Pro re nata versus fixed aflibercept regimen for neovascular age-related macular degeneration: a systematic review and meta-analysis
Abstract Background Aflibercept is a relatively new anti-VEGF used to treat neovascular age-related macular degeneration (AMD). The purpose of this review is to evaluate the effect of pro re nata (PRN) and fixed regimen (bimonthly) of aflibercept injection for neovascular AMD on visual outcomes at 1...
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| Format: | Article |
| Language: | English |
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BMC
2022-09-01
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| Series: | International Journal of Retina and Vitreous |
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| Online Access: | https://doi.org/10.1186/s40942-022-00416-x |
| _version_ | 1811208826017284096 |
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| author | Andi Arus Victor Yan Martha Putri |
| author_facet | Andi Arus Victor Yan Martha Putri |
| author_sort | Andi Arus Victor |
| collection | DOAJ |
| description | Abstract Background Aflibercept is a relatively new anti-VEGF used to treat neovascular age-related macular degeneration (AMD). The purpose of this review is to evaluate the effect of pro re nata (PRN) and fixed regimen (bimonthly) of aflibercept injection for neovascular AMD on visual outcomes at 12 months of follow-up. Methods We conducted a systematic search in PubMed (MEDLINE), Embase, Scopus, and Web of Science, EBSCOHost, and ClinicalTrials.gov databases. Number of injections, number of hospital visit, mean change of best corrected visual acuity (BCVA), mean change of central macular thickness (CMT), and adverse effects of the included studies were evaluated. Meta-analysis were performed using Review Manager 5.4. Results Four studies were selected for meta-analyses synthesis (3 RCT, 1 retrospective study). A total of 197 eyes in PRN group and 241 eyes in the fixed group. All four studies favored fixed regimen with standardized mean difference of 0.56 (95% CI 0.36–0.75, I2 = 0%, p < 0.00001). There was no significant difference in CMT between both group with SMD of 0.17 (95% CI − 0.14–0.48, I2 = 26%, p = 0.28). Conclusion The present meta-analysis shows that bimonthly injection of aflibercept for neovascular AMD is superior compared to PRN injection, shown by better improvement in BCVA at 12 months follow-up. However, high risk of bias downgrade the certainty of evidence. |
| first_indexed | 2024-04-12T04:28:14Z |
| format | Article |
| id | doaj.art-bf46a91c415d4e66877ff66f6ae0e6d4 |
| institution | Directory Open Access Journal |
| issn | 2056-9920 |
| language | English |
| last_indexed | 2024-04-12T04:28:14Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Retina and Vitreous |
| spelling | doaj.art-bf46a91c415d4e66877ff66f6ae0e6d42022-12-22T03:48:01ZengBMCInternational Journal of Retina and Vitreous2056-99202022-09-01811910.1186/s40942-022-00416-xPro re nata versus fixed aflibercept regimen for neovascular age-related macular degeneration: a systematic review and meta-analysisAndi Arus Victor0Yan Martha Putri1Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo National General HospitalFaculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo National General HospitalAbstract Background Aflibercept is a relatively new anti-VEGF used to treat neovascular age-related macular degeneration (AMD). The purpose of this review is to evaluate the effect of pro re nata (PRN) and fixed regimen (bimonthly) of aflibercept injection for neovascular AMD on visual outcomes at 12 months of follow-up. Methods We conducted a systematic search in PubMed (MEDLINE), Embase, Scopus, and Web of Science, EBSCOHost, and ClinicalTrials.gov databases. Number of injections, number of hospital visit, mean change of best corrected visual acuity (BCVA), mean change of central macular thickness (CMT), and adverse effects of the included studies were evaluated. Meta-analysis were performed using Review Manager 5.4. Results Four studies were selected for meta-analyses synthesis (3 RCT, 1 retrospective study). A total of 197 eyes in PRN group and 241 eyes in the fixed group. All four studies favored fixed regimen with standardized mean difference of 0.56 (95% CI 0.36–0.75, I2 = 0%, p < 0.00001). There was no significant difference in CMT between both group with SMD of 0.17 (95% CI − 0.14–0.48, I2 = 26%, p = 0.28). Conclusion The present meta-analysis shows that bimonthly injection of aflibercept for neovascular AMD is superior compared to PRN injection, shown by better improvement in BCVA at 12 months follow-up. However, high risk of bias downgrade the certainty of evidence.https://doi.org/10.1186/s40942-022-00416-xAfliberceptPro re nataBimonthlyNeovascular age-related macular degenerationAge-related macular degeneration |
| spellingShingle | Andi Arus Victor Yan Martha Putri Pro re nata versus fixed aflibercept regimen for neovascular age-related macular degeneration: a systematic review and meta-analysis International Journal of Retina and Vitreous Aflibercept Pro re nata Bimonthly Neovascular age-related macular degeneration Age-related macular degeneration |
| title | Pro re nata versus fixed aflibercept regimen for neovascular age-related macular degeneration: a systematic review and meta-analysis |
| title_full | Pro re nata versus fixed aflibercept regimen for neovascular age-related macular degeneration: a systematic review and meta-analysis |
| title_fullStr | Pro re nata versus fixed aflibercept regimen for neovascular age-related macular degeneration: a systematic review and meta-analysis |
| title_full_unstemmed | Pro re nata versus fixed aflibercept regimen for neovascular age-related macular degeneration: a systematic review and meta-analysis |
| title_short | Pro re nata versus fixed aflibercept regimen for neovascular age-related macular degeneration: a systematic review and meta-analysis |
| title_sort | pro re nata versus fixed aflibercept regimen for neovascular age related macular degeneration a systematic review and meta analysis |
| topic | Aflibercept Pro re nata Bimonthly Neovascular age-related macular degeneration Age-related macular degeneration |
| url | https://doi.org/10.1186/s40942-022-00416-x |
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