Department of Ophthalmology, The First Affiliated Hospital of China Medical University, Shenyang 110001, China.
Singapore Eye Research Institute, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Singapore National Eye Center, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore.
Photodiagnosis Photodyn Ther. 2017 Dec;20:215-220. doi: 10.1016/j.pdpdt.2017.09.008. Epub 2017 Sep 19.
To perform a systematic review and meta-analysis to compare the outcome and serious adverse effects of intravitreal ranibizumab (IVR) monotherapy vs. combined treatment of IVR and photodynamic therapy (PDT) on polypoidal choroidal vasculopathy (PCV).
A computerized online search was performed using PubMed, EMBASE, Cochrane Library, Web of Science and China National Knowledge Infrastructure (CNKI) database. The quality of included studies was evaluated according to the Newcastle-Ottawa Scale. Stata 11.0 software was used to do the Meta-analysis.
After a detailed systematic review, 4 articles (5 study samples) were included for this meta-analysis. PCV eyes treated with PDT combined with IVR achieved better best-corrected visual acuity (BCVA) than IVR monotherapy group throughout a follow-up of 12(th) month (weight mean difference [WMD] in BCVA, 0.132; 95% CI, 0.029-0.234, p=0.012). Further meta-analysis including studies with 24-month follow up period showed that BCVA at 24(th) month was also better in the combined treatment group than the monotherapy group (WMD in BCVA=0.234; 95% CI, 0.071-0.398, p=0.005). There were no significant differences both in serious ocular adverse effects and non-ocular adverse effects (p>0.05) between two groups.
Treatment of PCV by PDT combine with IVR is valuable in improving visual acuity and maintaining long term effectiveness. Given the inherent limitations of the included research, future studies are needed to further validate and update the findings in this area.
系统评价和荟萃分析比较玻璃体内雷珠单抗（IVR）单药治疗与 IVR 联合光动力疗法（PDT）治疗息肉样脉络膜血管病变（PCV）的疗效和严重不良事件。
计算机检索 PubMed、EMBASE、 Cochrane 图书馆、Web of Science 和中国知网（CNKI）数据库，检索时限均从建库至 2017 年 3 月。按照纽卡斯尔-渥太华量表（Newcastle-Ottawa Scale，NOS）评价纳入研究的质量，采用 Stata 11.0 软件进行 Meta 分析。
经过详细的系统评价，共纳入 4 篇文献（5 个研究样本）进行 Meta 分析。PDT 联合 IVR 治疗的 PCV 眼在 12 个月的随访中获得了更好的最佳矫正视力（BCVA）（BCVA 的加权均数差 [WMD]，0.132；95%CI，0.029-0.234，p=0.012）。进一步纳入 24 个月随访的研究进行 Meta 分析显示，联合治疗组在 24 个月时的 BCVA 也优于单药治疗组（BCVA 的 WMD=0.234；95%CI，0.071-0.398，p=0.005）。两组严重眼部不良事件和非眼部不良事件发生率差异均无统计学意义（p＞0.05）。
PDT 联合 IVR 治疗 PCV 可提高视力，维持长期疗效。鉴于纳入研究的固有局限性，需要进一步的研究来验证和更新该领域的发现。
