AIM: To systematically compare the efficacy and safety of off-label bevacizumab versus licensed ranibizumab intravitreal injections as well as monthly regimen versus pro re nata [PRN(as needed)] regimen in the treatment of neovascular age-related macular degeneration(n AMD).METHODS: Relevant publications were identified through automatically retrieve of database and manually retrieving. The methodological quality of studies included was assessed using the Jadad score and the risk-of-bias assessment. The efficacy estimates were measured by the weight mean difference(WMD) for the improvement of best-corrected visual acuity(BCVA) and central retinal thickness(CRT) reduction. The safety estimates were measured by odds ratios(OR) for adverse events rates. Statistical analysis was conducted by Revman 5.2.7.RESULTS: Seven studies were included in the Metaanalysis. There were no statistically significant differences between bevacizumab and ranibizumab in BCVA at 1 and 2y(P =0.37, P =0.18, respectively),However, both drugs has better BCVA given monthly than given as needed at 1 and 2y(P <0.05). The results demonstrated the mean decrease in CRT was less in bevacizumab group than ranibizumab group at 1y(P <0.05),while the difference was not significant at 2y(P =0.24).Treatment monthly gained much more decrease in CRT at 1 and 2y(P <0.005).There were no differences between drugs in the rates of death, arterial thrombotic events and venous thrombotic events(P =0.41, P =0.55, P =0.10,respectively), while the rates of medical dictionary for regulatory activities(Med DAR) system organ class events and ≥1 systemic serious adverse events were higher in bevacizumab group than ranibizumab group(P <0.05).But the incidences of death, arterial thrombotic events,venous thrombotic events, Med DAR system organ class events as well as ≥1 systemic serious adverse events were not statistically different between both treatment regimens of monthly and as needed(P =0.14, P =0.76,P =0.73, P =0.12, P =0.11, respectively).· CONCLUSION: Bevaci
AIM:To compare the efficacy of the sole intravitreal triamcinolone(IVT) versus intravitreal bevacizumab(IVB)alone or IVB combined with IVT in the treatment of diabetic macular edema(DME).·METHODS:Pertinent publications were identified through systematic searches of database and manually searching.Methodological quality of the literatures was valuated according to the Jadad Score.RevMan 5.1.0was used to do the meta-analysis.Heterogeneity was determined and sensitivity was conducted.·RESULTS:Six studies were ultimately included in the meta-analysis.The results of our analysis showed IVT had a statistically significant improvement in vision over the IVB at 1 month and 3 months(P<0.01).However,the reduction was not significant regarding central macular thickness(CMT) during the earlier(1 month and 3months) follow-up period(P =0.12,P =0.41,respectively).At later visit(6 months),IVT had a significant decrease in CMT when compared to IVB(P<0.01) while no significant improvement in visual acuity(VA) was observed(P =0.14).The incidence of intraocular hypertension was 13/102 in IVT group during follow-up period while 0/103 in IVB group.The difference was significant(P <0.01).With regards to IVT versus IVB combined with IVT,there were no significant differences in CMT at 1 month(P =0.86)and 3 months(P =0.06).The incidence of intraocular hypertension was 6/67 in IVT group during follow-up period while 4/66 in IVB +IVT group.But the difference was not significant(P =0.53).·CONCLUSION:Current evidence shows IVT is superior in improving VA at earlier follow-up(1 month and 3months) and in reducing CMT at later follow-up(6months) for DME.At other time,it is in favor of IVT treatment but there are no statistically significances.However,IVT has the side-effect of ocular hypertension.There is no adequate evidence of the benefit adding IVB to IVT in contrast to IVT alone.
