Intravitreal dexamethasone implants versus intravitreal anti-VEGF treatment in treating patients with retinal vein occlusion: a meta-analysis
Abstract Background Retinal vein occlusion (RVO) is a common retinal venous disorder that causes vision loss. No specific therapy has been developed. Controversy exists regarding two treatments: intravitreal dexamethasone implants and anti-vascular endothelial growth factor (VEGF). The goal of this...
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| Format: | Article |
| Language: | English |
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BMC
2019-01-01
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| Series: | BMC Ophthalmology |
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| Online Access: | http://link.springer.com/article/10.1186/s12886-018-1016-7 |
| _version_ | 1818526692346429440 |
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| author | Lixiong Gao Lijun Zhou Chunyu Tian Na Li Weiyang Shao Xiujun Peng Qian Shi |
| author_facet | Lixiong Gao Lijun Zhou Chunyu Tian Na Li Weiyang Shao Xiujun Peng Qian Shi |
| author_sort | Lixiong Gao |
| collection | DOAJ |
| description | Abstract Background Retinal vein occlusion (RVO) is a common retinal venous disorder that causes vision loss. No specific therapy has been developed. Controversy exists regarding two treatments: intravitreal dexamethasone implants and anti-vascular endothelial growth factor (VEGF). The goal of this study is to compare the effectiveness and safety of dexamethasone implants and anti-VEGF treatment for RVO. Methods The PubMed, Embase, and Cochrane Library databases were searched for studies comparing dexamethasone implants with anti-VEGF in patients with RVO. Best-corrected visual acuity (BCVA), central subfield thickness (CST), intraocular pressure changes, conjunctival haemorrhage, reduced VA, and macular oedema were extracted from the final included studies. RevMan 5.3 was used to conduct the quantitative analysis and bias assessment. Results Four randomised controlled trials assessing 969 eyes were included. The anti-VEGF treatment showed better BCVA improvement (mean difference [MD] = − 10.59, P < 0.00001) and more CST decrease (MD = − 86.71 μm, P = 0.02) than the dexamethasone implants. However, the dexamethasone implants required fewer injections. As for adverse effects, the dexamethasone implants showed significantly higher intraocular pressure (IOP) and more cataracts than the anti-VEGF treatment. No significant differences were found in conjunctival haemorrhage, reduced VA, and macular oedema. Conclusions Anti-VEGF treatment showed better functional and anatomical improvement with less risk of IOP elevation and cataract formation compared to dexamethasone implants. Thus, anti-VEGF treatment is the first choice for treating RVO patients. |
| first_indexed | 2024-12-11T06:26:23Z |
| format | Article |
| id | doaj.art-fcba61a779f74d2ba1e945d51eb4cd35 |
| institution | Directory Open Access Journal |
| issn | 1471-2415 |
| language | English |
| last_indexed | 2024-12-11T06:26:23Z |
| publishDate | 2019-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Ophthalmology |
| spelling | doaj.art-fcba61a779f74d2ba1e945d51eb4cd352022-12-22T01:17:40ZengBMCBMC Ophthalmology1471-24152019-01-0119111010.1186/s12886-018-1016-7Intravitreal dexamethasone implants versus intravitreal anti-VEGF treatment in treating patients with retinal vein occlusion: a meta-analysisLixiong Gao0Lijun Zhou1Chunyu Tian2Na Li3Weiyang Shao4Xiujun Peng5Qian Shi6Ophthalmology Department, General Navy Hospital of Chinese People’s Liberation ArmyCentral Laboratory, General Navy Hospital of Chinese People’s Liberation ArmyOphthalmology Department, General Navy Hospital of Chinese People’s Liberation ArmyOphthalmology Department, General Navy Hospital of Chinese People’s Liberation ArmyOphthalmology Department, General Navy Hospital of Chinese People’s Liberation ArmyOphthalmology Department, General Navy Hospital of Chinese People’s Liberation ArmyOphthalmology Department, General Navy Hospital of Chinese People’s Liberation ArmyAbstract Background Retinal vein occlusion (RVO) is a common retinal venous disorder that causes vision loss. No specific therapy has been developed. Controversy exists regarding two treatments: intravitreal dexamethasone implants and anti-vascular endothelial growth factor (VEGF). The goal of this study is to compare the effectiveness and safety of dexamethasone implants and anti-VEGF treatment for RVO. Methods The PubMed, Embase, and Cochrane Library databases were searched for studies comparing dexamethasone implants with anti-VEGF in patients with RVO. Best-corrected visual acuity (BCVA), central subfield thickness (CST), intraocular pressure changes, conjunctival haemorrhage, reduced VA, and macular oedema were extracted from the final included studies. RevMan 5.3 was used to conduct the quantitative analysis and bias assessment. Results Four randomised controlled trials assessing 969 eyes were included. The anti-VEGF treatment showed better BCVA improvement (mean difference [MD] = − 10.59, P < 0.00001) and more CST decrease (MD = − 86.71 μm, P = 0.02) than the dexamethasone implants. However, the dexamethasone implants required fewer injections. As for adverse effects, the dexamethasone implants showed significantly higher intraocular pressure (IOP) and more cataracts than the anti-VEGF treatment. No significant differences were found in conjunctival haemorrhage, reduced VA, and macular oedema. Conclusions Anti-VEGF treatment showed better functional and anatomical improvement with less risk of IOP elevation and cataract formation compared to dexamethasone implants. Thus, anti-VEGF treatment is the first choice for treating RVO patients.http://link.springer.com/article/10.1186/s12886-018-1016-7Dexamethasone intravitreal implantAnti-VEGF treatmentRetinal vein occlusionMeta-analysis |
| spellingShingle | Lixiong Gao Lijun Zhou Chunyu Tian Na Li Weiyang Shao Xiujun Peng Qian Shi Intravitreal dexamethasone implants versus intravitreal anti-VEGF treatment in treating patients with retinal vein occlusion: a meta-analysis BMC Ophthalmology Dexamethasone intravitreal implant Anti-VEGF treatment Retinal vein occlusion Meta-analysis |
| title | Intravitreal dexamethasone implants versus intravitreal anti-VEGF treatment in treating patients with retinal vein occlusion: a meta-analysis |
| title_full | Intravitreal dexamethasone implants versus intravitreal anti-VEGF treatment in treating patients with retinal vein occlusion: a meta-analysis |
| title_fullStr | Intravitreal dexamethasone implants versus intravitreal anti-VEGF treatment in treating patients with retinal vein occlusion: a meta-analysis |
| title_full_unstemmed | Intravitreal dexamethasone implants versus intravitreal anti-VEGF treatment in treating patients with retinal vein occlusion: a meta-analysis |
| title_short | Intravitreal dexamethasone implants versus intravitreal anti-VEGF treatment in treating patients with retinal vein occlusion: a meta-analysis |
| title_sort | intravitreal dexamethasone implants versus intravitreal anti vegf treatment in treating patients with retinal vein occlusion a meta analysis |
| topic | Dexamethasone intravitreal implant Anti-VEGF treatment Retinal vein occlusion Meta-analysis |
| url | http://link.springer.com/article/10.1186/s12886-018-1016-7 |
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