Pertl Laura, Steinwender Gernot, Mayer Christoph, Hausberger Silke, Pöschl Eva-Maria, Wackernagel Werner, Wedrich Andreas, El-Shabrawi Yosuf, Haas Anton
Department of Ophthalmology, Medical University Graz, Auenbruggerplatz 4, 8036, Graz, Austria.
Department of Ophthalmology, Klagenfurt Hospital, Feschnigstraße 11, 9020, Klagenfurt am Wörthersee, Austria.
PLoS One. 2015 Jun 17;10(6):e0129383. doi: 10.1371/journal.pone.0129383. eCollection 2015.
Laser photocoagulation is the current gold standard treatment for proliferative retinopathy of prematurity (ROP). However, it permanently reduces the visual field and might induce myopia. Vascular endothelial growth factor (VEGF) inhibitors for the treatment of ROP may enable continuing vascularization of the retina, potentially allowing the preservation of the visual field. However, for their use in infants concern remains. This meta-analysis explores the safety of VEGF inhibitors.
The Ovid Interface was used to perform a systematic review of the literature in the databases PubMed, EMBASE and the Cochrane Library.
This meta-analysis included 24 original reports (including 1.457 eyes) on VEGF inhibitor treatment for ROP. The trials were solely observational except for one randomized and two case-control studies. We estimated a 6-month risk of retreatment per eye of 2.8%, and a 6-month risk of ocular complication without the need of retreatment of 1.6% per eye. Systemic complications were only reported as isolated incidents.
VEGF inhibitors seem to be associated with low recurrence rates and ocular complication rates. They may have the benefit of potentially allowing the preservation of visual field and lower rates of myopia. Due to the lack of data, the risk of systemic side effects cannot be assessed.
激光光凝术是目前治疗早产儿增殖性视网膜病变（ROP）的金标准疗法。然而，它会永久性地缩小视野，还可能诱发近视。用于治疗ROP的血管内皮生长因子（VEGF）抑制剂或许能使视网膜持续血管化，有可能保留视野。然而，对于在婴儿中使用这类药物，人们仍存担忧。这项荟萃分析探讨了VEGF抑制剂的安全性。
利用Ovid界面在PubMed、EMBASE和Cochrane图书馆数据库中对文献进行系统综述。
这项荟萃分析纳入了24篇关于VEGF抑制剂治疗ROP的原始报告（包括1457只眼）。除了1项随机对照研究和2项病例对照研究外，其余试验均为观察性研究。我们估计每只眼6个月再次治疗的风险为2.8%，每只眼6个月无需再次治疗的眼部并发症风险为1.6%。全身并发症仅作为个别事件报告。
VEGF抑制剂似乎与低复发率和眼部并发症发生率相关。它们可能具有潜在保留视野和降低近视发生率的益处。由于缺乏数据，无法评估全身副作用的风险。
