A meta-analysis of anti-vascular endothelial growth factor remedy for macular edema secondary to central retinal vein occlusion
Central retinal vein occlusion (CRVO) associates with severe vision outcome and no proven beneficial treatment. Our meta-analysis intended to appraise the efficacy and safety of anti-vascular endothelial growth factor (anti-VEGF) agents in macular edema (ME) following CRVO. Data were collected and a...
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| description | Central retinal vein occlusion (CRVO) associates with severe vision outcome and no proven beneficial treatment. Our meta-analysis intended to appraise the efficacy and safety of anti-vascular endothelial growth factor (anti-VEGF) agents in macular edema (ME) following CRVO.
Data were collected and analyzed by Review Manager 5.2.1. We employed a random-effects model to eliminate between-study heterogeneity. Nfs (called fail-safe number) was calculated to evaluate the publication bias.
We included 5 trials consisting 323 cases and 281 controls. Primary outcomes showed that overall comparison of anti-VEGF agents with placebo control yielded a 374% and 136% increased tendency for a gain of 15 letters or more on Early Treatment Diabetic Retinopathy Study (ETDRS) chart (95% confidence interval [95% CI]: 2.43-9.23; P |
| doi_str_mv | 10.1371/journal.pone.0082454 |
| format | Article |
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Data were collected and analyzed by Review Manager 5.2.1. We employed a random-effects model to eliminate between-study heterogeneity. Nfs (called fail-safe number) was calculated to evaluate the publication bias.
We included 5 trials consisting 323 cases and 281 controls. Primary outcomes showed that overall comparison of anti-VEGF agents with placebo control yielded a 374% and 136% increased tendency for a gain of 15 letters or more on Early Treatment Diabetic Retinopathy Study (ETDRS) chart (95% confidence interval [95% CI]: 2.43-9.23; P<0.00001; I(2) = 59%, 95% CI: 1.60-3.49; P<0.0001; I(2) = 0%, respectively) at 6 and 12 months. Secondary outcomes showed that a 90% and 77% decreased risk at 6 and 12 months for a loss of 15 letters or more. The overall mean difference showed a statistically significance in best-corrected visual acuity (BCVA) on each time point. However, changes of central retinal thickness (CRT) lost significance at 12 months after 6-month as-needed treatment. The incidence of adverse events (AEs) had no statistical difference between anti-VEGF and placebo groups. Subgroup analyses indicated that patients receiving Aflibercept got the highest tendency to gain 15 letters or more (OR = 9.78; 95% CI: 4.43-21.56; P<0.00001). Age controlled analysis suggested a weaken tendency of BCVA improvement in age over 50 (MD = 12.26; 95% CI: 7.55-16.98; P<0.00001). Subgroup analysis by clinical classification showed a strengthen difference of BCVA changes at 6 months in ischemic type (MD = 19.65 letters, 95% CI: 13.15 to 26.14 letters, P<0.00001).
