玻璃体腔注射贝伐单抗和雷珠单抗治疗1型ROP疗效的Meta分析

Meta-analysis of comparison of IVB and IVR used for retinopathy of prematurity

目的:评价玻璃体腔注射贝伐单抗(IVB)和雷珠单抗(IVR)治疗1型早产儿视网膜病变(ROP)的疗效。方法:通过检索PubMed、Embase、Web of Science、the Cochrane Library、CQVIP、CBM、OVID、中国知网和万方数据库,检索时间为建库至2020-04-01。纳入所有比较IVB和IVR治疗ROP疗效的研究。由两位研究员进行独立的数据提取和质量评估。使用Review Manager 5.3软件进行统计分析。本研究观察的主要结局指标为再治疗率,次要结局指标包括:完全血管化比例和等效球镜度。结果:共纳入了8篇病例对照研究,共885眼。与IVB治疗组相比,IVR治疗组有更高的再治疗率(OR=0.55,95%CI:0.34~0.88,P<0.05)及更低的等效球镜度数(WMD=-1.44,95%CI:-2.28~-0.00,P<0.05),对于完全血管化比例,两组比较无差异(OR=2.15,95%CI:0.80~0.576,P>0.05)。结论:IVR和IVB治疗1型ROP均可以完成视网膜的完全血管化,但两种治疗方法各有优势,IVR对于儿童屈光的影响较小,但在降低再发率方面其作用较IVB差。

AIM:To evaluate the effectiveness of intravitreal bevacizumab(IVB)and ranibizumab(IVR)for the treatment of type 1 retinopathy of prematurity(ROP)by Meta-analysis.METHODS:The PubMed,Embase,Web of Science,the Cochrane Library,CNKI,CQVIP,CBM,OVID and Wanfang were systematically searched.All comparative studies of IVB or IVR as treatment for ROP were included.Two independent reviewers performed the date extraction and assessed study quality.Meta-analysis was performed using Review Manager 5.3 software.The retreatment rate was defined as the primary outcome.Secondary outcomes were prevalence of complete vascularization and myopic(spherical equivalent,SE).RESULTS:Eight non-randomized studies,including a total of 885 eyes were included in this study.Compared with IVB-treated children,IVR-treated children have higher retreatment rate[OR=0.55,95%CI:0.34-0.88,P<0.05],less spherical equivalent[WMD=-1.44,95%CI:-2.28 to-0.00,P<0.05],and the same percentage of complete vascularization[OR=2.15,95%CI:0.80-0.576,P>0.05].CONCLUSION:Both IVR and IVB can complete the vasculization of the retina in the treatment of type 1 ROP,but the two treatments have their own advantages.IVR has little effect on the refractive effect in children,but its effect in reducing the retreatment rate is worse than IVB.