AIM:To evaluate the effectiveness and safety of intravitreal ranibizumab(IVR)for diabetic macular edema(DME)in vitrectomized versus non-vitrectomized eyes.METHODS:The PubMed,EMBASE,Web of Science,Cochrane,EBSCO were c...AIM:To evaluate the effectiveness and safety of intravitreal ranibizumab(IVR)for diabetic macular edema(DME)in vitrectomized versus non-vitrectomized eyes.METHODS:The PubMed,EMBASE,Web of Science,Cochrane,EBSCO were comprehensively searched for studies comparing vitrectomized and non-vitrectomized eyes with DME.Clinical outcomes of best-corrected visual acuity(BCVA),central macular thickness(CMT),the mean number of intravitreal injection and adverse events were extracted and analyzed.RESULTS:Six studies involving 641 eyes were included.Final visual gain significantly improved and CMT significantly reduced in vitrectomized eyes at 6mo and 12mo visits(P<0.05).Although the mean reduction in CMT among non-vitrectomized eyes was significantly greater than in vitrectomized eyes at the 6mo[mean difference(MD)=53.57,95%confidence interval(CI):28.03 to 78.72,P<0.0001]and 12mo(MD=49.65,95%CI:19.58 to 79.72,P=0.01),no significant difference was detected in improvement in BCVA at either 6mo(MD=0.05,95%CI:-0.02 to 0.13,P=0.14)or 12mo(MD=0.03,95%CI:-0.04 to 0.09,P=0.43).Injection number of ranibizumab in non-vitrectomized eyes was significantly less than that in vitrectomized eyes during 6-month period(MD=0.60,95%CI:0.16 to 1.04,P=0.008),while there was no statistically significant difference between the two groups during 12mo of follow-up.CONCLUSION:Evidence from current study suggests that IVR was useful for both vitrectomized group and nonvitrectomized group with DME.Although less reduction in macular thickness is found in vitrectomized group,visual improvement between two groups is similar.展开更多
AIM:To evaluate and compare the anatomical and functional outcomes and negative effects of the three anti-vascular endothelial growth factor(VEGF)drugs in the treatment of macular edema(ME)due to retinal vein occlusio...AIM:To evaluate and compare the anatomical and functional outcomes and negative effects of the three anti-vascular endothelial growth factor(VEGF)drugs in the treatment of macular edema(ME)due to retinal vein occlusion(RVO)based on the evidence pooled from current clinical trials and observational studies.METHODS:A systematic literature search was conducted on nine online databases from inception until April 30,2022.The main endpoints were best corrected visual acuity(BCVA),central macular thickness(CMT),and adverse events(AEs).Cumulative Meta-analysis was conducted to synthesize the outcomes of the drugs.The retrieved data were analyzed using Stata software(version 12.0).RESULTS:A total of 20 studies comprising 1674 eyes met the inclusion criteria to the Meta-analysis.It was observed that conbercept and aflibercept had better visual acuity effects compared with ranibizumab at 1mo[weight mean difference(WMD)=-0.03,P=0.001;WMD=-0.05,P=0.019],but the effects were not different from that of ranibizumab at 6mo.Moreover,there was not statistically significant dif ference in the propor tion of patients gaining≥15 letters at 12-24mo between aflibercept and ranibizumab[odds ratio(OR)=1.16,P=0.427].Conbercept had higher mean CMT change effects at 1mo(WMD=-14.43,P=0.014)and 6mo(WMD=-35.63,P≤0.001)compared with ranibizumab.Meanwhile,the mean CMT change effects at 1mo(WMD=-10.14,P=0.170),6mo(WMD=-26.98,P=0.140)and 12-24mo(WMD=-12.34,P=0.071)were comparable among the groups.Similarly,AEs were not significantly different among the treatments(OR=0.75,P=0.305;OR=1.04,P=0.89).The stability of effect size of mean BCVA and CMT improved with the increase in sample size.Aflibercept and conbercept required fewer injections compared with ranibizumab.CONCLUSION:This is the first study to evaluate the efficacy and AEs of intravitreal administration of conbercept,ranibizumab,and aflibercept in the treatment of RVOME.Intravitreal aflibercept or conbercept results in better mean change in vision and CMT reduction compared with ranibizumab.Conbercept can be considered to be a promising and innovative drug with good anti-VEGF effects.展开更多
