Analysis Of Related Risk Factors And TCM Syndromes Of Macular Edema In Central Retinal Vein Occlusion

Objective:To study the risk factors of macular edema(ME)caused by central retinal vein occlusion(CRVO)and TCM syndrome differentiation,in order to improve the understanding of CRVO macular edema and provide CRVO for clinical diagnosis and treatment Must be based on.Methods:The data of patients diagnosed as CRVO were collected from 98 cases in January2014 to December 2016 in Chengdu Hospital of Traditional Chinese Medicine,according to the method of case review.Optical correlation tomography(OCT)was used to analyze the CRVO The central fovea thickness(CFT),the average thickness of the retina around the optic disc were measured quantitatively and the degree of macular edema was graded according to the measured values.The data of fundus fluorescein angiography(FFA)CRVO type(ischemic and non-ischemic type),capillary non-perfusion(NP),temporal suture anastomosis,while CRVO macular edema and patient sex(Age,duration of disease,systolic blood pressure,diastolic blood pressure,pulse pressure)and visual acuity,optic disc edema,CRVO type(ischemic type and non-ischemic type),NP,retinal temporal suture anastomosis.syndrome of intermingled phlegm and blood stasis,and syndrome of hyperactivity of yang due to yin deficiency for syndrome differentiation.SPSS 21.0 statistical software was used to analyze the correlation factors.Result:1.98 cases of CRVO patients 98 eyes,only 8 cases(8.2%,8/98)did not occur macular edema,90 cases(91.8%,90/98)occurred macular edema.Among the 90patients with CRVO macular edema,4 cases(4.44%,4/90)of mild macular edema,12cases(13.33%,12/90)of moderate macular edema,32 cases of severe macular edema(35.56%,32/90),45 cases of severe macular edema(46.67%,42/90).2.90 cases of CRVO macular edema patients with macular fovea thickness of232~1775?m,the average thickness of(801.99±361.50)?m,of which:mild macular edema in patients with macular fovea thickness of 232~269?m,the average thickness of(250.50±21.36)?m;the thickness of macular fovea was 312~487?m,the mean thickness was(420.00±61.24)?m;the macular fovea thickness of patients with severe macular edema was 512~698?m,the average thickness was(615.13±67.12)?m;the thickness of macular fovea in patients with severe macular edema was746~1775?m,and the average thickness was(1106.90±289.27)?m.3.There was no significant difference in age,course of disease,blood pressure and pulse pressure between CRVO macular edema(P>0.05).4.Among the 90 patients with CRVO macular edema,40 eyes(44.44%,40/90)were visual acuity is less than 0.1;Visual acuity in the range of 0.1 to 0.5 cases(48.89%,44/90);Visual acuity in the range of 0.6 to 0.8 in 6 cases(6.67%,6/90).And visual acuity<0.1 in 40 cases:mild macular edema in 0 cases(0%,0/4);Moderate macular edema in 2 cases(16.67%,2/12);Severe macular edema in 7 cases(21.87%,7/32);Very severe macular edema in 31 cases(73.81%,31/42).and the difference was statistically significant(r=-0.649,P=0.000<0.05),and the two were negatively correlated.5.CRVO macular edema patients with retinal thickness around the optic disc(592.80±175.42)?m.The thickness of the retina around the optic disc in patients with mild macular edema was(322.20±12.12)?m,and the retinal thickness of the optic disc in patients with moderate macular edema was(530.58±106.30)?m.The retinal thickness of the patients with severe macular edema was(560.20±131.88)?m.The retinal thickness of the optic disc in patients with severe macular edema was(660.93±660.92)?m.There was significant correlation between the degree of macular edema and the thickness of retina around the optic disc(r=0.501,P=0.000<0.05),and the difference was statistically significant.6.Of the 90 patients with CRVO macular edema,46(51.11%,46/90))were ischemic,44(48.89%,44/90)were nonunion.There was a significant difference in CRVO typing between macular edema(?~2=17.947,P=0.000<0.05).7.Of the 90 patients with CRVO macular edema,there were 50 patients(55.56%,50/90)without NP,40 patients with NP(44.44%,40/90).There was no significant difference between the two groups(?~2=11.242,P=0.010<0.05).And extensive NP12cases:mild macular edema in 0 cases;moderate macular edema in 2 cases;severe macular edema in 6 cases;very severe macular edema in 8 cases.There was significant difference between NP and macular edema(?~2=14.769,P=0.022<0.05).8.Among the 90 cases of CRVO macular edema,there were 16 cases of horizontal seam anastomosis,including 2 cases of mild macular edema 4 cases of horizontal suture anastomosis(50%,2/4),moderate macular edema in 12 cases(18.75%,6/32)in 6 of the 32 patients with severe macular edema,and 2 of the 42patients with severe macular edema(4.76%,2/42).There was significant difference between the level of anastomosis and the degree of macular edema(?~2=16.253,P=0.001<0.05).9.98 cases of CRVO patients,syndrome of qi stagnation and blood stasis in 62cases,accounting for 63.3%;syndrome of intermingled phlegm and blood stasis in 24cases,accounting for 24.5%;syndrome of hyperactivity of yang due to yin deficiency in 12 cases,accounting for 12.2%.That is,qi stagnation and blood stasis syndrome>phlegm and blood stasis syndrome>hyperactivity of yang due to yin deficiency syndrome.10.90 cases of CRVO macular edema patients,qi stagnation of blood stasis in 58cases,phlegm and blood stasis in 22 cases,hyperactivity of yang due to yin deficiency in 10 cases.There was no significant difference in the degree of macular edema between TCM syndromes(?~2=5.176,P=0.521>0.05).Conclusion:1.The vast majority of CRVO patients with varying degrees of macular edema.2.CRVO macular edema and visual acuity was negatively correlated with macular edema,the worse the visual acuity.3.CRVO macular edema and retinal thickness around the optic disc was positively correlated,that is,the more disc optic disc edema,macular edema is also heavier.4.Ischemic CRVO macular edema than non-ischemic type of CRVO macular edema,and poor visual acuity.5.CRVO macular edema more severe,the greater the possibility of occurrence of NP,NP range is also broader.6.CRVO macular edema in the retina when the temporal level of anastomosis,macular edema less light.7.CRVO patients with TCM syndromes to Qi and blood stasis syndrome is more common,followed by phlegm and blood stasis syndrome,hyperactivity of yang due to yin deficiency syndrome.8.There was no significant correlation between the edema of CRVO macular edema and the TCM syndromes.