PMID- 24376538
OWN - NLM
STAT- MEDLINE
DCOM- 20150303
LR  - 20220330
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 8
IP  - 12
DP  - 2013
TI  - A meta-analysis of anti-vascular endothelial growth factor remedy for macular 
      edema secondary to central retinal vein occlusion.
PG  - e82454
LID - 10.1371/journal.pone.0082454 [doi]
LID - e82454
AB  - BACKGROUND: Central retinal vein occlusion (CRVO) associates with severe vision 
      outcome and no proven beneficial treatment. Our meta-analysis intended to 
      appraise the efficacy and safety of anti-vascular endothelial growth factor 
      (anti-VEGF) agents in macular edema (ME) following CRVO. METHODS: Data were 
      collected and analyzed by Review Manager 5.2.1. We employed a random-effects 
      model to eliminate between-study heterogeneity. Nfs (called fail-safe number) was 
      calculated to evaluate the publication bias. RESULTS: We included 5 trials 
      consisting 323 cases and 281 controls. Primary outcomes showed that overall 
      comparison of anti-VEGF agents with placebo control yielded a 374% and 136% 
      increased tendency for a gain of 15 letters or more on Early Treatment Diabetic 
      Retinopathy Study (ETDRS) chart (95% confidence interval [95% CI]: 2.43-9.23; 
      P<0.00001; I(2) = 59%, 95% CI: 1.60-3.49; P<0.0001; I(2)  = 0%, respectively) at 
      6 and 12 months. Secondary outcomes showed that a 90% and 77% decreased risk at 6 
      and 12 months for a loss of 15 letters or more. The overall mean difference 
      showed a statistically significance in best-corrected visual acuity (BCVA) on 
      each time point. However, changes of central retinal thickness (CRT) lost 
      significance at 12 months after 6-month as-needed treatment. The incidence of 
      adverse events (AEs) had no statistical difference between anti-VEGF and placebo 
      groups. Subgroup analyses indicated that patients receiving Aflibercept got the 
      highest tendency to gain 15 letters or more (OR = 9.78; 95% CI: 4.43-21.56; 
      P<0.00001). Age controlled analysis suggested a weaken tendency of BCVA 
      improvement in age over 50 (MD = 12.26; 95% CI: 7.55-16.98; P<0.00001). Subgroup 
      analysis by clinical classification showed a strengthen difference of BCVA 
      changes at 6 months in ischemic type (MD = 19.65 letters, 95% CI: 13.15 to 26.14 
      letters, P<0.00001). CONCLUSIONS: Our results showed that anti-VEGF agents were 
      superior to placebo in CRVO-ME treatment with no statistically significant AEs, 
      especially in younger people and for ischemic type.
FAU - Huang, Peirong
AU  - Huang P
AD  - Department of Ophthalmology, Shanghai First People's Hospital, School of 
      Medicine, Shanghai Jiao Tong University, Shanghai, China.
FAU - Niu, Wenquan
AU  - Niu W
AD  - State Key Laboratory of Medical Genomics, Ruijin Hospital, School of Medicine, 
      Shanghai Jiao Tong University, Shanghai, China ; Department of Hypertension, 
      Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 
      China.
FAU - Ni, Zhentian
AU  - Ni Z
AD  - Department of Surgery, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong 
      University, Shanghai, China.
FAU - Wang, Renzuo
AU  - Wang R
AD  - Department of Surgery, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong 
      University, Shanghai, China.
FAU - Sun, Xiaodong
AU  - Sun X
AD  - Department of Ophthalmology, Shanghai First People's Hospital, School of 
      Medicine, Shanghai Jiao Tong University, Shanghai, China ; Eye Research Institute 
      of Shanghai Jiao Tong University, Shanghai, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
DEP - 20131223
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Angiogenesis Inhibitors)
RN  - 0 (Vascular Endothelial Growth Factor A)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Angiogenesis Inhibitors/adverse effects/pharmacology/*therapeutic use
MH  - Diabetic Retinopathy/complications
MH  - Female
MH  - Humans
MH  - Macular Edema/*drug therapy/*etiology/physiopathology
MH  - Male
MH  - Middle Aged
MH  - Randomized Controlled Trials as Topic
MH  - Retinal Vein Occlusion/*complications/physiopathology
MH  - Vascular Endothelial Growth Factor A/*antagonists & inhibitors
MH  - Visual Acuity
PMC - PMC3871640
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2014/01/01 06:00
MHDA- 2015/03/04 06:00
PMCR- 2013/12/23
CRDT- 2013/12/31 06:00
PHST- 2013/05/15 00:00 [received]
PHST- 2013/10/23 00:00 [accepted]
PHST- 2013/12/31 06:00 [entrez]
PHST- 2014/01/01 06:00 [pubmed]
PHST- 2015/03/04 06:00 [medline]
PHST- 2013/12/23 00:00 [pmc-release]
AID - PONE-D-13-19935 [pii]
AID - 10.1371/journal.pone.0082454 [doi]
PST - epublish
SO  - PLoS One. 2013 Dec 23;8(12):e82454. doi: 10.1371/journal.pone.0082454. 
      eCollection 2013.