Department of Pharmacy, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China.
J Ocul Pharmacol Ther. 2023 Sep;39(7):418-429. doi: 10.1089/jop.2023.0028. Epub 2023 Jul 27.
The efficacy and safety of anti-vascular endothelial growth factor (anti-VEGF) treatment for Coats' disease remains controversial. This study was designed to evaluate the efficacy and safety of anti-VEGF treatment for Coats' disease. PubMed, Embase, The Cochrane Library, Clinical Trials, CNKI, and WanFang databases were systematically searched for clinical efficacy and safety studies on anti-VEGF treatment for Coats' disease through June 2021. Study selection, data extraction, and quality assessment were independently performed by 2 reviewers. Quality assessments were performed using the Joanna Briggs Institute Critical Appraisal tools and GRADE-CERQual. A total of 1,501 articles were retrieved and reviewed, of which 24 case series involving 378 patients (range: 3-67 patients each with 3-71 eyes) were included in the analysis. No randomized controlled trials, case-controlled studies, or cohort studies were available for analysis. Most patients were male (60.0%-92.9%), aged 1.35-42.3 years, with a median follow-up time ranging from 3 to 63 months. Among the 24 case series, 22 reported changes in the visual acuity (VA) after anti-VEGF treatment and 21 reported safety outcomes. The results showed that VA improved in 73 patients (37.63%), was stable in 89 (45.87%), and worsening VA was observed in 12 cases (6.19%). The most common adverse event was fibrotic changes ( = 35). Systemic complications were not observed. The results of this study indicate that anti-VEGF drugs provide an effective and relatively safe treatment strategy for Coats' disease. However, conducting well-designed, prospective, randomized clinical trials are necessary to confirm our findings.
抗血管内皮生长因子（anti-VEGF）治疗 Coats 病的疗效和安全性仍存在争议。本研究旨在评估抗 VEGF 治疗 Coats 病的疗效和安全性。通过 2021 年 6 月，我们系统地检索了 PubMed、Embase、The Cochrane Library、ClinicalTrials、CNKI 和万方数据库中关于 Coats 病抗 VEGF 治疗的临床疗效和安全性研究。由 2 名评审员独立进行研究选择、数据提取和质量评估。使用 Joanna Briggs 研究所循证卫生保健中心的批判性评价工具和 GRADE-CERQual 进行质量评估。共检索到 1501 篇文章，并进行了回顾，其中包括 24 项病例系列研究，涉及 378 例患者（范围：每个患者 3-67 例，每例患者 3-71 只眼）。没有可供分析的随机对照试验、病例对照研究或队列研究。大多数患者为男性（60.0%-92.9%），年龄为 1.35-42.3 岁，中位随访时间为 3-63 个月。在这 24 项病例系列研究中，有 22 项报告了抗 VEGF 治疗后视力（VA）的变化，有 21 项报告了安全性结果。结果显示，73 例（37.63%）VA 改善，89 例（45.87%）VA 稳定，12 例（6.19%）VA 恶化。最常见的不良事件是纤维化改变（ = 35）。未观察到全身并发症。本研究结果表明，抗 VEGF 药物为 Coats 病提供了一种有效且相对安全的治疗策略。然而，有必要开展精心设计的、前瞻性的、随机临床试验来证实我们的研究结果。
