Refractive outcomes after intravitreal injection of antivascular endothelial growth factor versus laser photocoagulation for retinopathy of prematurity: a meta-analysis

ObjectiveTo determine the effects of the intraocular injection of antivascular endothelial growth factor (anti-VEGF) drugs on the refractive status of infants with retinopathy of prematurity (ROP).DesignSystematic review and meta-analysis of the refractive status of infants with ROP who receive anti...

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Published inBMJ open Vol. 11; no. 2; p. e042384
Main Authors Kong, Qihang, Ming, Wai-kit, Mi, Xue-Song
Format Journal Article
LanguageEnglish
Published England British Medical Journal Publishing Group 10.02.2021
BMJ Publishing Group LTD
BMJ Publishing Group
SeriesOriginal research
Subjects
Angiogenesis Inhibitors - therapeutic use
Bevacizumab - therapeutic use
Bias
Child
Developing countries
Drug dosages
Endothelial Growth Factors - therapeutic use
Eye diseases
Humans
Infant
Infant, Newborn
Intravitreal Injections
Laser Coagulation
Lasers
LDCs
Light Coagulation
medical ophthalmology
Meta-analysis
Ophthalmology
paediatric ophthalmology
paediatric surgery
Pediatrics
Retinopathy of Prematurity - drug therapy
Software
Systematic review
Vascular endothelial growth factor
Vascular Endothelial Growth Factor A
Turkey
paediatric surgery
paediatric ophthalmology
medical ophthalmology
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Abstract ObjectiveTo determine the effects of the intraocular injection of antivascular endothelial growth factor (anti-VEGF) drugs on the refractive status of infants with retinopathy of prematurity (ROP).DesignSystematic review and meta-analysis of the refractive status of infants with ROP who receive anti-VEGF drugs.Data sourcesThe PubMed, Web of Science and Embase databases and the ClinicalTrials.gov website were searched up to June 2020.Eligibility criteria when selecting studiesWe included randomised controlled trials (RCTs) and observational studies that compared refractive errors between anti-VEGF drug and laser therapies.Data extraction and synthesisData extraction and risk-of-bias assessments were conducted by two independent reviewers. We used a random-effect model to pool outcomes. The outcome measures were the spherical equivalents, axial length (AL), anterior chamber depth (ACD) and lens thickness (LT).ResultsThirteen studies involving 1850 eyes were assessed: 914 in the anti-VEGF drug group, and 936 in the control (laser) group. Children who received anti-VEGF drug treatment had less myopia than those who received laser therapy (mean difference=1.80 D, 95% CI 0.97 to 2.63, p＜0.0001, I2=78%). The AL, ACD and LT did not reach statistical significance difference between the two groups. The current evidence indicates that the refractive safety in children with ROP is better for anti-VEGF drug treatment than for laser therapy.ConclusionsThis meta-analysis indicates that anti-VEGF drug therapy results in less myopia compared with laser therapy. However, there are relatively few published articles on refractive errors in ROP, and so high-quality and powerful RCTs are needed in the future.PROSPERO registration numberCRD42020160673.
AbstractList ObjectiveTo determine the effects of the intraocular injection of antivascular endothelial growth factor (anti-VEGF) drugs on the refractive status of infants with retinopathy of prematurity (ROP).DesignSystematic review and meta-analysis of the refractive status of infants with ROP who receive anti-VEGF drugs.Data sourcesThe PubMed, Web of Science and Embase databases and the ClinicalTrials.gov website were searched up to June 2020.Eligibility criteria when selecting studiesWe included randomised controlled trials (RCTs) and observational studies that compared refractive errors between anti-VEGF drug and laser therapies.Data extraction and synthesisData extraction and risk-of-bias assessments were conducted by two independent reviewers. We used a random-effect model to pool outcomes. The outcome measures were the spherical equivalents, axial length (AL), anterior chamber depth (ACD) and lens thickness (LT).ResultsThirteen studies involving 1850 eyes were assessed: 914 in the anti-VEGF drug group, and 936 in the control (laser) group. Children who received anti-VEGF drug treatment had less myopia than those who received laser therapy (mean difference=1.80 D, 95% CI 0.97 to 2.63, p＜0.0001, I2=78%). The AL, ACD and LT did not reach statistical significance difference between the two groups. The current evidence indicates that the refractive safety in children with ROP is better for anti-VEGF drug treatment than for laser therapy.ConclusionsThis meta-analysis indicates that anti-VEGF drug therapy results in less myopia compared with laser therapy. However, there are relatively few published articles on refractive errors in ROP, and so high-quality and powerful RCTs are needed in the future.PROSPERO registration numberCRD42020160673.
