激光联合玻璃体腔注射雷珠单抗与单独激光治疗视网膜分支静脉阻塞继发黄斑水肿的Meta分析

Meta-Analysis of the effect of laser combined with intravitreal Ranibizumab versus laser alone in macular edema caused by branch retinal vein occlusion

目的系统评价激光联合玻璃体腔注射雷珠单抗与单独激光治疗视网膜分支静脉阻塞(branch retinal vein occlusion,BRVO)引起的黄斑水肿(macular edema,ME)的临床疗效。方法计算机检索Pubmed、CNKI等数据库,查找关于激光联合玻璃体腔注射雷珠单抗与单独激光治疗BRVO并发ME的临床对照试验。检索时限均为从建库到2015年11月,采用Rev Man 5.3软件进行Meta分析。结果共纳入6篇文献,共包括患者208例,218眼。Meta分析结果显示:治疗后随访6个月时,联合治疗组最佳矫正视力优于单独激光组(MD=-0.130,95%CI=-0.140^-0.120,P<0.000 01),联合治疗组黄斑中心凹厚度小于单独激光组(MD=229.580,95%CI=209.190~249.960,P<0.000 01)。结论对于BRVO患者,中期随访内,激光联合玻璃体腔注射雷珠单抗提高最佳矫正视力、减轻ME的疗效优于单独激光治疗。

Objective To systematically evaluate the clinical effects of laser combined with intravitreal ranibizumab and laser alone in patients with branch retinal vein occlnsion（BRVO） complicated by macular edema （ME）.Methods Databases including Pubmed,The Cochrane Library（Issue 11,2012 ）,EMbase,CBM,CNKI,VIPand WanFang Data were electronically searched for the trials about the effects of laser combined with intravitreal ranibizumab and laser alone in patients with BRVO complicated by ME from the date of establishment of the databases to November 2015.Meta-analysis was performed with RevMan 5.3 software.Results A total of 6 trials involving 208 petients and 218 eyes were included.Meta-analysis showed that there was significant statistical difference in best corrected visual acuity and central macular thickness between laser combined with intravitreal ranibizumab and laser alone in the 6-month follow-up （MD=-0.130,95%CI =-0.140 to -0.120,P〈0.00001）（MD=229.580,95%CI =209.190-249.960,P〈0.00001）.Conclusion Current evidence showed the effects of laser combined with intravitreal ranibizumab were better than that of laser alone in improving best corrected visual acuity and decreasing central macular thickness among BRVO.