Different approaches for treating myopic choroidal neovascularization:a network Meta-analysis  

作　　者：Ya-Jun Wu Yu-Liang Feng Jia-Song Yang Hua Fan Wen-Sheng Li 

机构地区：[1]Aier School of Ophthalmology,Central South University,Changsha 410000,Hunan Province,China [2]Department of Ophthalmology,Shanghai Aier Eye Hospital,Shanghai 200235,China [3]Shanghai Aier Eye Institute,Shanghai 200235,China

出　　处：《International Journal of Ophthalmology(English edition)》2023年第12期2105-2116,共12页国际眼科杂志（英文版）

基　　金：Supported by 2023 Research Fund of Aier Ophthalmology Research Institute(No.AEI202310LC01).

摘　　要：AIM:To evaluate the efficacy of intravitreal injection of anti-vascular endothelial growth factor(anti-VEGF),photodynamic therapy(PDT),and laser treatment(LT)for anatomical and functional improvement in myopic choroidal neovascularization(mCNV)patients.METHODS:Two researchers independently searched PubMed,Cochrane Library,Web of Science,and other databases to screen studies comparing best-corrected vision acuity(BCVA)and foveal center thickness(FCT)changes after mCNV treatment.Post-treatment chorioretinal atrophy(CRA)is a secondary outcome indicator.The retrieval time limit is from the database construction to January 30,2023.RESULTS:A total of 1072 eyes in 16 articles were included.In the RCTs,intravitreal bevacizumab(IVB)and intravitreal ranibizumab(IVR)were superior to PDT(MD=0.18,95%CI:0.02,0.40,MD=0.18,95%CI:0.01,0.42)in improving BCVA of mCNV patients(P<0.05).The relative effectiveness in improving BCVA,from high to low,appeared to be IVR,intravitreal aflibercept(IVA),IVB,LT,PDT,and sham first followed by IVA(Sham/IVA).While improving the FCT from high to low was IVA,IVR,IVB,PDT.In retrospective studies,the results of BCVA after long-term treatment showed that all the therapeutic effects from high to low was IVA,intravitreal conbercept(IVC),IVR,IVB,IVB/IVR,PDT with IVB/IVR,PDT.The effect of improving FCT was IVA,IVR,IVC,PDT,and IVB from high to low.And in the effects of improving CRA,the IVB appeared to be higher than IVR,while the PDT was the smallest,but none of the differences in the results were statistically significant.CONCLUSION:Anti-VEGF has the best effect on longterm vision improvement in mCNV patients,using IVB or IVR alone to treat mCNV may be better than IVB or IVR combined with PDT.There is no significant difference in the improvement of visual acuity,macular edema,and CRA in mCNV patients treated with any different anti-VEGF drugs.

关 键 词：myopic choroidal neovascularization AFLIBERCEPT BEVACIZUMAB conbercept laser treatment RANIBIZUMAB photodynamic therapy 

分 类 号：R779.6[医药卫生—眼科]