Our results showed that anti-VEGF agents were superior to placebo in CRVO-ME treatment with no statistically significant AEs, especially in younger people and for ischemic type.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0082454</identifier><identifier>PMID: 24376538</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acuity ; Aged ; Aged, 80 and over ; Angiogenesis Inhibitors - adverse effects ; Angiogenesis Inhibitors - pharmacology ; Angiogenesis Inhibitors - therapeutic use ; Clinical trials ; Comparative analysis ; Confidence intervals ; Data processing ; Diabetes ; Diabetes mellitus ; Diabetic retinopathy ; Diabetic Retinopathy - complications ; Edema ; Female ; Hospitals ; Humans ; Ischemia ; Laboratories ; Macular Edema - drug therapy ; Macular Edema - etiology ; Macular Edema - physiopathology ; Male ; Medicine ; Meta-analysis ; Middle Aged ; Occlusion ; Pharmaceuticals ; Randomized Controlled Trials as Topic ; Retina ; Retinal Vein Occlusion - complications ; Retinal Vein Occlusion - physiopathology ; Retinopathy ; Standard deviation ; Statistical analysis ; Studies ; Vascular endothelial growth factor ; Vascular Endothelial Growth Factor A - antagonists & inhibitors ; Visual Acuity</subject><ispartof>PloS one, 2013-12, Vol.8 (12), p.e82454</ispartof><rights>COPYRIGHT 2013 Public Library of Science</rights><rights>2013 Huang et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2013 Huang et al 2013 Huang et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c758t-a5cb7b0701d984c53d1cf7768f76fc299b8937662aea476e6d32c2e41b843b003</citedby><cites>FETCH-LOGICAL-c758t-a5cb7b0701d984c53d1cf7768f76fc299b8937662aea476e6d32c2e41b843b003</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3871640/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3871640/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24376538$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Wedrich, Andreas</contributor><creatorcontrib>Huang, Peirong</creatorcontrib><creatorcontrib>Niu, Wenquan</creatorcontrib><creatorcontrib>Ni, Zhentian</creatorcontrib><creatorcontrib>Wang, Renzuo</creatorcontrib><creatorcontrib>Sun, Xiaodong</creatorcontrib><title>A meta-analysis of anti-vascular endothelial growth factor remedy for macular edema secondary to central retinal vein occlusion</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Central retinal vein occlusion (CRVO) associates with severe vision outcome and no proven beneficial treatment. Our meta-analysis intended to appraise the efficacy and safety of anti-vascular endothelial growth factor (anti-VEGF) agents in macular edema (ME) following CRVO.
Data were collected and analyzed by Review Manager 5.2.1. We employed a random-effects model to eliminate between-study heterogeneity. Nfs (called fail-safe number) was calculated to evaluate the publication bias.
We included 5 trials consisting 323 cases and 281 controls. Primary outcomes showed that overall comparison of anti-VEGF agents with placebo control yielded a 374% and 136% increased tendency for a gain of 15 letters or more on Early Treatment Diabetic Retinopathy Study (ETDRS) chart (95% confidence interval [95% CI]: 2.43-9.23; P<0.00001; I(2) = 59%, 95% CI: 1.60-3.49; P<0.0001; I(2) = 0%, respectively) at 6 and 12 months. Secondary outcomes showed that a 90% and 77% decreased risk at 6 and 12 months for a loss of 15 letters or more. The overall mean difference showed a statistically significance in best-corrected visual acuity (BCVA) on each time point. However, changes of central retinal thickness (CRT) lost significance at 12 months after 6-month as-needed treatment. The incidence of adverse events (AEs) had no statistical difference between anti-VEGF and placebo groups. Subgroup analyses indicated that patients receiving Aflibercept got the highest tendency to gain 15 letters or more (OR = 9.78; 95% CI: 4.43-21.56; P<0.00001). Age controlled analysis suggested a weaken tendency of BCVA improvement in age over 50 (MD = 12.26; 95% CI: 7.55-16.98; P<0.00001). Subgroup analysis by clinical classification showed a strengthen difference of BCVA changes at 6 months in ischemic type (MD = 19.65 letters, 95% CI: 13.15 to 26.14 letters, P<0.00001).
