Meta-analysis of long-term efficacy of vitrectomy combined with anti-VEGF in the treatment of proliferative diabetic retinopathy
AIM: To explore the long-term efficacy of vitrectomy combined with or without anti-VEGF in the treatment of proliferative diabetic retinopathy(PDR).METHODS: Randomized controlled trials(RCTs)comparing the efficacy of vitrectomy combined with or without anti-VEGF therapy for PDR were retrieved from d...
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doaj-aa9fde5429404308918246a1a6131c162021-05-25T01:26:27ZengPress of International Journal of Ophthalmology (IJO PRESS)Guoji Yanke Zazhi1672-51232021-06-012161040104610.3980/j.issn.1672-5123.2021.6.21202106021Meta-analysis of long-term efficacy of vitrectomy combined with anti-VEGF in the treatment of proliferative diabetic retinopathyWen-Qiang Hu0Xiao-Ping Ji1Xue-Bin Zhou2Hui Zou3Yang Gao4Zao-Xia Liu5Eye Center of the Second Hospital·Jilin University, Changchun 130000, Jilin Province, ChinaDepartment of Radiology, First Affiliated Hospital, Jilin University, Changchun 130021, Jilin Province, ChinaEye Center of the Second Hospital·Jilin University, Changchun 130000, Jilin Province, ChinaEye Center of the Second Hospital·Jilin University, Changchun 130000, Jilin Province, ChinaEye Center of the Second Hospital·Jilin University, Changchun 130000, Jilin Province, ChinaEye Center of the Second Hospital·Jilin University, Changchun 130000, Jilin Province, ChinaAIM: To explore the long-term efficacy of vitrectomy combined with or without anti-VEGF in the treatment of proliferative diabetic retinopathy(PDR).METHODS: Randomized controlled trials(RCTs)comparing the efficacy of vitrectomy combined with or without anti-VEGF therapy for PDR were retrieved from databases including PUBMED, EMBASE, Cochrane Central Register of Controlled Trials(CENTRAL)and Web of Science. The retrieval time was from the establishment of the databases to July 2020. According to the inclusion and exclusion criteria, the literature was selected, then data extraction and quality evaluation was completed. Primary evaluation measures included postoperative incidence of retinal detachment, central retinal thickness(CRT), and best corrected visual acuity(BCVA). RESULTS: In this article, 11 randomized controlled studies(880 eyes)were included. Meta-analysis results showed that the incidence of retinal detachment after vitrectomy was significantly lower in PDR patients who received anti-VEGF injection before vitrectomy than in patients who did not receive anti-VEGF injection [Risk ratio(RR)=0.39, 95% Confidence interval(CI)0.22 to 0.71, P=0.002]. There were significant differences in the incidence of retinal detachment after vitrectomy between the anti-VEGF group and the non-VEFG group in both Asian and non-Asian populations(Asian: RR=0.20, 95%CI 0.05 to 0.87, P=0.03; Non-Asian: RR=0.46, 95%CI 0.24 to 0.89, P=0.02). The central retinal thickness of PDR patients who received preoperative anti-VEGF therapy was significantly lower than that of patients who did not receive anti-VEGF therapy 3 and 6mo after PPV(MD=-78.49, 95%CI -94.81 to -62.17, P<0.00001. MD= -39.62, 95%CI -48.44 to -30.80, P<0.00001). The BCVA at 6mo after PPV in PDR patients with preoperative anti-VEGF treatment was better than that in patients without preoperative anti-VEGF treatment(MD=-0.16, 95%CI -0.21 to -0.10, P<0.00001).CONCLUSION: Anti-VEGF injection before PPV can effectively reduce the incidence of retinal detachment, alleviate postoperative macular edema, reduce the central retinal thickness, and improve BCVA in PDR patients.http://ies.ijo.cn/cn_publish/2021/6/202106021.pdfanti-vegfvitrectomyproliferative diabetic retinopathyretinal detachmentcentral retinal thicknessbest corrected visual acuity |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Wen-Qiang Hu Xiao-Ping Ji Xue-Bin Zhou Hui Zou Yang Gao Zao-Xia Liu |
spellingShingle |
