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抗血管内皮生长因子治疗在治疗视网膜中央静脉阻塞引起的黄斑水肿中的疗效:系统评价和荟萃分析。

Current Outcomes of Anti-VEGF Therapy in the Treatment of Macular Edema Secondary to Central Retinal Vein Occlusions: A Systematic Review and Meta-Analysis.

机构信息

Sydney Institute of Vision Science, Sydney, NSW, Australia.

Save Sight Institute, University of Sydney, Sydney, NSW, Australia.

出版信息

Asia Pac J Ophthalmol (Phila). 2019 May-Jun;8(3):236-246. doi: 10.22608/APO.2018543. Epub 2019 May 27.

Abstract

PURPOSE

To evaluate the current anti-vascular endothelial growth factor (anti-VEGF) treatments for macular edema due to central retinal vein occlusions.

METHODS

PubMed, EMBASE, the Cochrane Library were systematically searched for studies between January 2013 and July 2018. Reference lists of published articles were searched and if necessary, authors were contacted to provide additional data. Meta-analysis was performed using Comprehensive Meta-analysis software. The best-corrected visual acuity (BCVA), central foveal thickness (CFT), injection frequency, and adverse events were evaluated.

RESULTS

Seventeen studies involving 1070 eyes were included in the meta-analysis. The mean differences in 12-month changes in BCVA and CFT were 14.4 ETDRS letters ( < 0.001) and -289.2 μm ( < 0.001), respectively. Visual acuity gains were maintained at 24 months (14.2 letters, < 0.001) and CFT continued to reduce (-327.45 μm, < 0.001). The incidence of severe adverse events was low and similar across all anti-VEGF therapies. Prospective studies administered a greater number of injections compared with retrospective studies, being 6.6 and 4.4 injections, respectively over 12 months ( < 0.001).

CONCLUSIONS

Intravitreal treatment with anti-VEGF agents demonstrated significant anatomical and functional gains in treating macular edema due to central retinal vein occlusions.

摘要

目的

评估目前用于治疗视网膜中央静脉阻塞所致黄斑水肿的抗血管内皮生长因子(anti-VEGF)治疗方法。

方法

系统检索了 2013 年 1 月至 2018 年 7 月间的 PubMed、EMBASE 和 Cochrane Library 中的相关研究。查阅已发表文章的参考文献,并在必要时联系作者以获取额外数据。使用 Comprehensive Meta-analysis 软件进行荟萃分析。评估最佳矫正视力(BCVA)、中心视网膜厚度(CFT)、注射频率和不良反应。

结果

共有 17 项研究纳入了 1070 只眼的 meta 分析。12 个月时 BCVA 和 CFT 的平均变化差值分别为 14.4 个 ETDRS 字母( < 0.001)和-289.2 μm( < 0.001)。24 个月时视力仍有提高(14.2 个字母, < 0.001),CFT 继续降低(-327.45 μm, < 0.001)。严重不良事件的发生率较低,且在所有抗 VEGF 治疗中相似。前瞻性研究的注射次数明显多于回顾性研究,12 个月内分别为 6.6 次和 4.4 次( < 0.001)。

结论

玻璃体内注射抗 VEGF 药物治疗视网膜中央静脉阻塞所致黄斑水肿可显著改善解剖和功能。

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