Our results showed that anti-VEGF agents were superior to placebo in CRVO-ME treatment with no statistically significant AEs, especially in younger people and for ischemic type.</description><subject>Acuity</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Angiogenesis Inhibitors - adverse effects</subject><subject>Angiogenesis Inhibitors - pharmacology</subject><subject>Angiogenesis Inhibitors - therapeutic use</subject><subject>Clinical trials</subject><subject>Comparative analysis</subject><subject>Confidence intervals</subject><subject>Data processing</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetic retinopathy</subject><subject>Diabetic Retinopathy - complications</subject><subject>Edema</subject><subject>Female</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Ischemia</subject><subject>Laboratories</subject><subject>Macular Edema - drug therapy</subject><subject>Macular Edema - etiology</subject><subject>Macular Edema - physiopathology</subject><subject>Male</subject><subject>Medicine</subject><subject>Meta-analysis</subject><subject>Middle Aged</subject><subject>Occlusion</subject><subject>Pharmaceuticals</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Retina</subject><subject>Retinal Vein Occlusion - complications</subject><subject>Retinal Vein Occlusion - physiopathology</subject><subject>Retinopathy</subject><subject>Standard deviation</subject><subject>Statistical analysis</subject><subject>Studies</subject><subject>Vascular endothelial growth factor</subject><subject>Vascular Endothelial Growth Factor A - antagonists & inhibitors</subject><subject>Visual Acuity</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNkl2L1DAUhoso7rr6D0QDguBFx6RJk_RmYVj8GFhY8Os2nKbpTIa2WZN0dK7862ac7jIFBclF0-R535y8OVn2nOAFoYK83brRD9Atbt1gFhjLgpXsQXZOKlrkvMD04cn8LHsSwhbjkkrOH2dnBaOCp5_z7NcS9SZCDslqH2xArkUwRJvvIOixA4_M0Li4MZ2FDq29-xE3qAUdnUfe9KbZozZNe5jgxvSAgtFuaMDvUXRImyH6pPUm2nQI2hk7IKd1NwbrhqfZoxa6YJ5N34vs6_t3X64-5tc3H1ZXy-tci1LGHEpdixoLTJpKMl3ShuhWCC5bwVtdVFUtq3QlXoABJrjhDS10YRipJaM1xvQie3n0ve1cUFN2QREmcFlKzmQiVkeicbBVt9726QLKgVV_FpxfK_DR6s4oSkmKsgGoTMO0hgq3UjQ1KWUF3NCD1-V02linjKYIZqbzncFu1NrtFJWCcHYo99Vk4N330YT4j5Inag2pKju0Lpnp3gatlkxIwmRViEQt_kKlkd7KpocyrU3rM8GbmSAx0fyMaxhDUKvPn_6fvfk2Z1-fsBsDXdwE140x9UGYg-wIau9C8Ka9T45gdWj-uzTUofnV1PxJ9uI09XvRXbfT36AZAXg</recordid><startdate>20131223</startdate><enddate>20131223</enddate><creator>Huang, Peirong</creator><creator>Niu, Wenquan</creator><creator>Ni, Zhentian</creator><creator>Wang, Renzuo</creator><creator>Sun, Xiaodong</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20131223</creationdate><title>A meta-analysis of anti-vascular endothelial growth factor remedy for macular edema secondary to central retinal vein occlusion</title><author>Huang, Peirong ; Niu, Wenquan ; Ni, Zhentian ; Wang, Renzuo ; Sun, Xiaodong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c758t-a5cb7b0701d984c53d1cf7768f76fc299b8937662aea476e6d32c2e41b843b003</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Acuity</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Angiogenesis Inhibitors - adverse effects</topic><topic>Angiogenesis Inhibitors - pharmacology</topic><topic>Angiogenesis Inhibitors - therapeutic use</topic><topic>Clinical trials</topic><topic>Comparative analysis</topic><topic>Confidence intervals</topic><topic>Data processing</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetic retinopathy</topic><topic>Diabetic Retinopathy - complications</topic><topic>Edema</topic><topic>Female</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Ischemia</topic><topic>Laboratories</topic><topic>Macular Edema - drug therapy</topic><topic>Macular Edema - etiology</topic><topic>Macular Edema - physiopathology</topic><topic>Male</topic><topic>Medicine</topic><topic>Meta-analysis</topic><topic>Middle Aged</topic><topic>Occlusion</topic><topic>Pharmaceuticals</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Retina</topic><topic>Retinal Vein Occlusion - complications</topic><topic>Retinal Vein Occlusion - physiopathology</topic><topic>Retinopathy</topic><topic>Standard deviation</topic><topic>Statistical analysis</topic><topic>Studies</topic><topic>Vascular endothelial growth factor</topic><topic>Vascular Endothelial Growth Factor A - antagonists & inhibitors</topic><topic>Visual Acuity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Huang, Peirong</creatorcontrib><creatorcontrib>Niu, Wenquan</creatorcontrib><creatorcontrib>Ni, Zhentian</creatorcontrib><creatorcontrib>Wang, Renzuo</creatorcontrib><creatorcontrib>Sun, Xiaodong</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Opposing Viewpoints Resource Center</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central</collection><collection>Advanced Technologies & Aerospace Database (1962 - 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Our meta-analysis intended to appraise the efficacy and safety of anti-vascular endothelial growth factor (anti-VEGF) agents in macular edema (ME) following CRVO.
