Hu Qiuming, Li Haoyu, Du Yi, He Jianfeng
Department of Ophthalmology, the First Affiliated Hospital of Medical University.
Guangxi University of Chinese Medicine, Nanning, Guangxi, China.
Medicine (Baltimore). 2019 Mar;98(12):e14905. doi: 10.1097/MD.0000000000014905.
To evaluate the effect of intravitreal bevacizumab (IVB) and ranibizumab (IVR) for the treatment of choroidal neovascularization (CNV) secondary to pathologic myopia (PM) by meta-analysis.
Pertinent publications of randomized controlled trials (RCTs) were identified through systemic searches of PubMed, EMBASE, Web of science, Cochrane Library, clinicaltrials.gov, CNKI, CQVIP, and Wanfang database. All comparative studies of IVB or IVR as treatment for CNV secondary to pathologic myopia were included. Meta-analysis of these RCTs was performed using Review Manager 5.3 software. The χ test and I values were used to analyze heterogeneity. Measurements included best-corrected visual acuity (BCVA) and central foveal thickness (CFT).
A total of 3 randomized controlled clinical trials involving 158 eyes were included, 81 eyes in IVB group and 77 eyes in IVR group. Compared with baseline, at 1, 3, 6, and 12 months after IVB or IVR treatment, BCVA was significantly increased. Change of BCVA at 1, 3, 6, and 12 months did not vary significantly between IVB and IVR group (1 month: Z = 0.30, 95% CI = -0.08 to 0.11, P = .76; 3 months: Z = 0.36, 95% CI = -0.10 to 0.15, P = .72; 6 months: Z = 0.17, 95% CI = -0.10 to 0.12, P = .86; 12 months: Z = 0.64, 95% CI = -0.15 to 0.08, P = .52).
Both IVR and IVB can significantly improve BCVA of eyes with mCNV, but there was no significant difference between the 2 therapies on the treatment of mCNV.
通过荟萃分析评估玻璃体内注射贝伐单抗(IVB)和雷珠单抗(IVR)治疗病理性近视(PM)继发脉络膜新生血管(CNV)的效果。
通过系统检索PubMed、EMBASE、科学网、Cochrane图书馆、clinicaltrials.gov、中国知网、维普资讯和万方数据库,确定相关随机对照试验(RCT)的出版物。纳入所有关于IVB或IVR治疗病理性近视继发CNV的比较研究。使用Review Manager 5.3软件对这些RCT进行荟萃分析。采用χ检验和I值分析异质性。测量指标包括最佳矫正视力(BCVA)和中心凹厚度(CFT)。
共纳入3项涉及158只眼的随机对照临床试验,IVB组81只眼,IVR组77只眼。与基线相比,IVB或IVR治疗后1、3、6和12个月时,BCVA显著提高。IVB组和IVR组在1、3、6和12个月时BCVA的变化无显著差异(1个月:Z = 0.30,95%CI = -0.08至0.11,P = 0.76;3个月:Z = 0.36,95%CI = -0.10至0.15,P = 0.72;6个月:Z = 0.17,95%CI = -0.10至0.12,P = 0.86;12个月:Z = 0.64,95%CI = -0.15至0.08,P = 0.52)。
IVR和IVB均可显著提高近视性CNV患眼的BCVA,但两种治疗方法在治疗近视性CNV方面无显著差异。