Division of Ophthalmology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
Division of Ophthalmology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Surv Ophthalmol. 2024 May-Jun;69(3):349-361. doi: 10.1016/j.survophthal.2023.11.008. Epub 2023 Nov 24.
With the introduction of therapies to treat geographic atrophy (GA), GA management in clinical practice is now possible. A living systematic review can provide access to timely and robust evidence synthesis. This review found that complement factor 3 and 5 (C3 and C5) inhibition compared to sham likely reduces change in square root GA area at 12 months and untransformed GA area at 24 months. There is likely little to no difference in the rate of systemic treatment-emergent adverse events compared to sham. C3 and C5 inhibition, however, likely does not improve best-corrected visual acuity (BCVA) at 12 months, and the evidence is uncertain regarding change in BCVA at 24 months. Higher rates of ocular treatment emergent adverse effects with complement inhibition occur at 12 months and likely at 24 months. Complement inhibition likely results in new onset neovascular age-related macular degeneration at 12 months. This living meta-analysis will continuously incorporate new evidence.
随着治疗方法的引入，治疗地图状萎缩（GA）成为可能。实时系统综述可提供及时且稳健的证据综合。该综述发现，与假手术相比，补体因子 3 和 5（C3 和 C5）抑制剂可能会降低 12 个月时平方根 GA 面积的变化和 24 个月时未经转换的 GA 面积。与假手术相比，全身性治疗相关不良事件的发生率可能差异不大。然而，C3 和 C5 抑制剂可能不会在 12 个月时改善最佳矫正视力（BCVA），并且关于 24 个月时 BCVA 变化的证据不确定。在 12 个月和可能在 24 个月时，补体抑制的眼部治疗相关不良事件发生率更高。补体抑制可能导致 12 个月时新发性新生血管性年龄相关性黄斑变性。本实时荟萃分析将不断纳入新证据。
