Abstract:AIM: To investigate the clinical efficacy of intravitreal injection of Ranibizumab combined with retinal photocoagulation(523 laser)in the treatment of central retinal vein occlusion(CRVO)with retinal neovascularization and macular edema.
METHODS: The subjects of this study were 70 patients(70 eyes)with CRVO and retinal neovascularization and macular edema treated in our hospital from January 2016 to January 2017. There were 35 patients(35 eyes)treated with intravitreal injection of ranibizumab combined 523 laser and enrolled in the observation group; 35 patients(35 eyes)treated with 523 laser alone and selected as the control group. The medical records were retrospectively analyzed. The best corrected visual acuity and intraocular pressure(IOP)were observed before treatment and 3mo after treatment. The central retinal thickness(CRT)was measured by optical coherence tomography(OCT)and fundus fluorescein angiography(FFA)to evaluate the changes of retinal lesions progress and follow-up observation of the incidence of complications after treatment.
RESULTS: After 3mo of treatment, the best corrected visual acuity remained unchanged in both groups. There was no significant difference between the two groups in best corrected visual acuity improved by 1 lines, 2 lines, 3 lines and above(P<0.05). There was no significant difference in intraocular pressure before and after operation, and in those between the two groups(P>0.05). There was significant difference of CRT between the two groups, before and after treatment(P<0.01); postoperatively CRT of observation group was significantly lower than that of the control group, the difference was statistically significant(P<0.01). There were 25 cases(71%)of macular edema subsided detected by OCT and FFA 3mo after operation, which was significantly higher than that of the control group(19 eyes, 54%), the difference was statistically significant(χ2=6.292, P=0.012). Neovascularization significantly relieved in both groups at 1mo after the operation. In the observation group, 2 cases recurred 1mo after operation, the recurrence rate was 6%; 10 cases recurred in the control group, and the recurrence rate was 29%. In the observation group, there were 3 cases of recurrence 3mo after operation, the recurrence rate was 9%, the recurrence of the control group was 19 cases, the recurrence rate was 54%, the difference was statistically significant(P<0.05).
CONCLUSION: Intravitreal injection of ranibizumab combined with 523 laser can significantly improve visual acuity in patients with CRVO, which can effectively prevent the formation of retinal neovascularization and accelerate the exudation bleeding and edema absorption.