| ObjectiveThrough observation and analysis of clinical curative effect of Traditional Chinese medicine combined with anti-VEGF and anti-VEGF alone in the treatment of macular edema of retinal vein occlusion,to scientific and objective evaluate the effection on visual function improvement of Traditional Chinese medicine for the treatment after therapy with anti-VEGF of macular edema of retinal vein occlusion,to explore more effective treatment of macular edema of retinal vein occlusion.MethodsWe used retrospective case-control clinical study method,the patient of the diagnosis of macular edema of retinal vein occlusion and coform to the standard of including and exclusion criteria were choiced between January 2015 and March 2018 in Guangdong Provincial Hospital.According to the different methods of treatment,patients with divided into pure anti VEGF group and Traditional Chinese Medicine combined with anti-VEGF group.After observation of 3 months,the best corrected visual acuity,retinal thickness of macular center,retinal thickness of macular area,total macular volume,evaluation of vision-related quality of life,the numbers of injections of anti-VEGF and safety index were observed before and after treatment.Results:This study included 71 cases,71 eyes,including simple treatment group of 34 cases,comprehensive treatment group of 37 cases,comparing the baseline comparison in patients of two groups such as gender,age,type of retinal vein occlusion,to be found it is no difference by statistical analysis.(P>0.05),there is the comparability between the two groups.1.Improvement in visual function:the Best Corrected Visual Acuity(BCVA)of group of simple treatment before and after treatment in 1mo,2mo,and 3mo were0.17±0.11.0.28±0.17.0.31±0.18.0.30±0.16,the BCVA of group of comprehensive treatment before and after treatment in 1mo,2mo,and 3mo were 0.19±0.16?0.38±0.25?0.42±0.26?0.41±0.25,It had significant difference compared with that before treatment(P<0.01).BCVA had significant difference between the group of comprehensive treatment and the group of simple treatment in lmo,2mo and 3mo after treatment(P<0.01),the best corrected visual acuity of the group of comprehensive treatment are better than the group of simple treatment.2.Macular central retinal thickness(CMT,unit:um):the CMT of the group of simple treatment before and after treatment in lmo,2mo,and 3mo were 505.91±142.67?389.85±131.83?374.38±127.21?374.29±108.42,the CMT of the group of comprehensive treatment before and after treatment in 1mo,2mo,and 3mo were were 521.43± 194.48?333.95±116.82?335.99± 116.82?346.81±113.55.It had significant difference compared with that before treatment(P<0.01).CMT had no significant difference between the group of comprehensive treatment and the group of simple treatment in 1mo,2mo and 3mo after treatment(P>0.05).3.The macular area average retinal thickness(AVG,unit:um):the AVG of the group of simple treatment before and after treatment in 1mo,2mo,and 3mo were 373.82±96.78?342.72±69.01?338.51±77.01?342.73±78.48,the AVG of the group of comprehensive treatment before and after treatment in 1mo,2mo,and 3mo were were369.75±90.46?328.07±62.94?312.73±54.99?322.53±57.06.It had significant difference compared with that before treatment(P<0.01).AVG had no significant difference between the group of comprehensive treatment and the group of simple treatment in lmo,2mo and 3mo after treatment(P>0.05).4.Total macular volume(TMV,unit:um3):the TMV of the group of simple treatment before and after treatment in 1mo,2mo,and 3mo were10.26+2.71?9.28±1.80?9.19±1.86?9.20±1.84,the TMV of the group of comprehensive treatment before and after treatment in lmo,2mo,and 3mo were 10.30±2.30?9.16±1.25?9.04±1.28?9.05±1.29.It had significant difference compared with that before treatment(P<0.01).TMV had no significant difference between the group of comprehensive treatment and the group of simple treatment in lmo,2mo and 3mo after treatment(P>0.05).5.Evaluation of vision-related quality of life:the results of the NEI-VFQ-25 showed that the group of comprehensive treatment get the higher scores in terms of the total visual acuity,distant vision acuity,social role restriction,color vision and peripheral vision compared with the group of simple treatment,it had significant difference by statistical analysis(P<0.05).6.Health economics and safety evaluation:Mean numbers of injections were 2.62 + 0.74 and 2.05 + 0.81 for the group of simple treatment and comprehensive treatment during observation of 3 months,with statistically significant differences between the two groups(P<0.05).Patients had no systemic adverse react ions or ocular complications such as vitreous hemorrhage,endophthalmitis and improving intraocular pressure throughout the study.Conclusion:1.The treatment of Traditional Chinese medicine differentiation combined with anti-VEGF and anti-VEGF both have a certain effect on improving patients visual acuity and reducing macular edema.2.It had no significant difference in reducing macular edema between the group of the treatment of Traditional Chinese medicine combined with anti-VEGF and the group of the treatment of anti-VEGF,but it had significant differences in BCVA and vision-related quality of life between the groups for patients with macular edema of retinal vein occlusion,and reduce the times of injections.The treatment of Traditional Chinese medicine combined with anti-VEGF can bring a greater clinical benefit to patients,and improving quality of life.3.NO adverse reactions occurred in the process of treatment either in the group of Traditional Chinese medicine combined with anti-VEGF and the group of anti-VEGF,it shows both the treatments are safety. |
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