Effects of intravitreal injection of ranibizumab combined with triamcinolone acetonide on macular retinal microcirculation in RVO-ME
Objective To explore the effects of intravitreal injection of ranibizumab combined with tri-amcinolone acetonide on macular retinal microcirculation in macular edema(ME)secondary to retinal vein occlu-sion(RVO).Methods A retrospective analysis was conducted on the clinical data of RVO-ME patients who were treated in Affiliated Jinhua Hospital,Zhejiang University School of Medicine from January 2022 to September 2023.The observation group was treated with intravitreal injection of ranibizumab combined with triamcinolone acetonide(n=197,eyes=229),while the control group was treated with intravitreal injection of ranibizumab alone(n=183,eyes=211).The vision-related parameters,retinal microcirculation perfusion parameters in the macular area,ocular hemodynamic parameters,and the occurrence of adverse reactions during treatment were compared between the two groups before treatment and 3 months after treatment.Results Three months after treatment,the best-corrected visual acuity(BCVA),central macular thickness(CMT),foveal avascular zone(FAZ)area,and FAZ perimeter in both groups improved significantly compared to before treatment.Moreover,the observation group had lower BCVA(0.43±0.09),CMT(280±22)μm,FAZ area(0.21±0.06)mm2,and FAZ perimeter(2.11±0.26)mm compared to the control group[BCVA(0.51±0.11),CMT(301±30)μm,FAZ area(0.27±0.07)mm2,FAZ perimeter(2.29±0.20)mm](t=8.375,8.447,9.675,8.090,all P＜0.05).The blood flow density of superficial capillary plexus(SCP),deep capillary plexus(DCP),peak systolic velocity(PSV)of retinal veins,and end-diastolic velocity(EDV)were significantly increased in both groups compared to before treatment;Furthermore,the observation group showed higher values in SCP blood flow density(46±3)％,DCP blood flow density(47.3±3.8)％,PSV(24.4±1.4)cm/s,and EDV(8.3±1.4)cm/s compared to the control group[SCP blood flow density(44±3)％,DCP blood flow density(46.0±3.5％),PSV(23.44±1.33)cm/s,EDV(7.9±1.3)cm/s](t=5.120,3.753,6.673,3.122,all P＜0.05).There was no statistically significant difference in intraocular pressure,resistance index(RI),and arm-retina time(ART)between the two groups before and after treatment(t=0.997,0.001,0.821,all P＞0.05).During the treatment period,the incidence of adverse reactions in the observation group was significantly higher than that in the control group(6.6％vs 2.1％,x2=4.324,P＜0.05).Conclusion Intravitreal injection of ranibizumab combined with triamci-nolone acetonide can effectively treat patients with RVO-ME,promote the recovery of visual acuity,significantly improve the retinal microcirculation in the macular area and ocular hemodynamics,with good safety.
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