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Objective: central retinal vein occlusion (central retinal vein occlusion, CRVO) is a common clinical blinding retinal disease. Macular edema (macular edema, ME) are common complications, but also one of the main reasons for this disease decreased vision. The treatment including laser grid photocoagulation therapy, intravitreal injection of triamcinolone acetonide. Laser photocoagulation treatment: clinical been using laser grid photocoagulation treatment of macular cystoid edema or diffuse macular edema, multi-center study, according to central retinal vein occlusion study group (CVOS): however, relative to the untreated group than laser grid photocoagulation group there was no significant difference in visual outcome. Triamcinolone acetonide (triamcinolone acetonide, TA) is a glucocorticoid, has many biological effects, the basic role is to stabilize the blood - retinal barrier in reabsorption of exudate and down-regulation of inflammatory stimuli, in the clinical treatment of macular edema has made some effect. However, intravitreal TA Problems: need repeated injections; 2. Increased intraocular pressure; 3. Cataract; 4. Endophthalmitis and retinal detachment. Recently, a large number of studies have shown that vascular endothelial growth factor (vascular endothelial growth factor, VEGF) is not only the potential of new blood vessels irritants, and can lead to vascular leakage and macular edema due to increased vascular permeability and development plays an important role. Anti-VEGF drugs targeting VEGF or its receptor signaling pathway, thereby treating vascular permeability increase in macular edema. Bevacizumab (trade name Avastin) is a recombinant humanized anti-VEGF murine monoclonal antibody, VEGF binding sites, all having the activity of VEGF binding, all the type of activity against VEGF-A. Avastin has the role of inhibition of VEGF, since 2005-05 up some eye specialists began to try to apply it to choroidal neovascularization (choroidal neovascularization, CNV) related diseases, and achieved encouraging results, preliminary clinical application found its side effects less, are easier to implement. In this study, optical coherence tomography (optical coherence tomography, OCT) combined with multifocal electroretinography (multifocal electroretinography, MFERG) learn two ways to explore the intravitreal injection of bevacizumab (Avastin) in tissue morphology and function of the central retinal vein occlusion due to macular edema. The purpose of observing Avastin for the treatment of macular edema due to central retinal vein occlusion effect, and through the establishment of triamcinolone acetonide control group and its comparison to explore its advantages and disadvantages. Treatment to explore the effect of the disease, less side effects treatment. Methods: 40 patients with CRVO merger ME patients were randomly divided into two groups, 20 cases intravitreal injection of Avastin with a disposable 1 ml syringe at the bottom of the temporal angle 4mm limbal injection of 0.05 ml (containing 1.25 mg) Avastin. Control group, 20 cases intravitreal injection of triamcinolone acetonide (TA), below the limbus in the temporal 4mm with a disposable 1 ml syringe, inject 0.1 ml (containing 4 mg) TA remain sitting for at least 2 hours, to prevent drug particles deposited on macular area. Before and after treatment are best corrected visual acuity, slit lamp, fundus, intraocular pressure, fundus fluorescein angiography (fundus fluorescein angiography, FFA), mf-ERG and OCT examination. Follow-up period of 6 months. Results: The experimental group after 1 month, 3 months, 6 months eyesight were (0.274 ± 0.206), (0.335 ± 0.254), (0.372 ± 0.289) were compared with those before treatment (0.226 ± 0.176) statistically significant (t = -3.540, -5.215, -5.868, P values ??were 0.002,0.000,0.000). After 1 month, 3 months, 6 months, retinal thickness were (503.45 ± 167.304μm), (357.90 ± 156.630μm), (303.15 ± 147.056μm), were compared with those before treatment (657.85 ± 189.492μm) statistically significant (t = 7.928,9.406,9.768 P value = 0.000). Experimental group after 1 month, 3 months, 6 months mean IOP compared with preoperative no significant change in the difference was not significant (t = 1.738,2.803,1.867 P value gt; 0.05) Control group after one month, three months, six months vision was (0.295 ± 0.252), (0.355 ± 0.242), (0.301 ± 0.222), compared with before treatment (0.225 ± 0.171) were statistically learning difference (t = -2.904, -4.421, -3.179, P values ??were lt; 0.05) After 1 month, 3 months, 6 months, retinal thickness were (500.35 ± 161.893μm), (393.30 ± 180.757μm), (373.55 ± 187.332μm), were compared with those before treatment (646.95 ± 172.435μm) statistically significant (t = 5.924,7.167,6.675 P value = 0.000). In the control group after 1 month, 3 months, 6 months, mean IOP compared with preoperative improve, the difference was significant (t = -3.350, -2.169, -2.304, P values ??were lt; 0.05) . Experimental group after 1 month, 3 months, 6 months, and the control group the corresponding point-in-time vision, OCT value does not have any significant difference (P value gt; 0.05). During the observation period, the experimental group, high intraocular pressure, cataract, retinal detachment, endophthalmitis complications. 7 cases of patients with elevated intraocular pressure in the control group during the observation period, but no cataracts, retinal detachment, endophthalmitis complications. Conclusion: Avastin is a safe and effective treatment for CRVO ME due to the short-term effect is significant, compared with the TA safer. The disadvantage of this experiment is the small sample size, the observation time is short, they need large sample of long-term observation to determine the long-term efficacy and its superiority over the TA.
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