Objective To determine the effects of the intraocular injection of antivascular endothelial growth factor (anti-VEGF) drugs on the refractive status of infants with retinopathy of prematurity (ROP).Design Systematic review and meta-analysis of the refractive status of infants with ROP who receive anti-VEGF drugs.Data sources The PubMed, Web of Science and Embase databases and the ClinicalTrials.gov website were searched up to June 2020.Eligibility criteria when selecting studies We included randomised controlled trials (RCTs) and observational studies that compared refractive errors between anti-VEGF drug and laser therapies.Data extraction and synthesis Data extraction and risk-of-bias assessments were conducted by two independent reviewers. We used a random-effect model to pool outcomes. The outcome measures were the spherical equivalents, axial length (AL), anterior chamber depth (ACD) and lens thickness (LT).Results Thirteen studies involving 1850 eyes were assessed: 914 in the anti-VEGF drug group, and 936 in the control (laser) group. Children who received anti-VEGF drug treatment had less myopia than those who received laser therapy (mean difference=1.80 D, 95% CI 0.97 to 2.63, p＜0.0001, I2=78%). The AL, ACD and LT did not reach statistical significance difference between the two groups. The current evidence indicates that the refractive safety in children with ROP is better for anti-VEGF drug treatment than for laser therapy.Conclusions This meta-analysis indicates that anti-VEGF drug therapy results in less myopia compared with laser therapy. However, there are relatively few published articles on refractive errors in ROP, and so high-quality and powerful RCTs are needed in the future.PROSPERO registration number CRD42020160673.
To determine the effects of the intraocular injection of antivascular endothelial growth factor (anti-VEGF) drugs on the refractive status of infants with retinopathy of prematurity (ROP).OBJECTIVETo determine the effects of the intraocular injection of antivascular endothelial growth factor (anti-VEGF) drugs on the refractive status of infants with retinopathy of prematurity (ROP).Systematic review and meta-analysis of the refractive status of infants with ROP who receive anti-VEGF drugs.DESIGNSystematic review and meta-analysis of the refractive status of infants with ROP who receive anti-VEGF drugs.The PubMed, Web of Science and Embase databases and the ClinicalTrials.gov website were searched up to June 2020.DATA SOURCESThe PubMed, Web of Science and Embase databases and the ClinicalTrials.gov website were searched up to June 2020.We included randomised controlled trials (RCTs) and observational studies that compared refractive errors between anti-VEGF drug and laser therapies.ELIGIBILITY CRITERIA WHEN SELECTING STUDIESWe included randomised controlled trials (RCTs) and observational studies that compared refractive errors between anti-VEGF drug and laser therapies.Data extraction and risk-of-bias assessments were conducted by two independent reviewers. We used a random-effect model to pool outcomes. The outcome measures were the spherical equivalents, axial length (AL), anterior chamber depth (ACD) and lens thickness (LT).DATA EXTRACTION AND SYNTHESISData extraction and risk-of-bias assessments were conducted by two independent reviewers. We used a random-effect model to pool outcomes. The outcome measures were the spherical equivalents, axial length (AL), anterior chamber depth (ACD) and lens thickness (LT).Thirteen studies involving 1850 eyes were assessed: 914 in the anti-VEGF drug group, and 936 in the control (laser) group. Children who received anti-VEGF drug treatment had less myopia than those who received laser therapy (mean difference=1.80 D, 95% CI 0.97 to 2.63, p＜0.0001, I2=78%). The AL, ACD and LT did not reach statistical significance difference between the two groups. The current evidence indicates that the refractive safety in children with ROP is better for anti-VEGF drug treatment than for laser therapy.RESULTSThirteen studies involving 1850 eyes were assessed: 914 in the anti-VEGF drug group, and 936 in the control (laser) group. Children who received anti-VEGF drug treatment had less myopia than those who received laser therapy (mean difference=1.80 D, 95% CI 0.97 to 2.63, p＜0.0001, I2=78%). The AL, ACD and LT did not reach statistical significance difference between the two groups. The current evidence indicates that the refractive safety in children with ROP is better for anti-VEGF drug treatment than for laser therapy.This meta-analysis indicates that anti-VEGF drug therapy results in less myopia compared with laser therapy. However, there are relatively few published articles on refractive errors in ROP, and so high-quality and powerful RCTs are needed in the future.CONCLUSIONSThis meta-analysis indicates that anti-VEGF drug therapy results in less myopia compared with laser therapy. However, there are relatively few published articles on refractive errors in ROP, and so high-quality and powerful RCTs are needed in the future.CRD42020160673.PROSPERO REGISTRATION NUMBERCRD42020160673.
