Clinical efficacy of intravitreal corticoid as an adjunctive therapy to anti-VEGF treatment of neovascular age-related macular degeneration: a Meta-analysis

International Journal of Ophthalmology

Ya-Lan Dong¹  Yuan-Yuan Liu²  Hua Yan²  Wei Zhou²  Hao Yang³  Bo-Hao Cui⁴  Wen-Wen Wang⁵ 

[1] Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, Tianjin 300052, China;Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin 300052, China;Graduate School, Tianjin Medical University, Tianjin 300070, China;Hua Yan. Department of Ophthalmology, Tianjin Medical University, No. 22, Qixiangtai Road, Tianjin 300070, China. [e-mail];Laboratory of Molecular Ophthalmology, Tianjin Medical University, Tianjin 300070, China;

关键词: age-related macular degeneration;    dexamethasone;    triamcinolone;    anti-vascular endothelial growth factor;    meta-analysis;   

DOI  :  10.18240/ijo.2021.07.19

来源: DOAJ

【 摘 要 】

AIM: To evaluate the efficacy and safety of intravitreal corticoid as an adjunctive therapy to anti-vascular endothelial growth factor (VEGF) treatment of neovascular age-related macular degeneration (nvAMD). METHODS: Four databases including PubMed, Embase, Cochrane Library, and the clinicaltrials.gov were comprehensively searched for studies comparing intravitreal corticoid plus anti-VEGF (IVC/IVA) vs anti-VEGF monotherapy (IVA) in patients with nvAMD. GRADE profiler was used to assess the quality of outcomes. Best-corrected visual acuity (BCVA), central macular thickness (CMT) and adverse events including the occurrence of severe elevation of intraocular pressure (IOP) and the progress of cataract were extracted from the eligible studies. Review Manager (RevMan) 5.3 was used to analyze the data. RESULTS: There was no statistic difference of mean change in BCVA at 6 and 12mo between IVC/IVA and IVA group [95% confidence interval (CI): -2.28 to 4.24, P=0.55; 95%CI: -3.01 to 8.70, P=0.34]. No statistic difference was found in the change of CMT between two groups at 6mo time point (95%CI: -17.98 to 16.42, P=0.93) while the CMT reduction in IVC/IVA group was significantly more obvious than IVA group at 12mo time point [mean difference (MD)=-44.08, 95%CI: -80.52 to -7.63, P=0.02]. The risk of occurrence of severe elevation of IOP in the IVC/IVA group was higher than that in the IVA group (95%CI: 1.92 to 9.48; P=0.0004). Cataract progression risk was calculated no statistic difference between two groups (95%CI: 0.74 to 4.66; P=0.18). CONCLUSION: No visual or anatomical benefits are observed in IVC/IVA group at 6mo. At 12mo, the CMT of the IVC/IVA group is significantly lower than that of the IVA group. Risk of severe elevation of IOP is significantly higher when treated by IVC/IVA.

【 授权许可】

Unknown