Evidence construction of Fufang Xueshuantong Capsule against retinal vein occlusion: A meta-analysis and network pharmacology

• Fufang Xueshuantong Capusle (FXC) can enhance clinical effectiveness. • FXC treats retinal vein occlusion (RVO) with a low adverse reaction. • FXC employs a network of multiple components, targets, and pathways to treat RVO. • The AGE-RAGE signaling pathway in diabetic complications could be key to FXC for RVO. Retinal vein occlusion (RVO) is the second most prevalent retinal vascular disease. In China, Fufang Xueshuantong Capsule (FXC) is a common compound Chinese medicine used to treat RVO. This review aims to illustrate the therapeutic efficacy and pharmacological mechanisms of FXC for RVO. Eight databases were searched until 17 September 2024 to collect literature meeting the criteria. Two investigators independently assessed the quality of the review and used Stata 16.0 to meta-analyse each metric. Then, network pharmacology was performed to explore the underlying mechanisms of FXC in the treatment of RVO. A meta-analysis included 18 randomized control trials (RCTs) with 1574 patients. Our results indicated that compared to conventional/traditional Chinese medicine injection (TCM) therapies, FXC alone or in combination can enhance clinical effectiveness, raise best-corrected visual acuity (BCVA), reduce central macular thickness (CMT), improve hemorheology, ameliorate hemodynamic indices, enhance fundus morphology, and decrease TCM scores with a lower adverse reaction incident. Network pharmacology revealed core components included quercetin, β-sitosterol, formononetin, luteolin, tanshinone IIA, etc., and the core targets such as TGFβ1, PKC, JNK, ERK1/2, VEGF, MCP-1, VACM-1, IL-6, TNF-α, and Akt. Several of these targets and pathways are related to RVO, and the pharmacological mechanism is mainly related to the AGE-RAGE signaling pathway in diabetic complications. FXC is clinically effective and safe for treating RVO. It synergistically treats RVO through a multi-component, multi-target, and multi-pathway network. The AGE-RAGE signaling pathway in diabetic complications may be one of the key pathways of FXC to ameliorate inflammation and thrombosis in RVO. Further basic experiments and high-quality RCTs are still needed to enrich the evidence chain for FXC in treating RVO.