Meta-analysis of anti-VEGF drugs combined steroids for macular edema secondary to retinal vein occlusion

Abstract

AIM: To evaluate the clinical effects of using anti-VEGF drugs combined with Steroids to treat macular edema(ME)secondary to retinal vein occlusion. METHODS: Chinese and English electronic databases(Pubmed, Embase, Cochrane, CNKI, Wanfang and Weipu)were searched to obtain qualified random controlled test(RCT)researches from their foundation to January 2020. According to inclusion and exclusion criteria, two researchers retrieved the literature independently, extracted data and evaluate methodological quality. Review Manager 5.3 was used for Meta-analysis.RESULTS: A total of 5 RCTs were identified with 212 patients. There was no significant difference in patients' best correct visual acuity(BCVA)improvement in 1mo, 3mo and 6mo between anti-VEGF combined with steroids and anti-VEGF monopoly. Significant difference was found in the relieve of ME in 1mo and 3mo(1mo: MD=-20.89, 95% CI: -34.65 to -7.13, P=0.003; 3mo: MD=-22.83, 95% CI: -33.68 to -11.97, P<0.0001), but not in 6mo between two groups. As for side effects and complications, the combination group occurs more often than the monopoly group(P=0.02). Meanwhile, significant difference was found in the number of injections between two groups(P<0.001). CONCLUSION: Compared with the single use of anti-VEGF drugs, anti-VEGF drugs combined with corticosteroids for the treatment of ME secondary to RVO have the characteristics of rapid onset, fewer injections, and more economical. The treatment process should closely follow the patient's intraocular pressure and lens status.

Keywords

• retinal vein occlusion
• macular edema
• anti-vegf drugs
• corticosteroids
• random controlled trail
• meta-analysis