PMID- 35422768
OWN - NLM
STAT- MEDLINE
DCOM- 20220418
LR  - 20220519
IS  - 1664-2392 (Print)
IS  - 1664-2392 (Electronic)
IS  - 1664-2392 (Linking)
VI  - 13
DP  - 2022
TI  - Effectiveness of Panretinal Photocoagulation Plus Intravitreal Anti-VEGF 
      Treatment Against PRP Alone for Diabetic Retinopathy: A Systematic Review With 
      Meta-Analysis.
PG  - 807687
LID - 10.3389/fendo.2022.807687 [doi]
LID - 807687
AB  - OBJECTIVE: To compare the efficacy and safety of panretinal photocoagulation 
      (PRP) combined with intravitreal anti-vascular endothelial growth factor 
      (anti-VEGF) against PRP monotherapy for diabetic retinopathy (DR). METHODS: We 
      searched Pubmed, Cochrane Library, Web of Science, Embase, and Science Direct 
      Register of Controlled Trials from April 2011 to January 2021 to identify the 
      randomized trials that compared the efficacy and safety between PRP combined with 
      intravitreal anti-VEGF and PRP monotherapy for DR. We searched in the following 
      databases between April 2011 and January 2021: Pubmed, Cochrane Library, Web of 
      Science, Embase, and Science Direct without any restriction of countries or 
      article type. The outcome measures were the best-corrected visual acuity (BCVA), 
      neovascularization on the disc (NVD), neovascularization elsewhere (NVE), central 
      macula thickness (CMT), and total retinal volume over time (FAS), and we also 
      observed the adverse events (AEs) between the two groups. RESULTS: A total of 351 
      studies were identified, of which 11 studies were included in this meta-analysis 
      (N = 1,182 eyes). Compared with PRP monotherapy, PRP plus anti-VEGF combination 
      treatment produced a mean reduction in BCVA in units of logMAR of -0.23 [95% CI 
      -0.32, -0.15] or a mean improvement in BCVA in units of letters of 4.99 [95% CI 
      3.79, 6.19], and also yielded a mean reduction in NVD of -28.41 [95% CI -30.30, 
      -26.52], in NVE of -1.33 [95% CI -1.52, -1.14], in CMT of -1.33 [95% CI -1.52, 
      -1.14], or in total FAS. No significant difference was observed on the risk of 
      AEs as vitreous hemorrhage, elevation in intraocular pressure, and cataract 
      between the two different treatments. CONCLUSION: PRP with anti-VEGF combination 
      treatment can achieve the ideal efficacy on DR by improving BCVA and NV 
      regression, with no potential increased incidence of AEs, which proves that the 
      combination therapy is an efficient therapeutic strategy that could improve the 
      management of patients with DR.
CI  - Copyright (c) 2022 Zhang, Geng and Sang.
FAU - Zhang, Wuyue
AU  - Zhang W
AD  - School of Medicine, Nantong University, Nantong, China.
FAU - Geng, Jinsong
AU  - Geng J
AD  - Department of Medical Informatics, School of Medicine, Nantong University, 
      Nantong, China.
FAU - Sang, Aimin
AU  - Sang A
AD  - Affiliated Hospital of Nantong University, Nantong, China.
LA  - eng
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20220329
PL  - Switzerland
TA  - Front Endocrinol (Lausanne)
JT  - Frontiers in endocrinology
JID - 101555782
RN  - 0 (Angiogenesis Inhibitors)
RN  - 0 (Vascular Endothelial Growth Factor A)
SB  - IM
MH  - Angiogenesis Inhibitors/therapeutic use
MH  - *Diabetes Mellitus/drug therapy
MH  - *Diabetic Retinopathy/drug therapy
MH  - Humans
MH  - Laser Coagulation
MH  - Vascular Endothelial Growth Factor A
MH  - Visual Acuity
PMC - PMC9004461
OTO - NOTNLM
OT  - anti-vascular endothelial growth factor
OT  - combination therapy
OT  - diabetic retinopathy
OT  - meta-analysis
OT  - panretinal photocoagulation
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/04/16 06:00
MHDA- 2022/04/19 06:00
PMCR- 2022/01/01
CRDT- 2022/04/15 05:24
PHST- 2021/11/02 00:00 [received]
PHST- 2022/01/31 00:00 [accepted]
PHST- 2022/04/15 05:24 [entrez]
PHST- 2022/04/16 06:00 [pubmed]
PHST- 2022/04/19 06:00 [medline]
PHST- 2022/01/01 00:00 [pmc-release]
AID - 10.3389/fendo.2022.807687 [doi]
PST - epublish
SO  - Front Endocrinol (Lausanne). 2022 Mar 29;13:807687. doi: 
      10.3389/fendo.2022.807687. eCollection 2022.