Centre for Medical Education, Queen's University Belfast School of Medicine Dentistry and Biomedical Sciences, Belfast, UK
Centre for Medical Education, Queen's University Belfast Faculty of Medicine Health and Life Sciences, Belfast, UK.
BMJ Open Ophthalmol. 2022 Jun;7(1). doi: 10.1136/bmjophth-2022-001010.
This systematic review assessed the long-term outcomes for patients treated with intravitreal antivascular endothelial growth factor or dexamethasone for macular oedema (MO) secondary to retinal vein occlusion (RVO). Studies investigating patients of all ages with MO due to RVO only were included. The review was deliberately broad in scope, including comparative and non-comparative studies to ensure inclusion of real-world type evidence. Risk of bias was assessed. In total, 76 data sets were included (10 775 participants). Overall, mean best-corrected visual acuity (BCVA) improved from baseline to 5 years by 16.1 letters (p<0.01). BCVA improved from baseline in both central RVO (CRVO) and branch RVO (BRVOs) at 2 years, by 9.1 (p<0.01) (difference from baseline in CRVOs) and 9.1 (p<0.01) letters, respectively. At 5 years, BCVA improved from baseline in CRVOs by 15.6 letters and in BRVOs by 16.2; the difference between RVO types was not significant (p=0.18). Two studies had 5-year data for ranibizumab, and improvement was evident. There was no significant difference between outcomes in randomised controlled trials (RCTs) compared with non RCTs. These results suggest a benefit to receiving long-term intravitreal treatments for MO due to RVO.
本系统评价评估了接受玻璃体内抗血管内皮生长因子或地塞米松治疗视网膜静脉阻塞（RVO）继发黄斑水肿（MO）患者的长期结局。纳入了仅患有 RVO 所致 MO 的所有年龄段患者的研究。该综述的范围很广，包括比较和非比较研究，以确保纳入真实世界类型的证据。评估了偏倚风险。共纳入 76 个数据集（10775 名参与者）。总体而言，平均最佳矫正视力（BCVA）从基线到 5 年提高了 16.1 个字母（p<0.01）。在 2 年时，中央 RVO（CRVO）和分支 RVO（BRVOs）的 BCVA 均从基线开始改善，分别提高了 9.1（p<0.01）（与 CRVOs 的基线差异）和 9.1（p<0.01）个字母。在 5 年时，CRVOs 的 BCVA 从基线提高了 15.6 个字母，BRVOs 提高了 16.2 个字母；两种 RVO 类型之间的差异无统计学意义（p=0.18）。有两项研究有 5 年的 ranibizumab 数据，结果表明有改善。随机对照试验（RCT）与非 RCT 之间的结局无显著差异。这些结果表明，接受长期玻璃体内治疗 RVO 继发 MO 有获益。
