Clinical Science Meta-analysis of the effect of intravitreal anti-VEGF drugs versus intravitreal triamcinolone in macular edema caused by central retinal vein occlusion

Authors:Zhang Peng,  Ma Jingxue
DOI: 10.3760/cma.j.issn.2095-0160.2016.12.010
Published 2016-12-10
Cite as Chin J Exp Ophthalmol, 2016,34(12): 1097-1101.

Abstract

Background

Central retinal vein occlusion (CRVO) is a common retinal vascular disease.Macular edema is a common complication and can lead to the decrease of visual acuity.Intravitreal injection of anti-vascular endothelial growth factor (VEGF) drugs and triamcinolone acetonide has become the important treatment on macular edema.

Objective

This study was to systematically evaluate the clinical effects of anti-VEGF drugs and triamcinolone in patients with macular edema caused by CRVO.

Methods

The Databases including PubMed, Cochrane Library (Issue 11, 2012), EMbase, CBM, CNKI, VIP and WanFang Database were electronically searched for the trials about the effects of anti-VEGF drugs and triamcinolone in patients with macular edema caused by CRVO from the date of establishment of the databases to September 2015.The combined effect was analyzed by using Review Manager 5.3 software.

Results

A total 7 trials involving 345 patients and 348 eyes were included.Meta-analysis showed that there was no statistical difference in best corrected visual acuity (BCVA) and macular central thickness between anti-VEGF drugs and triamcinolone in the 6-month follow-up(mean difference[MD]=-0.03, 95% confidence interval[CI]: -0.11- 0.05, P=0.52; MD=-15.37, 95%CI: -36.29-5.55, P=0.15), but there was statistical difference in intraocular pressure (MD=-2.73, 95%CI: -3.59- -1.86, P<0.000 01). Twenty-two cases of lens opacity and 8 cases elevated intraocular pressure were observed in the triamcinolone group.Only 2 cases of lens opacity were observed in the anti-VEGF drugs group.

Conclusions

Anti-VEGF drugs and triamcinolone have similar improvement of BCVA and decrease of macular central thickness in CRVO patients, while the triamcinolone is accompanied with more side effects such as high intraocular pressure and progressing cataract.

Key words:

Central retinal vein occlusion; Macular edema; Triamcinolone; Vascular endothelial growth factor

Contributor Information

Zhang Peng
Department of Ophthalmology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
Ma Jingxue
(Read 20 times, 1 visits today)
Updated: September 24, 2019 — 2:23 am