Clinical observation of anti-vascular endothelial growth factor combined with dexamethasone implant in the treatment of patients with diabetic macular edema
Clinical observation of anti-vascular endothelial growth factor combined with dexamethasone implant in the treatment of patients with diabetic macular edema
Objective To prospectively study the clinical effect of anti-vascular endothelial growth factor(VEGF)combined with dexa-methasone implant(DEX)in the treatment of patients with diabetic macular edema(DME).Methods A total of 90 cases(90 eyes)of DME patients were treated in Affiliated Hospital of Guizhou Medical University from January 2021 to December 2022 were seleted and prospectively di-vided into experimental group(n=45)and control group(n=45)according to random number table method.The control group was treated with anti-VEGF,and the experimental group was treated with anti-VEGF combined with DEX.The central macular thickness(CMT),best corrected visual acuity(BCVA)and intraocular pressure,platelet-derived growth factor(PDGF),micrornA-377-3p(miR-377-3p),en-dostatin(ES)and other DME-related factors of aqueous humor were observed before treatment and after 3 months of treatment,and the clinical effects,postoperative complications and recurrence of the two groups were compared.Results After 3 months of treatment,the CMT and BCVA of two groups were lower than those before treatment,and the CMT and BCVA of the experimental group were(286.77±31.22)μm,(0.50± 0.06)logMAR,respectively,which were lower than those in the control group[(322.95±34.61)μm,(0.43±0.04)logMAR],the differ-ences were statistically significant(P＜0.05),and there was no statistically significant difference in intraocular pressure between the two groups(P＞0.05).After 3 months of treatment,the levels of PDGF and ES of aqueous humorin of the two groups were lower than those before treat-ment,and the levels of miR-377-3p of aqueous humor in two groups were higher than those before treatment,the levels of PDGF and ES of a-queous humor in the experimental group were(3.80±0.40)ng/mL and(89.95±9.27)ng/L,respectively,which were lower than those in the control group[(4.65±0.48)ng/mL and(102.26±11.34)ng/L],the level of miR-377-3p of aqueous humor was 0.57±0.07,which was higher than that in the control group(0.50±0.06),and the differences were statistically significant(P＜0.05).The total effective rate of ex-perimental group was 93.18％,which was higher than that of control group(73.33％),and the difference was statistically significant(P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(6.67％vs.4.44％)(P＞0.05).The recurrence rate of experimental group was 2.22％,which was lower than that of control group(17.78％),and the difference was statistically significant(P＜0.05).Conclusion Anti-VEGF combined with DEX in the treatment of DME can reduce CMT,improve the best corrected visual acuity of the affected eye,improve the level of DME-related factors in aqueous fluid,with significant efficacy,fewer postoperative compli-cations,the recurrence rate is low,and no significant increase in IOP,it is worth recommending in clinic.
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