AIM:To identify risk factors of recurrence of this disorder after intravitreal ranibizumab(IVR)monotherapy.METHODS:Totally 33 eyes of 19 patients who underwent initial IVR treatments for type 1 retinopathy of prematur...AIM:To identify risk factors of recurrence of this disorder after intravitreal ranibizumab(IVR)monotherapy.METHODS:Totally 33 eyes of 19 patients who underwent initial IVR treatments for type 1 retinopathy of prematurity(ROP)at our center were retrospectively reviewed between April 1,2016 and December 31,2017.Patient demographics,the side of ROP,multiple gestations,Apgar scores,zone,stage,plus disease,postmenstrual age at injection,surfactant therapy,blood transfusion therapy,hemorrhage before IVR,hemorrhage after IVR,gestational diabetes mellitus,pregnancy-induced hypertension,anemia,intraventricular hemorrhage,sepsis,respiratory distress syndrome,carbohemia,and congenital heart defects were recorded.Adjusted hazard ratios(HRs)and 95%confidence intervals were determined after adjusting for potential confounders using multivariate proportional Cox regression.RESULTS:Of the 33 eyes,12(36.4%)had ROP recurrences 45.3(5.1,50.9)mo after initial IVR treatments.The independent risk factors for ROP recurrences were zone(ⅡvsⅠ,HR:0.056,P=0.003)and gestational diabetes mellitus(no vs yes,HR:0.095,P<0.001).The mean uncorrected visual acuity for four recurrence eyes was 0.46 logMAR(0.13,0.70)at 55.0(51.0,58.9)mo after the initial IVR treatment.The mean uncorrected visual acuity for 10 eyes without recurrence was 0.46 logMAR(0.19,0.63)at 48.0(43.8,58.4)mo after the initial IVR treatment.CONCLUSION:Two independent risk factors for type 1 ROP recurrence after IVR treatment involving zoneⅠand gestational diabetes mellitus are identified,and the mean uncorrected visual acuity is 0.46 logMAR at 51.0(44.0,58.9)mo.The findings of this study are important for followup management and for improving the visual function of ROP patients.展开更多
Objective:To analyze the effect of triamcinolone acetonide combined with ranibizumab in patients with fundus diseases.Methods:100 patients with fundus diseases admitted from January 2018 to January 2023 were selected....Objective:To analyze the effect of triamcinolone acetonide combined with ranibizumab in patients with fundus diseases.Methods:100 patients with fundus diseases admitted from January 2018 to January 2023 were selected.The patients were separated into two groups according to the random number table method,with 50 cases in the control group(treated with ranibizumab),and 50 cases in the observation group(treated with triamcinolone acetonide combined with ranibizumab).The clinical effects of both treatment regimens were compared.Results:The time taken for symptom disappearance of the observation group was shorter than that of the control group(P<0.05).The observation group had higher naked-eye visual acuity(4.18±0.89)compared to the control group.Besides,the observation group also had lower intraocular pressure(14.19±1.33 mmHg)and retinal thickness(283.14±3.29μm),with(P<0.05)compared to the control group.Moreover,the observation group had a lower adverse reaction rate and a higher quality of life(P<0.05).Conclusion:The application of triamcinolone acetonide combined with ranibizumab treatment can quickly relieve the clinical symptoms of patients with fundus disease,improve visual acuity,intraocular pressure,and retinal thickness,with low adverse reaction rate and better prognosis and quality of life.展开更多
文摘AIM:To evaluate the effectiveness and safety of intravitreal ranibizumab(IVR)for diabetic macular edema(DME)in vitrectomized versus non-vitrectomized eyes.METHODS:The PubMed,EMBASE,Web of Science,Cochrane,EBSCO were comprehensively searched for studies comparing vitrectomized and non-vitrectomized eyes with DME.Clinical outcomes of best-corrected visual acuity(BCVA),central macular thickness(CMT),the mean number of intravitreal injection and adverse events were extracted and analyzed.RESULTS:Six studies involving 641 eyes were included.Final visual gain significantly improved and CMT significantly reduced in vitrectomized eyes at 6mo and 12mo visits(P<0.05).Although the mean reduction in CMT among non-vitrectomized eyes was significantly greater than in vitrectomized eyes at the 6mo[mean difference(MD)=53.57,95%confidence interval(CI):28.03 to 78.72,P<0.0001]and 12mo(MD=49.65,95%CI:19.58 to 79.72,P=0.01),no significant difference was detected in improvement in BCVA at either 6mo(MD=0.05,95%CI:-0.02 to 0.13,P=0.14)or 12mo(MD=0.03,95%CI:-0.04 to 0.09,P=0.43).Injection number of ranibizumab in non-vitrectomized eyes was significantly less than that in vitrectomized eyes during 6-month period(MD=0.60,95%CI:0.16 to 1.04,P=0.008),while there was no statistically significant difference between the two groups during 12mo of follow-up.CONCLUSION:Evidence from current study suggests that IVR was useful for both vitrectomized group and nonvitrectomized group with DME.Although less reduction in macular thickness is found in vitrectomized group,visual improvement between two groups is similar.
