摘要
AIM:To evaluate the efficacy and safety of intravitreal cor ticoid as an adjunctive therapy to anti-vascular endothelial growth factor(VEGF)treatment of neovascular age-related macular degeneration(nvAMD).METHODS:Four databases including Pub Med,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(Rev Man)5.3 was used to analyze the data.RESULTS:There was no statistic difference of mean change in BCVA at 6 and 12 mo 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 6 mo 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 12 mo 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 6 mo.At 12 mo,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.
基金
Supported by the National Natural Science Foundation of China(No.81830026)
Youth Program of National Natural Science Foundation of China(No.81900883)
the Science and Technology Support Project of Tianjin(No.18ZXDBSY00030)。
作者简介
Co-first authors:Bo-Hao Cui;Co-first authors:Wei Zhou;Co-first authors:Wen-Wen Wang;Correspondence to:Hua Yan.Department of Ophthalmology,Tianjin Medical University,No.22,Qixiangtai Road,Tianjin 300070,China.zyyyanhua@tmu.edu.cn。
