File Download
  Links for fulltext
     (May Require Subscription)
Supplementary

Article: A meta-analysis of the effect of a dexamethasone intravitreal implant versus intravitreal anti-vascular endothelial growth factor treatment for diabetic macular edema

TitleA meta-analysis of the effect of a dexamethasone intravitreal implant versus intravitreal anti-vascular endothelial growth factor treatment for diabetic macular edema
Authors
KeywordsAnti-VEGF
Dexamethasone implant
Diabetic macular edema
Meta-analysis
Ozurdex
Issue Date2018
PublisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcophthalmol/
Citation
BMC Ophthalmology, 2018, v. 18 n. 1, p. article no. 121 How to Cite?
AbstractBACKGROUND: This meta-analysis evaluated the effectiveness and safety of dexamethasone (DEX) implant and intravitreal anti-vascular endothelial growth factor (VEGF) treatment for diabetic macular edema (DME). METHODS: The PubMed, Embase, clinicaltrials.gov website and Cochrane Library databases were comprehensively searched for studies comparing DEX implant with anti-VEGF in patients with DME. Best-corrected visual acuity (BCVA), central subfield thickness (CST) and adverse events were extracted from the final eligible studies. Review Manager (RevMan) 5.3 for Mac was used to analyze the data and GRADE profiler were used to access the quality of outcomes. RESULTS: Based on four randomized clinical trials assessing a total of 521 eyes, the DEX implant can achieve visual acuity improvement for DME at rates similar to those achieved via anti-VEGF treatment (mean difference [MD] = - 0.43, P = 0.35), with superior anatomic outcomes at 6 months (MD = - 86.71 μm, P = 0.02), while requiring fewer injections, in comparison to anti-VEGF treatment. Although the mean reduction in CST did not showed significant difference at 12 months (MD = - 33.77 μm, P = 0.21), the significant in BCVA from baseline to 12 months supported the anti-VEGF treatment (MD = - 3.26, P < 0.00001). No statistically significant differences in terms of the serious adverse events. However, use of the DEX implant has higher risk of intraocular pressure elevation and cataract than anti-VEGF treatment. CONCLUSIONS: Compared with anti-VEGF, DEX implant improved anatomical outcomes significantly. However, this did not translate to improved visual acuity, which may be due to the progression of cataract. Therefore, the DEX implant may be recommended as a first chioce for select cases, such as for pseudophakic eyes, anti-VEGF-resistant eyes, or patients reluctant to receive intravitreal injections frequently
Persistent Identifierhttp://hdl.handle.net/10722/277425
ISSN
2023 Impact Factor: 1.7
2023 SCImago Journal Rankings: 0.749
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorHe, Y-
dc.contributor.authorRen, X-J-
dc.contributor.authorHu, B-J-
dc.contributor.authorLam, W-C-
dc.contributor.authorLi, X-R-
dc.date.accessioned2019-09-20T08:50:50Z-
dc.date.available2019-09-20T08:50:50Z-
dc.date.issued2018-
dc.identifier.citationBMC Ophthalmology, 2018, v. 18 n. 1, p. article no. 121-
dc.identifier.issn1471-2415-
dc.identifier.urihttp://hdl.handle.net/10722/277425-
dc.description.abstractBACKGROUND: This meta-analysis evaluated the effectiveness and safety of dexamethasone (DEX) implant and intravitreal anti-vascular endothelial growth factor (VEGF) treatment for diabetic macular edema (DME). METHODS: The PubMed, Embase, clinicaltrials.gov website and Cochrane Library databases were comprehensively searched for studies comparing DEX implant with anti-VEGF in patients with DME. Best-corrected visual acuity (BCVA), central subfield thickness (CST) and adverse events were extracted from the final eligible studies. Review Manager (RevMan) 5.3 for Mac was used to analyze the data and GRADE profiler were used to access the quality of outcomes. RESULTS: Based on four randomized clinical trials assessing a total of 521 eyes, the DEX implant can achieve visual acuity improvement for DME at rates similar to those achieved via anti-VEGF treatment (mean difference [MD] = - 0.43, P = 0.35), with superior anatomic outcomes at 6 months (MD = - 86.71 μm, P = 0.02), while requiring fewer injections, in comparison to anti-VEGF treatment. Although the mean reduction in CST did not showed significant difference at 12 months (MD = - 33.77 μm, P = 0.21), the significant in BCVA from baseline to 12 months supported the anti-VEGF treatment (MD = - 3.26, P < 0.00001). No statistically significant differences in terms of the serious adverse events. However, use of the DEX implant has higher risk of intraocular pressure elevation and cataract than anti-VEGF treatment. CONCLUSIONS: Compared with anti-VEGF, DEX implant improved anatomical outcomes significantly. However, this did not translate to improved visual acuity, which may be due to the progression of cataract. Therefore, the DEX implant may be recommended as a first chioce for select cases, such as for pseudophakic eyes, anti-VEGF-resistant eyes, or patients reluctant to receive intravitreal injections frequently-
dc.languageeng-
dc.publisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcophthalmol/-
dc.relation.ispartofBMC Ophthalmology-
dc.rightsBMC Ophthalmology. Copyright © BioMed Central Ltd.-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectAnti-VEGF-
dc.subjectDexamethasone implant-
dc.subjectDiabetic macular edema-
dc.subjectMeta-analysis-
dc.subjectOzurdex-
dc.titleA meta-analysis of the effect of a dexamethasone intravitreal implant versus intravitreal anti-vascular endothelial growth factor treatment for diabetic macular edema-
dc.typeArticle-
dc.identifier.emailLam, W-C: waichlam@hku.hk-
dc.identifier.authorityLam, W-C=rp02162-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1186/s12886-018-0779-1-
dc.identifier.pmid29784048-
dc.identifier.pmcidPMC5963018-
dc.identifier.scopuseid_2-s2.0-85047308545-
dc.identifier.hkuros305713-
dc.identifier.volume18-
dc.identifier.issue1-
dc.identifier.spagearticle no. 121-
dc.identifier.epagearticle no. 121-
dc.identifier.isiWOS:000432947500001-
dc.publisher.placeUnited Kingdom-
dc.identifier.issnl1471-2415-

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats