PMID- 27401800
OWN - NLM
STAT- MEDLINE
DCOM- 20170206
LR  - 20181202
IS  - 1471-2415 (Electronic)
IS  - 1471-2415 (Linking)
VI  - 16
DP  - 2016 Jul 11
TI  - Systematic literature review of treatments for management of complications of 
      ischemic central retinal vein occlusion.
PG  - 104
LID - 10.1186/s12886-016-0282-5 [doi]
LID - 104
AB  - BACKGROUND: To understand the clinical and economic outcomes of treatments for 
      managing complications of ischemic central retinal vein occlusion (iCRVO). 
      METHODS: We conducted a systematic literature review by searching multiple 
      databases and ophthalmology conferences from 2004 to 2015. Studies published in 
      English language and populations of age >/=45 years were included. For clinical 
      endpoints, we defined eligibility criteria as randomized controlled trials, 
      prospective before-and-after study designs, and non-randomized studies reporting 
      on treatments in patients with iCRVO. For economic endpoints, all types of study 
      design except cost-of-illness studies were included. We evaluated the definitions 
      of ischemia, clinical and economic endpoints, and rate of development of 
      complications. Risk of bias was assessed for clinical studies using the Cochrane 
      risk-of-bias tool. RESULTS: A total of 20 studies (1338 patients) were included. 
      Treatments included anti-vascular endothelial growth factors (anti-VEGFs), 
      steroids, and procedures primarily targeting macular edema and 
      neovascularization. Ischemia was not defined consistently in the included 
      studies. The level of evidence was mostly low. Most treatments did not improve 
      visual acuity significantly. Development of treatment complications ranged from 
      11 to 57 %. Incremental cost-effectiveness ratios reported for anti-VEGFs and 
      steroids were below the accepted threshold of GB pound30,000, but considering such 
      treatments only ameliorate disease symptoms they seem relatively expensive. 
      CONCLUSIONS: There is a lack of evidence for any intervention being effective in 
      iCRVO, especially in the prevention of neovascularisation. iCRVO poses a 
      significant clinical and economic burden. There is a need to standardize the 
      definition of ischemia, and for innovative treatments which can significantly 
      improve visual outcomes and prevent neovascular complications.
FAU - Bradshaw, Steven E
AU  - Bradshaw SE
AD  - Valid Insight(R), Kemp House, 152 City Road, London, EC1V 2NX, UK. 
      sbradshaw@validinsight.com.
FAU - Gala, Smeet
AU  - Gala S
AD  - Valid Insight(R), Kemp House, 152 City Road, London, EC1V 2NX, UK.
FAU - Nanavaty, Merena
AU  - Nanavaty M
AD  - Market Access Solutions, 575 State Route 28, Raritan, NJ, 08869, USA.
FAU - Shah, Anshul
AU  - Shah A
AD  - Market Access Solutions, 575 State Route 28, Raritan, NJ, 08869, USA.
FAU - Mwamburi, Mkaya
AU  - Mwamburi M
AD  - Market Access Solutions, 575 State Route 28, Raritan, NJ, 08869, USA.
FAU - Kefalas, Panos
AU  - Kefalas P
AD  - Cell Therapy Catapult, 12th Floor Tower Wing, Guy's Hospital, Great Maze Pond, 
      London, SE1 9RT, UK.
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Systematic Review
DEP - 20160711
PL  - England
TA  - BMC Ophthalmol
JT  - BMC ophthalmology
JID - 100967802
RN  - 0 (Angiogenesis Inhibitors)
RN  - 0 (Steroids)
SB  - IM
MH  - Angiogenesis Inhibitors/*therapeutic use
MH  - Glaucoma/etiology/therapy
MH  - Humans
MH  - Macular Edema/etiology/therapy
MH  - Neovascularization, Pathologic/etiology/therapy
MH  - *Ophthalmologic Surgical Procedures
MH  - Retinal Diseases/etiology/therapy
MH  - Retinal Vein Occlusion/*complications/*therapy
MH  - Steroids/*therapeutic use
PMC - PMC4940864
EDAT- 2016/07/13 06:00
MHDA- 2017/02/07 06:00
PMCR- 2016/07/11
CRDT- 2016/07/13 06:00
PHST- 2015/12/02 00:00 [received]
PHST- 2016/06/13 00:00 [accepted]
PHST- 2016/07/13 06:00 [entrez]
PHST- 2016/07/13 06:00 [pubmed]
PHST- 2017/02/07 06:00 [medline]
PHST- 2016/07/11 00:00 [pmc-release]
AID - 10.1186/s12886-016-0282-5 [pii]
AID - 282 [pii]
AID - 10.1186/s12886-016-0282-5 [doi]
PST - epublish
SO  - BMC Ophthalmol. 2016 Jul 11;16:104. doi: 10.1186/s12886-016-0282-5.