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2015 ; 9
(ä): 5397-405
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Intravitreal anti-VEGF injections for treating wet age-related macular
degeneration: a systematic review and meta-analysis
#MMPMID26451092
Ba J
; Peng RS
; Xu D
; Li YH
; Shi H
; Wang Q
; Yu J
Drug Des Devel Ther
2015[]; 9
(ä): 5397-405
PMID26451092
show ga
AIMS: Age-related macular degeneration (AMD) is the main cause of blindness.
Anti-vascular endothelial growth factor is used to prevent further
neovascularization due to wet AMD. The purpose of this systematic review was to
investigate the effect and protocol of anti-vascular endothelial growth factor
treatment on wet AMD. METHODS: A comprehensive literature search was performed in
PubMed, Embase, the Cochrane Library, CNKI, and reference lists. Meta-analysis
was performed using Stata12.0 software, best corrected visual acuity (BCVA),
retinal thickness, and lesion size were evaluated. RESULTS: Twelve randomized
controlled trials spanning from 2010 to 2014 and involving 5,225 patients were
included. A significant difference was observed between the intravitreal
ranibizumab (IVR) group and the intravitreal bevacizumab group (standard mean
difference = -0.14, 95% confidence interval [CI] = -0.23 to -0.05). No
significant differences were observed in best corrected VA, retinal thickness, or
lesion size between IVR and the intravitreal aflibercept group. Compared to
monthly injection, IVR as-needed injections (PRN) can raise VA by 1.97 letters
(weighted mean difference = 1.97, 95% CI = 0.14-3.794). Combination therapy of
IVR and photodynamic therapy can significantly raise VA by 2.74 letters when
combined with IVR monotherapy (weighted mean difference = 2.74, 95% CI =
0.26-5.21). CONCLUSION: The superiority remains unclear between IVR and
intravitreal bevacizumab in the treatment of neovascular AMD. Intravitreal
aflibercept dosed every 2 months required fewer injection times, but produced
similar efficacy as monthly IVR. IVR PRN could significantly increase VA.
Combined with photodynamic therapy, IVR therapy could also increase VA
effectively.