Treatments for macular oedema following central retinal vein occlusion: systematic review.
Treatments for macular oedema following central retinal vein occlusion: systematic review.
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DOI：
10.1136/bmjopen-2013-004120
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发表时间：
2014-02-10
期刊：
影响因子：
2.9
通讯作者：
Waugh N
中科院分区：
文献类型：
--
作者：
Ford JA;Clar C;Lois N;Barton S;Thomas S;Court R;Shyangdan D;Waugh N
系统回顾视网膜中央静脉阻塞（CRVO）所致黄斑水肿治疗的随机对照试验（RCT）证据。MEDLINE、EMBASE、CDSR、DARE、HTA、NHSEED、CENTRAL和会议摘要（2005年1月至2013年3月）。纳入了至少随访12个月的评估CRVO药物治疗的RCT，无语言限制。2名作者筛选标题和摘要，并进行数据提取和科克伦偏倚风险评估。由于缺乏可比研究，无法进行荟萃分析。纳入了8项研究（35篇文章，1714只眼），评估了阿柏西普（n=2）、曲安西龙（n= 2）、贝伐珠单抗（n =1）、培加他尼（n=1）、地塞米松（n=1）和雷珠单抗（n=1）。总体而言，贝伐单抗、雷珠单抗、阿柏西普和曲安西龙导致视力改善≥15个字母的受试者比例临床显著增加，活性药物组40-60%的受试者视力改善≥15个字母，而假手术组为12-28%。哌加他尼和地塞米松的结果混合。类固醇与白内障形成和眼内压升高有关。与对照组相比，贝伐单抗、雷珠单抗、阿柏西普或哌加他尼组的不良事件总体上没有增加。生活质量报告不佳。所有研究的偏倚风险均较低或不明确。所有研究均评价了相对较短的主要随访期（1年或更短）。 大多数有一个未设盲的扩展阶段。没有正面交锋的证据。纳入的大多数受试者患有非缺血性CRVO。贝伐单抗、雷珠单抗、阿柏西普和曲安西龙似乎可有效治疗继发于CRVO的黄斑水肿。需要关于有效性和安全性的长期数据。需要进行头对头试验和研究来确定“反应者”，以帮助临床医生为患者做出正确的选择。需要进行旨在改善缺血性CRVO患者视力的研究。
To review systematically the randomised controlled trial (RCT) evidence for treatment of macular oedema due to central retinal vein occlusion (CRVO). MEDLINE, EMBASE, CDSR, DARE, HTA, NHSEED, CENTRAL and meeting abstracts (January 2005 to March 2013). RCTs with at least 12 months of follow-up assessing pharmacological treatments for CRVO were included with no language restrictions. 2 authors screened titles and abstracts and conducted data extracted and Cochrane risk of bias assessment. Meta-analysis was not possible due to lack of comparable studies. 8 studies (35 articles, 1714 eyes) were included, assessing aflibercept (n=2), triamcinolone (n=2), bevacizumab (n=1), pegaptanib (n=1), dexamethasone (n=1) and ranibizumab (n=1). In general, bevacizumab, ranibizumab, aflibercept and triamcinolone resulted in clinically significant increases in the proportion of participants with an improvement in visual acuity of ≥15 letters, with 40–60% gaining ≥15 letters on active drugs, compared to 12–28% with sham. Results for pegaptanib and dexamethasone were mixed. Steroids were associated with cataract formation and increased intraocular pressure. No overall increase in adverse events was found with bevacizumab, ranibizumab, aflibercept or pegaptanib compared with control. Quality of life was poorly reported. All studies had a low or unclear risk of bias. All studies evaluated a relatively short primary follow-up (1 year or less). Most had an unmasked extension phase. There was no head-to-head evidence. The majority of participants included had non-ischaemic CRVO. Bevacizumab, ranibizumab, aflibercept and triamcinolone appear to be effective in treating macular oedema secondary to CRVO. Long-term data on effectiveness and safety are needed. Head-to-head trials and research to identify ‘responders’ is needed to help clinicians make the right choices for their patients. Research aimed to improve sight in people with ischaemic CRVO is required.
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影响因子：
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作者：
Curtis, Lesley H.;Hammill, Bradley G.;Cousins, Scott W.
通讯作者：
Cousins, Scott W.
DOI：
10.1001/archophthalmol.2010.193
发表时间：
2010-09
期刊：
Archives of ophthalmology (Chicago, Ill. : 1960)
影响因子：
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2011-06-01
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DOI：
10.1007/s00417-012-2134-1
发表时间：
2013-04-01
影响因子：
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