Data were collected and analyzed by Review Manager 5.2.1. We employed a random-effects model to eliminate between-study heterogeneity. Nfs (called fail-safe number) was calculated to evaluate the publication bias.
We included 5 trials consisting 323 cases and 281 controls. Primary outcomes showed that overall comparison of anti-VEGF agents with placebo control yielded a 374% and 136% increased tendency for a gain of 15 letters or more on Early Treatment Diabetic Retinopathy Study (ETDRS) chart (95% confidence interval [95% CI]: 2.43-9.23; P<0.00001; I(2) = 59%, 95% CI: 1.60-3.49; P<0.0001; I(2) = 0%, respectively) at 6 and 12 months. Secondary outcomes showed that a 90% and 77% decreased risk at 6 and 12 months for a loss of 15 letters or more. The overall mean difference showed a statistically significance in best-corrected visual acuity (BCVA) on each time point. However, changes of central retinal thickness (CRT) lost significance at 12 months after 6-month as-needed treatment. The incidence of adverse events (AEs) had no statistical difference between anti-VEGF and placebo groups. Subgroup analyses indicated that patients receiving Aflibercept got the highest tendency to gain 15 letters or more (OR = 9.78; 95% CI: 4.43-21.56; P<0.00001). Age controlled analysis suggested a weaken tendency of BCVA improvement in age over 50 (MD = 12.26; 95% CI: 7.55-16.98; P<0.00001). Subgroup analysis by clinical classification showed a strengthen difference of BCVA changes at 6 months in ischemic type (MD = 19.65 letters, 95% CI: 13.15 to 26.14 letters, P<0.00001).
Our results showed that anti-VEGF agents were superior to placebo in CRVO-ME treatment with no statistically significant AEs, especially in younger people and for ischemic type.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>24376538</pmid><doi>10.1371/journal.pone.0082454</doi><tpages>e82454</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Acuity Aged Aged, 80 and over Angiogenesis Inhibitors - adverse effects Angiogenesis Inhibitors - pharmacology Angiogenesis Inhibitors - therapeutic use Clinical trials Comparative analysis Confidence intervals Data processing Diabetes Diabetes mellitus Diabetic retinopathy Diabetic Retinopathy - complications Edema Female Hospitals Humans Ischemia Laboratories Macular Edema - drug therapy Macular Edema - etiology Macular Edema - physiopathology Male Medicine Meta-analysis Middle Aged Occlusion Pharmaceuticals Randomized Controlled Trials as Topic Retina Retinal Vein Occlusion - complications Retinal Vein Occlusion - physiopathology Retinopathy Standard deviation Statistical analysis Studies Vascular endothelial growth factor Vascular Endothelial Growth Factor A - antagonists & inhibitors Visual Acuity |
| title | A meta-analysis of anti-vascular endothelial growth factor remedy for macular edema secondary to central retinal vein occlusion |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-20T23%3A43%3A09IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20meta-analysis%20of%20anti-vascular%20endothelial%20growth%20factor%20remedy%20for%20macular%20edema%20secondary%20to%20central%20retinal%20vein%20occlusion&rft.jtitle=PloS%20one&rft.au=Huang,%20Peirong&rft.date=2013-12-23&rft.volume=8&rft.issue=12&rft.spage=e82454&rft.pages=e82454-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0082454&rft_dat=%3Cgale_plos_%3EA478148927%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1470558648&rft_id=info:pmid/24376538&rft_galeid=A478148927&rft_doaj_id=oai_doaj_org_article_331053daa9ed4cca90f87db1589a6e38&rfr_iscdi=true |