基金Supported by the Natural Science Foundation of Hainan Province(No.821QN1005)Hainan Provincial Health Commission Project(No.21A200067)Hainan Provincial Classification of Project(No.ZDYF2020110)。
文摘AIM:To evaluate and compare the anatomical and functional outcomes and negative effects of the three anti-vascular endothelial growth factor(VEGF)drugs in the treatment of macular edema(ME)due to retinal vein occlusion(RVO)based on the evidence pooled from current clinical trials and observational studies.METHODS:A systematic literature search was conducted on nine online databases from inception until April 30,2022.The main endpoints were best corrected visual acuity(BCVA),central macular thickness(CMT),and adverse events(AEs).Cumulative Meta-analysis was conducted to synthesize the outcomes of the drugs.The retrieved data were analyzed using Stata software(version 12.0).RESULTS:A total of 20 studies comprising 1674 eyes met the inclusion criteria to the Meta-analysis.It was observed that conbercept and aflibercept had better visual acuity effects compared with ranibizumab at 1mo[weight mean difference(WMD)=-0.03,P=0.001;WMD=-0.05,P=0.019],but the effects were not different from that of ranibizumab at 6mo.Moreover,there was not statistically significant dif ference in the propor tion of patients gaining≥15 letters at 12-24mo between aflibercept and ranibizumab[odds ratio(OR)=1.16,P=0.427].Conbercept had higher mean CMT change effects at 1mo(WMD=-14.43,P=0.014)and 6mo(WMD=-35.63,P≤0.001)compared with ranibizumab.Meanwhile,the mean CMT change effects at 1mo(WMD=-10.14,P=0.170),6mo(WMD=-26.98,P=0.140)and 12-24mo(WMD=-12.34,P=0.071)were comparable among the groups.Similarly,AEs were not significantly different among the treatments(OR=0.75,P=0.305;OR=1.04,P=0.89).The stability of effect size of mean BCVA and CMT improved with the increase in sample size.Aflibercept and conbercept required fewer injections compared with ranibizumab.CONCLUSION:This is the first study to evaluate the efficacy and AEs of intravitreal administration of conbercept,ranibizumab,and aflibercept in the treatment of RVOME.Intravitreal aflibercept or conbercept results in better mean change in vision and CMT reduction compared with ranibizumab.Conbercept can be considered to be a promising and innovative drug with good anti-VEGF effects.
文摘AIM:To identify risk factors of recurrence of this disorder after intravitreal ranibizumab(IVR)monotherapy.METHODS:Totally 33 eyes of 19 patients who underwent initial IVR treatments for type 1 retinopathy of prematurity(ROP)at our center were retrospectively reviewed between April 1,2016 and December 31,2017.Patient demographics,the side of ROP,multiple gestations,Apgar scores,zone,stage,plus disease,postmenstrual age at injection,surfactant therapy,blood transfusion therapy,hemorrhage before IVR,hemorrhage after IVR,gestational diabetes mellitus,pregnancy-induced hypertension,anemia,intraventricular hemorrhage,sepsis,respiratory distress syndrome,carbohemia,and congenital heart defects were recorded.Adjusted hazard ratios(HRs)and 95%confidence intervals were determined after adjusting for potential confounders using multivariate proportional Cox regression.RESULTS:Of the 33 eyes,12(36.4%)had ROP recurrences 45.3(5.1,50.9)mo after initial IVR treatments.The independent risk factors for ROP recurrences were zone(ⅡvsⅠ,HR:0.056,P=0.003)and gestational diabetes mellitus(no vs yes,HR:0.095,P<0.001).The mean uncorrected visual acuity for four recurrence eyes was 0.46 logMAR(0.13,0.70)at 55.0(51.0,58.9)mo after the initial IVR treatment.The mean uncorrected visual acuity for 10 eyes without recurrence was 0.46 logMAR(0.19,0.63)at 48.0(43.8,58.4)mo after the initial IVR treatment.CONCLUSION:Two independent risk factors for type 1 ROP recurrence after IVR treatment involving zoneⅠand gestational diabetes mellitus are identified,and the mean uncorrected visual acuity is 0.46 logMAR at 51.0(44.0,58.9)mo.The findings of this study are important for followup management and for improving the visual function of ROP patients.
文摘Objective:To analyze the effect of triamcinolone acetonide combined with ranibizumab in patients with fundus diseases.Methods:100 patients with fundus diseases admitted from January 2018 to January 2023 were selected.The patients were separated into two groups according to the random number table method,with 50 cases in the control group(treated with ranibizumab),and 50 cases in the observation group(treated with triamcinolone acetonide combined with ranibizumab).The clinical effects of both treatment regimens were compared.Results:The time taken for symptom disappearance of the observation group was shorter than that of the control group(P<0.05).The observation group had higher naked-eye visual acuity(4.18±0.89)compared to the control group.Besides,the observation group also had lower intraocular pressure(14.19±1.33 mmHg)and retinal thickness(283.14±3.29μm),with(P<0.05)compared to the control group.Moreover,the observation group had a lower adverse reaction rate and a higher quality of life(P<0.05).Conclusion:The application of triamcinolone acetonide combined with ranibizumab treatment can quickly relieve the clinical symptoms of patients with fundus disease,improve visual acuity,intraocular pressure,and retinal thickness,with low adverse reaction rate and better prognosis and quality of life.
