The efficacy and safety of acupuncture combined with ranibizumab in the treatment of macular edema secondary to retinal vein occlusion

Abstract

Background: Macular edema secondary to retinal vein occlusion (RVO-ME) impairs vision. Intravitreal ranibizumab is commonly used, but the adjunctive value of acupuncture remains unclear. Objective: To evaluate the clinical efficacy and safety of acupuncture combined with intravitreal ranibizumab injection for RVO-ME. Methods: Patients with RVO-ME (n = 45) were randomized into a control group (ranibizumab monotherapy) and an acupuncture group (ranibizumab and acupuncture). Both groups received monthly intravitreal ranibizumab (0.5 mg/0.05 mL) for 3 months, with a total follow-up of 6 months. Best-corrected visual acuity (BCVA), central macular thickness (CMT), macular vessel density (MVD) of superficial vascular complex (SVC), and deep vascular complex (DVC), foveal avascular zone (FAZ) area, and safety outcomes were assessed. Results: At 3 and 6 months post-treatment, BCVA, CMT, SVC-MVD, and DVC-MVD improved significantly in both groups (p <0.05). The acupuncture group showed significant reductions in SVC-FAZ and DVC-FAZ at 6 months (p <0.05), whereas the control group showed no such changes. Between-group differences at 6 months were significant for BCVA, CMT, DVC-MVD, and DVC-FAZ (p <0.05), with DVC-MVD differing significantly at 3 months (p <0.05). Adverse events (subconjunctival hemorrhage, elevated intraocular pressure, subcutaneous hemorrhage) were mild and comparable between groups (p >0.05). Conclusion: Acupuncture combined with ranibizumab effectively reduces RVO-ME, improves the microvascular structure of the macula, and is safe and reliable, with no serious adverse reactions. Relevance for patients: Patients with vision loss from RVO-ME may benefit from this combined treatment, which improves visual acuity, reduces retinal edema, and supports better long-term macular health with a favorable safety profile.

Keywords

Acupuncture / Ranibizumab injection / Retinal vein occlusion / Macular edema / Optical coherence tomography angiography

Acknowledgments

The authors would like to thank Dr. Wei Gao at Ningbo University of Technology for providing valuable assistance with the study and field tests.

Funding

This work was supported by The Zhejiang Province Traditional Chinese Medicine Science and Technology Plan (Award Number: 2023ZL647), The Zhejiang Province Medical and Health Science and Technology Plan (Award Number: 2024KY1496), and The Ningbo Public Welfare Research Project (Award Number: 2024S160).

Conflict of interest

The authors declare that they have no competing interests.

Author contributions

Conceptualization: Yan Shi, Bo Li Data curation: Yimeng Ruan Formal analysis: Yan Shi Funding acquisition: Yan Shi Investigation: Yan Shi, Manhua Shi Methodology: Yan Shi Resources: Manhua Shi, Bo Li Software: Pengyao Lin Supervision: Bo Li Visualization: Pengyao Lin Writing-original draft: Yan Shi, Yimeng Ruan Writing-review & editing: Bo Li

Ethics approval and consent to participate

All included patients provided their oral and written informed consent. The data of this study were published with the approval of the Ethics Committee of the First Affiliated Hospital of Ningbo University (Ethics batch number: 2023 Research No. 083RS-01).

Consent for publication

Written informed consent for publication was obtained from all participants.

Availability of data

All data included in this study are available upon request from the corresponding author.

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