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@#AIM: To observe the therapeutic effect of intravitreal injection of ranibizumab combined with compound Xueshuantong capsule on patients with central exudative chorioretinopathy(CEC).<p>METHODS: A total of 98 consecutive patients(98 eyes)with CEC treated in our hospital from September 2013 to May 2015 were enrolled in this study and randomly divided into 2 groups. The experimental group received intravitreal injection of ranibizumab treatment, were treated with compound Xueshuantong capsule, 3 consecutive months of treatment; the control group only treated with compound Xueshuantong capsule treatment, the same dosage and course of treatment with the experimental group. Two groups of patients were reviewed monthly, the follow-up time was 6mo. Before and after treatment, visual acuity, foveal retinal thickness and leakage area were measured. <p>RESULTS: Visual acuity(LogMAR): the visual acuity of the two groups before and after surgery was significantly different(<i>P</i><0.05); the visual acuity of the experimental group was significantly better than that of the control group, the difference was statistically significant(<i>P</i><0.05). There was significant difference between experimental group and control group on central macular thickness macular(CMT)(<i>P</i><0.05), which of experimental group decreased more than that of control group. The improved leakage of the two groups was significant different by <i>χ</i>2 test(<i>P</i><0.05). <p>CONCLUSION: Ranibizumab combined with compound Xueshuantong capsule in the treatment of CEC can reduce vascular leakage, reduce macular edema, shorten the course, improve eyesight, which is a safe and effective method for the treatment of CEC. Multiple intravitreal injection of ranibizumab to CEC can improve the vision of patients and keep it stable.
ABSTRACT
Background The dosage of verteporfin photodynamic therapy (PDT) for central exudative chorioretinopathy(CEC) depends on the calculation formula of Treatment of Age-related Macular Degeneration with Photodynamic Therapy Study Group(TAP)and Verteporfin in Photodynamic Therapy Study Group(VIP).Some local adverse responses or normal tissue damage have been noted under the standard dose of verteporfin during the treatment of CEC.So it is necessary to explore an appropriate therapeutic dosage of verteporfin.Objective This clinical study aimed to observe and compare the clinical efficacy and safety of different doses of verteporfin PDT for CEC.Methods Ninety eyes of 90 patients with CEC were enrolled in this study with the approval of the Ethic Commission of Affiliated Second Hospital of Nanchang University.Written informed consent was obtained before PDT.The patients were randomly divided into standard dose group,half dose group and 1/3 dose group.All of the patients received PDT.Standard dose(6 mg/m2),3 mg/m2 or 2 mg/m2 of verteporfin was applied in the three groups respectively,with the laser intensity 50 J/cm2.The patients were followed-up for 3 months.Repeat treating regimen was performed in the same way in the patient with fundus fluorescein leakage after initial PDT.Results The BCVA(logMAR) value was 0.44±0.36 after PDT in the standard dose group.Visual acuity improved in 20 patients (66.67％),stabilized in 8 patients(26.67％)and decreased in 2 patients (6.67％).The BCVA showed a significant difference between the preoperative and postoperative BCVA (t =6.719,P =0.000).CNV disappeared in 19 patients (63.33％),obviously improved in 7 patients (23.33％),partially disappeared in 3 patients (10.00％) and unchanged in 1 patient (3.33％).The central fovea thickness (CFT)value was significantly declined in postoperation compared with preoperation (t =5.758,P =0.000).Eight patients received secondary PDT with the recurrence rate 26.67％.In the half dose group,visual acuity improved in 18 patients(60.00％),stabilized in 11 patients(36.67％)and decreased in 1 patient (3.33％).CNV disappeared in 16 patients (53.33％),obviously improved in 8 patients (26.67％),partially disappeared in 5 patients (16.67％) and unchanged in 1 patient (3.33 ％).Significant difference was seen between the preoperative BCVA and postoperative BCVA(t=8.294,P =0.000).The decrease of C FT was significant in postoperation(t =8.493,P =0.000).Ten patients received secondary treatment with the recurrence rate 33.33％.In 1/3 dose group,visual acuity improved in 8 patients (26.67 ％),stabilized in 12 patients (40.00％),decreased in 10 patient (33.3％).CNV disappeared in 8 patients (26.67％),obviously improved in 8 patients (26.67％),partially disappeared in 6 patients (20.00％) and unchanged in 8 patient (26.67％).There was no significant difference between the preoperative BCVA and postoperative BCVA (t =0.536,P =0.596).The difference between preoperative CFT and postoperative CFT was insignificant(t =0.942,P=0.354).Fourteen patients received secondary PDT and 8 patients received three times with the recurrence rate 73.33％.Conclusions 3 mg/m2 verteporfin PDT for CEC shows a similar clinical efficiency and safety to 6 mg/m2 verteporfin.3 mg/m2 verteporfin PDT can decrease cost,but the effect of 2 mg/m2verteporfin PDT is not satisfacted.
ABSTRACT
Central exudative chorioretinopathy( CEC),also known as idiopathic choroidal neovascularization (ICN),was more common in middle-aged,appearing the isolated macular choroidal neovascularization lesions ( CNV ).CNV can cause macular hemorrhage,exudativeing and scarring and therefore affect the patient' s central vision.The etiology of CEC is below understanding,and the treatment aimed at CNV.The clinical management of CEC include photodynamic therapy ( PDT),the administration of antibody of vascular epithelial growth factor ( VEGF ),adrenal glucocorticoid drug,combined therapy,transpupillary thermotherapy (TTT),laser photocoagulation,ratiotherapy,surgery,Chinese traditional medicine and gene therapy.The various treating approaches and their mechanisms were reviewed.
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Objective To observe the effects of central exudative chorioretinopathy(central exudative chorioretinopathy,CEC)treated with blood-activating and stasis-removing Chinese medicines.Methods All 339 cases of central exudative chorioretinopathy with 346 infected eyes were randomly recruited into a treatment group(176 cases with 181 infected eyes)and a control group(163 cases with 165 infected eyes).The treatment group was treated with traditional Chinese medicine by dialectical combination of syndrome and disease,while the control group was treated with conventional treatment.Results The corrected visual acuity was 0.01～1.2 in the treatment group.Of all 181 eyes in 176 patients,76 eyes were cured(41.98%),85 eyes were improved(46.96%),and 20 eyes were ineffective(11.6%),with a total effective rate being 88.94%.BY contrast,in the control group,of all 165 eyes in 163 patients,62 eyes were cured(37.57%),67 eyes were improved(40.60%),and 36 eyes were ineffective(21.83%),with a total effective rate being 78.17%.There was significant difference in the total effective difference between the two groups(U=2.05693,P＜0.05).FFA and OCT were reexamined for the patients in the treatment group three menths after the treatment.The results showed that fluorescein leakage and choroidal neovascularization(choroid al neovascularisation,CNV)lesions disappeared in 76 eyes;fluorescein leakage and CNV lesions relieved in 85 Eyes;fluorescein leakage still existed in 12 eyes;and sear formed in 8 eyes.Conclusion Blood-circulating and stasis-removing Chinese medicines have good effects in promoting subhyaloid hemorrhage and exudation,eliminating retinal oedema,and improving eyesight.