A meta-analysis of the effect of a dexamethasone intravitreal implant versus intravitreal anti-vascular endothelial growth factor treatment for diabetic macular edema

Autor: Xin-jun Ren, Wai Ching Lam, Xiaorong Li, Ye He, Bo-jie Hu
Rok vydání: 2018
Předmět:
Vascular Endothelial Growth Factor A
Intraocular pressure
medicine.medical_specialty
Visual acuity
genetic structures
Anti-Inflammatory Agents
Visual Acuity
Angiogenesis Inhibitors
Cochrane Library
Dexamethasone
Macular Edema
law.invention
03 medical and health sciences
0302 clinical medicine
lcsh:Ophthalmology
Randomized controlled trial
Diabetic macular edema
law
Ranibizumab
Ophthalmology
Dexamethasone Intravitreal Implant
Humans
Medicine
Dexamethasone implant
030212 general & internal medicine
Adverse effect
Glucocorticoids
Drug Implants
Diabetic Retinopathy
business.industry
Anti-VEGF
General Medicine
eye diseases
Bevacizumab
Meta-analysis
lcsh:RE1-994
Delayed-Action Preparations
Ozurdex
Intravitreal Injections
030221 ophthalmology & optometry
Implant
medicine.symptom
business
Research Article
medicine.drug
Zdroj: BMC Ophthalmology, Vol 18, Iss 1, Pp 1-11 (2018)
BMC Ophthalmology
ISSN: 1471-2415
Popis: Background This meta-analysis evaluated the effectiveness and safety of dexamethasone (DEX) implant and intravitreal anti-vascular endothelial growth factor (VEGF) treatment for diabetic macular edema (DME). Methods The PubMed, Embase, clinicaltrials.gov website and Cochrane Library databases were comprehensively searched for studies comparing DEX implant with anti-VEGF in patients with DME. Best-corrected visual acuity (BCVA), central subfield thickness (CST) and adverse events were extracted from the final eligible studies. Review Manager (RevMan) 5.3 for Mac was used to analyze the data and GRADE profiler were used to access the quality of outcomes. Results Based on four randomized clinical trials assessing a total of 521 eyes, the DEX implant can achieve visual acuity improvement for DME at rates similar to those achieved via anti-VEGF treatment (mean difference [MD] = − 0.43, P = 0.35), with superior anatomic outcomes at 6 months (MD = − 86.71 μm, P = 0.02), while requiring fewer injections, in comparison to anti-VEGF treatment. Although the mean reduction in CST did not showed significant difference at 12 months (MD = − 33.77 μm, P = 0.21), the significant in BCVA from baseline to 12 months supported the anti-VEGF treatment (MD = − 3.26, P
Databáze: OpenAIRE
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