AIM: To evaluate the efficacy of intravitreal injection of conbercept(IVC) and ranibizumab(IVR) in patients with diabetic macular edema.METHODS: Reviewers have searched 12 databases, including PubMed, Medline, EMBASE,...AIM: To evaluate the efficacy of intravitreal injection of conbercept(IVC) and ranibizumab(IVR) in patients with diabetic macular edema.METHODS: Reviewers have searched 12 databases, including PubMed, Medline, EMBASE, Web of Science, Springer, ScienceDirect, OVID, Cochrane Library, Clinical Trials.gov, cqVIP, WanFangdata and China National Knowledge Infrastructure(CNKI), up to December 28, 2018. Rev Man 5.3(Cochrane Library Software, Oxford, UK) was employed for statistical analysis. Fixed and random effects models were applied to assess heterogeneity. Odds ratio(OR) was applied for dichotomous variables;weighted mean difference(WMD) was applied for continuous variables. The confidence interval(CI) was set at 95%. Central macular thickness(CMT) and best-corrected visual acuity(BCVA) were employed to analyze the improvement of DME patients. Inclusion criteria for picking out studies were retrospective studies and randomized controlled trials(RCTs) that compared IVC and IVR for the treatment of diabetic macular edema.RESULTS: Four retrospective studies and five RCTs were included with a total of 609 patients. No statistically significant difference was observed in mean CMT and mean BCVA in the baseline parameters [BCVA(WMD:-0.48;95%CI:-1.06 to 0.10;P=0.1), CMT(WMD:-0.83;95%CI:-15.15 to 13.49;P=0.91). No significant difference was found in the improvement of BCVA and adverse event(AE) in IVC group, compared with IVR group after treatment of loading dosage [the 1 st month BCVA(WMD: 0.01;95%CI:-0.26 to 0.27;P=0.96), the 3 rd month BCVA(WMD:-0.04;95%CI:-0.14 to 0.06;P=0.46);the 6 th month BCVA(WMD:-0.24;95%CI:-1.62 to 1.14;P=0.73)], AE(OR: 0.84;95%CI: 0.38 to 1.84;P=0.66)]. A slight difference was found in the effectiveness rate(OR: 1.70;95%CI: 0.97 to 2.96;P=0.06), There were statistically significant differences between IVC and IVR treatment in terms of CMT (1 st month CMT(WMD:-19.88;95%CI:-27.94 to-11.82;P<0.001), 3 rd month CMT(WMD:-23.31;95%CI:-43.30 to-3.33;P=0.02), 6 th month CMT(WMD:-74.74;95%CI:-106.22 to-43.26;P<0.001))CONCLUSION: Pooled evidence suggests that both IVC and IVR are effective in the therapy of diabetic macular edema and affirms that IVC presents superiority over IVR therapy in regard of CMT in patients with diabetic macular edema, but no statistically significant difference with regard to visual improvement. Relevant RCTs with longerterm follow-up are necessary to back up our conclusion.展开更多
AIM:To observe and characterize imaging features of macular and optic disc areas in less than 60-year-old patients with early primary open angle glaucoma(POAG)by optical coherence tomography(OCT)and optical coherence ...AIM:To observe and characterize imaging features of macular and optic disc areas in less than 60-year-old patients with early primary open angle glaucoma(POAG)by optical coherence tomography(OCT)and optical coherence tomography angiography(OCTA),and to evaluate the diagnostic value of OCT and OCTA.METHODS:Totally 15 patients(23 eyes)with early POAG as observation group and 30 health people(30 eyes)as normal control group were enrolled in this cross-sectional study.OCTA-based superficial macula vessel density,superficial macula perfusion density,superficial optic disc vessel density,superficial optic disc perfusion density and spectral domain OCT(SD-OCT)-based macular area thickness,ganglion cell complex(GCC)thickness and retinal nerve fiber layer(RNFL)thickness were measured in the two groups.Independent t-test and receiver operating characteristic curve were used for analysis.Area under the receiver operating characteristic curves(AUROC)were used to measure the diagnostic utility.RESULTS:Among all the parameters,the optimal diagnostic utility parameter was the superficial vessel density in the macular area(except the center of the macula),and the AUROC reached 0.98.The diagnostic utility of macular area perfusion density(except the center of the macula)was similar to that of superficial vessel density in the macular area,and the AUROC was above 0.97.Followed by the diagnostic utility of vessel density in the optic disc area,the best parameter was the inner ring of the vessel density,and its AUROC reached 0.97.The diagnostic utility of perfusion density in the optic disc area was slightly lower than that of vessel density in the optic disc area.The best parameter was the central optic disc perfusion density,and its AUROC was 0.95.The SD-OCT-based diagnostic utility parameters were generally lower than that mentioned above,the top three parameters were the inferior RNFL thickness(AUROC=0.919),the superior(AUROC=0.919)and the inferior GCC thickness(AUROC=0.9077).CONCLUSION:The OCT-based diagnostic utility parameters are generally lower than the OCTA-based diagnostic utility parameters.OCTA has an important clinical application value in diagnosis and evaluation for less than 60-year-old patients with early POAG.展开更多
