Loutfi M, Siddiqui M R S, Dhedhi A, Kamal A
University of Liverpool Medical School, Liverpool, UK.
Department of General Surgery, St Heliers Hospital, London, UK.
Saudi J Ophthalmol. 2015 Apr-Jun;29(2):147-55. doi: 10.1016/j.sjopt.2014.09.004. Epub 2014 Sep 26.
Intravitreal injections of ranibizumab (IVR) and bevacizumab (IVB) have both been used as treatments for myopic choroidal neovascularisation. We aimed to produce a meta-analysis of published literature comparing IVR with IVB for the treatment of myopic choroidal neovascularisation, by searching electronic databases from January 1950 to March 2013. Our search produced three suitable studies that reported on 117 patients in total. The results of the meta-analysis demonstrated that the mean number of lines improvement after IVR appeared better compared with IVB [fixed effects model: SMD = 0.46, 95% CI (0.09, 0.83), z = 2.44, p = 0.01]. The number of patients who had a greater than 3 line improvement was similar between groups [fixed effects model: RR = 0.95, 95% CI (0.67, 1.32), z = 0.33, p = 0.74]. At follow up there was no difference in number of those who had an absence of leakage [fixed effects model: RR = 1.04, 95% CI (0.93, 1.16), z = 0.64, p = 0.52]. There was no statistical significance between the two groups in relation to the number of injections [random effects model: SMD = -0.25, 95% CI (-1.12, 0.61), z = 0.57, p = 0.57]. Early evidence therefore suggests that intravitreal injections of ranibizumab are comparable to intravitreal injections of bevacizumab in the treatment of myopic choroidal neovascularisation. Both treatments result in a statistically significant increase in visual acuity with high numbers of patients maintaining stable vision. Further studies are still needed to strengthen results.
玻璃体内注射雷珠单抗（IVR）和贝伐单抗（IVB）均已被用作治疗近视性脉络膜新生血管的方法。我们旨在通过检索1950年1月至2013年3月的电子数据库，对已发表的比较IVR与IVB治疗近视性脉络膜新生血管的文献进行荟萃分析。我们的检索产生了三项合适的研究，总共报道了117例患者。荟萃分析结果表明，与IVB相比，IVR治疗后视力改善的平均行数似乎更好[固定效应模型：标准化均数差（SMD）=0.46，95%可信区间（CI）（0.09，0.83），z=2.44，p=0.01]。两组中视力改善超过3行的患者数量相似[固定效应模型：相对危险度（RR）=0.95，95%CI（0.67，1.32），z=0.33，p=0.74]。随访时，无渗漏患者的数量没有差异[固定效应模型：RR=1.04，95%CI（0.93，1.16），z=0.64，p=0.52]。两组在注射次数方面无统计学意义[随机效应模型：SMD=-0.25，95%CI（-1.12，0.61），z=0.57，p=0.57]。因此，早期证据表明，玻璃体内注射雷珠单抗在治疗近视性脉络膜新生血管方面与玻璃体内注射贝伐单抗相当。两种治疗方法均使视力有统计学意义的提高，大量患者保持视力稳定。仍需要进一步的研究来强化结果。
