Detection of cytokines in aqueous humor of patients with secondary macular edema caused by retinal vein occlusion and evaluation of related treatment efficacy
Objective To collect aqueous humor from patients with retinal vein occlusion secondary macu-lar edema(RVO-ME),detect and analyze the concentration of inflammatory factors and vascular endothelial growth factor in the intraocular fluid,and then select the type of intraocular injection drugs,and compare and analyze the therapeutic effect difference between the precision treatment guided by intraocular fluid and the ranibizumab monotherapy.Methods A total of 40 patients(40 eyes)diagnosed with RVO-ME from Novem-ber 2021 to March 2023 were selected from the Ophthalmology Department of the First Affiliated Hospital of Bengbu Medical University and divided into two groups:Precision treatment group:Based on the difference in the concentration of inflammatory factors or vascular endothelial growth factor in aqueous fluid compared with normal values,the patients were selected for injection of dexamethasone intravitreal implant,ranibizumab,or combination treatment.Ranibizumab group:No aqueous humor sampling was performed,and ranibizumab monotherapy was selected.The central macular foveal thickness(CMT)and best-corrected visual acuity(BC-VA)were followed up and recorded at 1,2,3 and 6 months before and after treatment in both groups.We then recorded the number of injections,intraocular pressure and other adverse events during follow-up.Re-sults The average number of injections in the precision treatment group was 2.55±0.83,and that of the Ranibizumab group was 3.45±1.05.There was a statistically significant difference between the two groups(P＜0.05).Compared with before treatment,CMT decreased and BCVA increased in both groups at all fol-low-up time points,with statistical significance(P＜0.05).There was no significant difference in CMT and BCVA(LogMAR)between the two groups at any follow-up time point(P＞0.05).During the treatment peri-od,no complications such as intraocular hypertension,intraocular infection,or retinal hemorrhage occurred in either group.Conclusion Both accurate treatment for RVO-ME precision therapy guided by intraocular fluid cytokine concentrations and intravitreal injection of ranibizumab are safe and effective in improving visual acuity and alleviating macular edema.The precision treatment approach can reduce the number of injections required for patients,potentially reducing the economic burden compared to ranibizumab monotherapy.
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