Wen-Qiang Hu Xiao-Ping Ji Xue-Bin Zhou Hui Zou Yang Gao Zao-Xia Liu Meta-analysis of long-term efficacy of vitrectomy combined with anti-VEGF in the treatment of proliferative diabetic retinopathy Guoji Yanke Zazhi anti-vegf vitrectomy proliferative diabetic retinopathy retinal detachment central retinal thickness best corrected visual acuity |
author_facet |
Wen-Qiang Hu Xiao-Ping Ji Xue-Bin Zhou Hui Zou Yang Gao Zao-Xia Liu |
author_sort |
Wen-Qiang Hu |
title |
Meta-analysis of long-term efficacy of vitrectomy combined with anti-VEGF in the treatment of proliferative diabetic retinopathy |
title_short |
Meta-analysis of long-term efficacy of vitrectomy combined with anti-VEGF in the treatment of proliferative diabetic retinopathy |
title_full |
Meta-analysis of long-term efficacy of vitrectomy combined with anti-VEGF in the treatment of proliferative diabetic retinopathy |
title_fullStr |
Meta-analysis of long-term efficacy of vitrectomy combined with anti-VEGF in the treatment of proliferative diabetic retinopathy |
title_full_unstemmed |
Meta-analysis of long-term efficacy of vitrectomy combined with anti-VEGF in the treatment of proliferative diabetic retinopathy |
title_sort |
meta-analysis of long-term efficacy of vitrectomy combined with anti-vegf in the treatment of proliferative diabetic retinopathy |
publisher |
Press of International Journal of Ophthalmology (IJO PRESS) |
series |
Guoji Yanke Zazhi |
issn |
1672-5123 |
publishDate |
2021-06-01 |
description |
AIM: To explore the long-term efficacy of vitrectomy combined with or without anti-VEGF in the treatment of proliferative diabetic retinopathy(PDR).METHODS: Randomized controlled trials(RCTs)comparing the efficacy of vitrectomy combined with or without anti-VEGF therapy for PDR were retrieved from databases including PUBMED, EMBASE, Cochrane Central Register of Controlled Trials(CENTRAL)and Web of Science. The retrieval time was from the establishment of the databases to July 2020. According to the inclusion and exclusion criteria, the literature was selected, then data extraction and quality evaluation was completed. Primary evaluation measures included postoperative incidence of retinal detachment, central retinal thickness(CRT), and best corrected visual acuity(BCVA). RESULTS: In this article, 11 randomized controlled studies(880 eyes)were included. Meta-analysis results showed that the incidence of retinal detachment after vitrectomy was significantly lower in PDR patients who received anti-VEGF injection before vitrectomy than in patients who did not receive anti-VEGF injection [Risk ratio(RR)=0.39, 95% Confidence interval(CI)0.22 to 0.71, P=0.002]. There were significant differences in the incidence of retinal detachment after vitrectomy between the anti-VEGF group and the non-VEFG group in both Asian and non-Asian populations(Asian: RR=0.20, 95%CI 0.05 to 0.87, P=0.03; Non-Asian: RR=0.46, 95%CI 0.24 to 0.89, P=0.02). The central retinal thickness of PDR patients who received preoperative anti-VEGF therapy was significantly lower than that of patients who did not receive anti-VEGF therapy 3 and 6mo after PPV(MD=-78.49, 95%CI -94.81 to -62.17, P<0.00001. MD= -39.62, 95%CI -48.44 to -30.80, P<0.00001). The BCVA at 6mo after PPV in PDR patients with preoperative anti-VEGF treatment was better than that in patients without preoperative anti-VEGF treatment(MD=-0.16, 95%CI -0.21 to -0.10, P<0.00001).CONCLUSION: Anti-VEGF injection before PPV can effectively reduce the incidence of retinal detachment, alleviate postoperative macular edema, reduce the central retinal thickness, and improve BCVA in PDR patients. |
topic |
anti-vegf vitrectomy proliferative diabetic retinopathy retinal detachment central retinal thickness best corrected visual acuity |
url |
http://ies.ijo.cn/cn_publish/2021/6/202106021.pdf |
work_keys_str_mv |
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