To determine the effects of the intraocular injection of antivascular endothelial growth factor (anti-VEGF) drugs on the refractive status of infants with retinopathy of prematurity (ROP). Systematic review and meta-analysis of the refractive status of infants with ROP who receive anti-VEGF drugs. The PubMed, Web of Science and Embase databases and the ClinicalTrials.gov website were searched up to June 2020. We included randomised controlled trials (RCTs) and observational studies that compared refractive errors between anti-VEGF drug and laser therapies. Data extraction and risk-of-bias assessments were conducted by two independent reviewers. We used a random-effect model to pool outcomes. The outcome measures were the spherical equivalents, axial length (AL), anterior chamber depth (ACD) and lens thickness (LT). Thirteen studies involving 1850 eyes were assessed: 914 in the anti-VEGF drug group, and 936 in the control (laser) group. Children who received anti-VEGF drug treatment had less myopia than those who received laser therapy (mean difference=1.80 D, 95% CI 0.97 to 2.63, p＜0.0001, I =78%). The AL, ACD and LT did not reach statistical significance difference between the two groups. The current evidence indicates that the refractive safety in children with ROP is better for anti-VEGF drug treatment than for laser therapy. This meta-analysis indicates that anti-VEGF drug therapy results in less myopia compared with laser therapy. However, there are relatively few published articles on refractive errors in ROP, and so high-quality and powerful RCTs are needed in the future. CRD42020160673.
Author Ming, Wai-kit
Mi, Xue-Song
Kong, Qihang
AuthorAffiliation 3 Li Ka Shing Faculty of Medicine , University of Hong Kong , Hong Kong , China
4 Changsha Academician Expert Workstation, Aier Eye Hospital Group , Changsha , China
1 Department of Ophthalmology , the First Affiliated Hospital of Jinan University , Guangzhou , China
2 Department of Public Health and Preventive Medicine, School of Medicine , Jinan University , Guangzhou , China
AuthorAffiliation_xml – name: 1 Department of Ophthalmology , the First Affiliated Hospital of Jinan University , Guangzhou , China
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– name: 4 Changsha Academician Expert Workstation, Aier Eye Hospital Group , Changsha , China
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/33568373$$D View this record in MEDLINE/PubMed
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Keywords paediatric surgery
paediatric ophthalmology
medical ophthalmology
Language English
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2021021008402519000_11.2.e042384.22
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2021021008402519000_11.2.e042384.33
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2021021008402519000_11.2.e042384.5
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2021021008402519000_11.2.e042384.1
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Snippet ObjectiveTo determine the effects of the intraocular injection of antivascular endothelial growth factor (anti-VEGF) drugs on the refractive status of infants...
To determine the effects of the intraocular injection of antivascular endothelial growth factor (anti-VEGF) drugs on the refractive status of infants with...
Objective To determine the effects of the intraocular injection of antivascular endothelial growth factor (anti-VEGF) drugs on the refractive status of infants...
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StartPage e042384
SubjectTerms Angiogenesis Inhibitors - therapeutic use
Bevacizumab - therapeutic use
Bias
Child
Developing countries
Drug dosages
Endothelial Growth Factors - therapeutic use
Eye diseases
Humans
Infant
Infant, Newborn
Intravitreal Injections
Laser Coagulation
Lasers
LDCs
Light Coagulation
medical ophthalmology
Meta-analysis
Ophthalmology
paediatric ophthalmology
paediatric surgery
Pediatrics
Retinopathy of Prematurity - drug therapy
Software
Systematic review
Vascular endothelial growth factor
Vascular Endothelial Growth Factor A
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Title Refractive outcomes after intravitreal injection of antivascular endothelial growth factor versus laser photocoagulation for retinopathy of prematurity: a meta-analysis
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