文摘AIM: To evaluate the efficacy of intravitreal injection of conbercept(IVC) and ranibizumab(IVR) in patients with diabetic macular edema.METHODS: Reviewers have searched 12 databases, including PubMed, Medline, EMBASE, Web of Science, Springer, ScienceDirect, OVID, Cochrane Library, Clinical Trials.gov, cqVIP, WanFangdata and China National Knowledge Infrastructure(CNKI), up to December 28, 2018. Rev Man 5.3(Cochrane Library Software, Oxford, UK) was employed for statistical analysis. Fixed and random effects models were applied to assess heterogeneity. Odds ratio(OR) was applied for dichotomous variables;weighted mean difference(WMD) was applied for continuous variables. The confidence interval(CI) was set at 95%. Central macular thickness(CMT) and best-corrected visual acuity(BCVA) were employed to analyze the improvement of DME patients. Inclusion criteria for picking out studies were retrospective studies and randomized controlled trials(RCTs) that compared IVC and IVR for the treatment of diabetic macular edema.RESULTS: Four retrospective studies and five RCTs were included with a total of 609 patients. No statistically significant difference was observed in mean CMT and mean BCVA in the baseline parameters [BCVA(WMD:-0.48;95%CI:-1.06 to 0.10;P=0.1), CMT(WMD:-0.83;95%CI:-15.15 to 13.49;P=0.91). No significant difference was found in the improvement of BCVA and adverse event(AE) in IVC group, compared with IVR group after treatment of loading dosage [the 1 st month BCVA(WMD: 0.01;95%CI:-0.26 to 0.27;P=0.96), the 3 rd month BCVA(WMD:-0.04;95%CI:-0.14 to 0.06;P=0.46);the 6 th month BCVA(WMD:-0.24;95%CI:-1.62 to 1.14;P=0.73)], AE(OR: 0.84;95%CI: 0.38 to 1.84;P=0.66)]. A slight difference was found in the effectiveness rate(OR: 1.70;95%CI: 0.97 to 2.96;P=0.06), There were statistically significant differences between IVC and IVR treatment in terms of CMT (1 st month CMT(WMD:-19.88;95%CI:-27.94 to-11.82;P<0.001), 3 rd month CMT(WMD:-23.31;95%CI:-43.30 to-3.33;P=0.02), 6 th month CMT(WMD:-74.74;95%CI:-106.22 to-43.26;P<0.001))CONCLUSION: Pooled evidence suggests that both IVC and IVR are effective in the therapy of diabetic macular edema and affirms that IVC presents superiority over IVR therapy in regard of CMT in patients with diabetic macular edema, but no statistically significant difference with regard to visual improvement. Relevant RCTs with longerterm follow-up are necessary to back up our conclusion.
基金Supported by Key Research and Development(R&D)Projects of Shanxi Province(No.201803D31095)。
文摘AIM:To observe and characterize imaging features of macular and optic disc areas in less than 60-year-old patients with early primary open angle glaucoma(POAG)by optical coherence tomography(OCT)and optical coherence tomography angiography(OCTA),and to evaluate the diagnostic value of OCT and OCTA.METHODS:Totally 15 patients(23 eyes)with early POAG as observation group and 30 health people(30 eyes)as normal control group were enrolled in this cross-sectional study.OCTA-based superficial macula vessel density,superficial macula perfusion density,superficial optic disc vessel density,superficial optic disc perfusion density and spectral domain OCT(SD-OCT)-based macular area thickness,ganglion cell complex(GCC)thickness and retinal nerve fiber layer(RNFL)thickness were measured in the two groups.Independent t-test and receiver operating characteristic curve were used for analysis.Area under the receiver operating characteristic curves(AUROC)were used to measure the diagnostic utility.RESULTS:Among all the parameters,the optimal diagnostic utility parameter was the superficial vessel density in the macular area(except the center of the macula),and the AUROC reached 0.98.The diagnostic utility of macular area perfusion density(except the center of the macula)was similar to that of superficial vessel density in the macular area,and the AUROC was above 0.97.Followed by the diagnostic utility of vessel density in the optic disc area,the best parameter was the inner ring of the vessel density,and its AUROC reached 0.97.The diagnostic utility of perfusion density in the optic disc area was slightly lower than that of vessel density in the optic disc area.The best parameter was the central optic disc perfusion density,and its AUROC was 0.95.The SD-OCT-based diagnostic utility parameters were generally lower than that mentioned above,the top three parameters were the inferior RNFL thickness(AUROC=0.919),the superior(AUROC=0.919)and the inferior GCC thickness(AUROC=0.9077).CONCLUSION:The OCT-based diagnostic utility parameters are generally lower than the OCTA-based diagnostic utility parameters.OCTA has an important clinical application value in diagnosis and evaluation for less than 60-year-old patients with early POAG.
