학술논문
Treat-and-extend regimens of anti-vascular endothelial growth factor therapy for retinal vein occlusions: a systematic review and meta-analysis.
Document Type
Academic Journal
Author
Nanji K; Department of Surgery, Division of Ophthalmology, McMaster University, Hamilton, Ontario, Canada.; Khan M; Department of Surgery, Division of Ophthalmology, McMaster University, Hamilton, Ontario, Canada.; Khalid MF; Department of Surgery, Division of Ophthalmology, McMaster University, Hamilton, Ontario, Canada.; Xie JS; Department of Surgery, Division of Ophthalmology, McMaster University, Hamilton, Ontario, Canada.; Sarohia GS; Department of Ophthalmology and Visual Sciences, 2319 Active Treatment Centre, University of Alberta, Edmonton, Alberta, Canada.; Phillips M; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.; Thabane L; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.; St. Joseph's Healthcare-Hamilton, Biostatistics Unit, Hamilton, Ontario, Canada.; Garg SJ; The Retina Service of Wills Eye Hospital, MidAtlantic Retina, Philadelphia, PA, USA.; Kaiser P; Cleveland Clinic, Cole Eye Institute, Cleveland, Ohio, USA.; Sivaprasad S; Moorfields Eye Hospital, NIHR Moorfields Biomedical Research Centre, London, UK.; Wykoff CC; Retina Consultants of Houston, Texas, Blanton Eye Institute, Houston Methodist Hospital and Weill Cornell Medical College, Houston, Texas, USA.; Chaudhary V; Department of Surgery, Division of Ophthalmology, McMaster University, Hamilton, Ontario, Canada.; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Source
Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101468102 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1755-3768 (Electronic) Linking ISSN: 1755375X NLM ISO Abbreviation: Acta Ophthalmol Subsets: MEDLINE
Subject
Language
English
Abstract
Objective: To investigate treat-and-extend (T&E) regimens of anti-vascular endothelial growth factor (anti-VEGF) therapy for the treatment of macular oedema secondary to retinal vein occlusions (RVOs).
Methods: Ovid MEDLINE, Ovid EMBASE and CENTRAL were searched on 25 February 2021. Randomized controlled trials, cohort studies, case-control studies and case series were included. The primary outcome was the change in Early Treatment Diabetic Retinopathy Score (ETDRS) letters from baseline. Conversions from Snellen to ETDRS letters were performed utilizing a published protocol. Secondary outcomes included improvement in retinal thickness from baseline, number of anti-VEGF injections and frequency of adverse events. Outcomes were examined at 12 and 24 months. Certainty of evidence was assessed utilizing GRADE (Grading of Recommendations Assessments, Development and Evaluations) guidelines.
Results: Seven hundred eighty-six eyes from 16 studies were included. Meta-analysis demonstrated a mean improvement of 15.7 (95% CI: 13.3-18.0) ETDRS letters at 12 months. Central retinal thickness improved 269.7 μm (95% CI: 233.64-305.90) at 12 months. Injections were performed 8.1 (95% CI: 7.4-8.7) and 13.1 (95% CI: 9.4-16.8) times at 12 and 24 months respectively. Adverse events were infrequent across all studies. Grading of Recommendations Assessments, Development and Evaluations (GRADE) certainty of evidence was very low across all outcomes.
Conclusions: The results support the viability of T&E regimens for the treatment of macular oedema secondary to RVOs.
(© 2021 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)
Methods: Ovid MEDLINE, Ovid EMBASE and CENTRAL were searched on 25 February 2021. Randomized controlled trials, cohort studies, case-control studies and case series were included. The primary outcome was the change in Early Treatment Diabetic Retinopathy Score (ETDRS) letters from baseline. Conversions from Snellen to ETDRS letters were performed utilizing a published protocol. Secondary outcomes included improvement in retinal thickness from baseline, number of anti-VEGF injections and frequency of adverse events. Outcomes were examined at 12 and 24 months. Certainty of evidence was assessed utilizing GRADE (Grading of Recommendations Assessments, Development and Evaluations) guidelines.
Results: Seven hundred eighty-six eyes from 16 studies were included. Meta-analysis demonstrated a mean improvement of 15.7 (95% CI: 13.3-18.0) ETDRS letters at 12 months. Central retinal thickness improved 269.7 μm (95% CI: 233.64-305.90) at 12 months. Injections were performed 8.1 (95% CI: 7.4-8.7) and 13.1 (95% CI: 9.4-16.8) times at 12 and 24 months respectively. Adverse events were infrequent across all studies. Grading of Recommendations Assessments, Development and Evaluations (GRADE) certainty of evidence was very low across all outcomes.
Conclusions: The results support the viability of T&E regimens for the treatment of macular oedema secondary to RVOs.
(© 2021 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)