Li Zijing, Zhang Yichi, Liao Yunru, Zeng Rui, Zeng Peng, Lan Yuqing
Department of Ophthalmology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
BMC Ophthalmol. 2018 Jan 30;18(1):19. doi: 10.1186/s12886-018-0685-6.
Retinopathy of Prematurity (ROP) is one of the most common causes of childhood blindness worldwide. Comparisons of anti-VEGF and laser treatments in ROP are relatively lacking, and the data are scattered and limited. The objective of this meta-analysis is to compare the efficacy of both treatments in type-1 and threshold ROP.
A comprehensive literature search on ROP treatment was conducted using PubMed and Embase up to March 2017 in all languages. Major evaluation indexes were extracted from the included studies by two authors. The fixed-effects and random-effects models were used to measure the pooled estimates. The test of heterogeneity was performed using the Q statistic.
Ten studies were included in this meta-analysis. Retreatment incidence was significantly increased for anti-VEGF (OR 2.52; 95% CI 1.37 to 4.66; P = 0.003) compared to the laser treatment, while the incidences of eye complications (OR 0.29; 95% CI 0.10 to 0.82; P = 0.02) and myopia were significantly decreased with anti-VEGF compared to the laser treatment. However, there was no difference in the recurrence incidence (OR 1.86; 95% CI 0.37 to 9.40; P = 0.45) and time between treatment and retreatment (WMD 7.54 weeks; 95% CI 2.00 to 17.08; P = 0.12).
This meta-analysis indicates that laser treatment may be more efficacious than anti-VEGF treatment. However, the results of this meta-analysis also suggest that laser treatment may cause more eye complications and increase myopia. Large-scale prospective RCTs should be performed to assess the efficacy and safety of anti-VEGF versus laser treatment in the future.
早产儿视网膜病变（ROP）是全球儿童失明的最常见原因之一。关于ROP中抗VEGF和激光治疗的比较相对较少，且数据分散且有限。本荟萃分析的目的是比较这两种治疗方法在1型和阈值ROP中的疗效。
截至2017年3月，使用PubMed和Embase对所有语言的ROP治疗进行了全面的文献检索。两位作者从纳入的研究中提取主要评估指标。采用固定效应和随机效应模型来测量合并估计值。使用Q统计量进行异质性检验。
本荟萃分析纳入了10项研究。与激光治疗相比，抗VEGF治疗的再次治疗发生率显著增加（OR 2.52；95%CI 1.37至4.66；P = 0.003），而与激光治疗相比，抗VEGF治疗的眼部并发症发生率（OR 0.29；95%CI 0.10至0.82；P = 0.02）和近视发生率显著降低。然而，复发发生率（OR 1.86；95%CI 0.37至9.40；P = 0.45）以及治疗与再次治疗之间的时间（WMD 7.54周；95%CI 2.00至17.08；P = 0.12）没有差异。
本荟萃分析表明激光治疗可能比抗VEGF治疗更有效。然而，本荟萃分析的结果也表明激光治疗可能会导致更多的眼部并发症并增加近视。未来应进行大规模前瞻性随机对照试验，以评估抗VEGF与激光治疗的疗效和安全性。
