Bevacizumab as adjuvant therapy in the management of pterygium: a systematic review and Meta-analysis

AIM： To evaluate the clinical effect of bevacizumab in pterygium treatment.METHODS： A systematic review and quantitative Metaanalysis was performed. Pub Med, EMBASE, Web of Science and Cochrane database were searched for eligible literatures published in English until June 2016. The endpoint was recurrence rate and pooled risk ratio（RR） was calculated.RESULTS： Nine eligible studies were included and Metaanalysis results showed no significantly difference in patients treated with bevacizumab in short term followup [3mo： RR=0.70（0.34, 1.45）; 6mo： RR=0.55（0.23, 1.32）] compared with control groups. No significant effects were observed in favor of bevacizumab in subgroup analyses： patients with subconjunctival injection of bevacizumab [3mo： RR=0.95（0.70, 1.29）; 6mo： RR=0.83（0.55, 1.28）], primary pterygium [3mo： RR=0.59（0.23, 1.54; 6mo： RR=0.59（0.23, 1.53）], simple pterygium excision [3mo： 0.32（0.05, 2.04）, P=0.23; 6mo： 0.27（0.05, 1.53）] and excision with conjunctival autograft [3mo： 1.51（0.25, 9.15）; 6mo： 1.11（0.06, 21.69）].CONCLUSION： In this Meta-analysis, we did not found the significant effect of bevacizumab in pterygium treatment, at least in short term follow-up（3mo and 6mo）.

Laser therapy versus intravitreal injection of anti-VEGF agents in monotherapy of ROP:a Meta-analysis

AIM:To compare the efficacy and safety between laser therapy and anti-vascular endothelial growth factor(VEGF)agents intravitreal injection monotherapy in type-1 retinopathy of prematurity(ROP)and aggressive posterior retinopathy of prematurity(APROP).METHODS:A systematic literature search was performed in PubMed,Cochrane Library,and Embase for original comparable studies.We included studies that compare laser therapy and intravitreal injections of anti-VEGF agents monotherapy in ROP regardless of languages and publication types.RESULTS:Complication incidence was significantly higher in laser therapy group(OR:0.38;95%CI:0.19-0.75;P=0.005).Spherical equivalent(SE)was higher in laser therapy[weighted mean difference(WMD):2.40,95%CI:0.88-3.93;P=0.002].The time between treatment and retreatment was longer in laser therapy group(WMD:8.45,95%CI:5.35-11.55;P<0.00001).Recurrence incidence(OR:0.97;95%CI:0.45-2.09;P=0.93)and retreatment incidence(OR:1.24;95%CI:0.56-2.73;P=0.59)were similar in two approaches.Subgroup analysis between type-1 ROP and APROP was not significant except SE reported in the included studies(P<0.0001).CONCLUSION:This Meta-analysis outcome indicates anti-VEGF agents are as effective as laser treatment,and safer than laser in type-1 ROP and APROP.The degree of myopia in APROP is higher than type-1 ROP.More randomized controlled trials in large sample size should be conducted in the future.