences in FAZ,scdp,and hard exudate area between the two groups at each follow-up time point before and after treatment(P > 0.05).The RNP free rate at3 months after treatment in the two groups of patients increased significantly compared with the control group,and the difference was statistically significant(P < 0.05).A total of 19 injections of intravitreal ranibizumab with a mean number of 1.90 ± 1.52 were administered to the patients in the experimental group,and 34 injections with a mean number of 3.40 ± 1.65 were administered to the patients in the control group,and the mean number of injections was higher in the experimental group than in the control group,with a significant difference(P < 0.05).A total of 13 sessions of salvage laser were performed with an average number of 1.30 ± 1.70 cycles in the experimental group patients,and an average of 1.30 ± 1.25 cycles in the experimental group patients,and the number of salvage laser sessions in the two groups patients was not statistically significant(P > 0.05).No serious complications or systemic adverse reactions occurred during the course of this study.The results of pharmacohealth Economics showed that the costs required to achieve a benefit per unit of BCVA or CMT were lower in the experimental group than in the control group,and the experimental group had a more cost-effectiveness advantage.Conclusion:1.In the short term,the combination of ranibizumab plus Xuesaitong Soft Capsule and ranibizumab alone in rvo-me improved visual acuity,reduced macular edema,improved deep capillary plexus and choroidal blood flow,reduced the non circularity index of foveal avascular area,and reduced the retinal hemorrhage area,and the combination therapy resulted in better outcomes and fewer infusions.2.Ranibizumab combined with sanguinarine soft capsules offers a cost-effectiveness advantage over ranibizumab alone in the treatment of rvo-me.