• 1. Department of Ophthalmology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China;
  • 2. State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, China;
Zhang Ji, Email: zhangjieyesz@163.com
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Objective To evaluate the efficacy of intravitreal injection of anti-vascular endothelial growth factor (VEGF) drugs combined with retinal laser photocoagulation and anti-VEGF drugs alone in the treatment of retinal vein occlusion (RVO) combined with macular edema (ME). Methods A evidence-based medicine study. Retinal vein occlusion (obstruction), macular edema, anti-vascular endothelial growth factor, bevacizumab, ranibizumab, conbercept, aflibercept, and retinal laser photocoagulation were the Chinese and English search terms. Related literature was searched in China National Knowledge Infrastructure, Wanfang, Weipu, PubMed, Embase, Cochrane Library. RVO combined with ME was selected as the research object, and the treatment plan was a clinical randomized controlled study comparing intravitreal injection of anti-VEGF drugs combined with laser photocoagulation and anti-VEGF drugs alone. The search time range was from January 2011 to February 2021. Repeated, incomplete or irrelevant literature, case reports and review literature were excluded. Review Manager 5.4 statistical software was used to conduct a meta-analysis of the literature. The weighted mean difference (WMD) and 95% confidence interval (CI) were selected as the estimated value of effect size, and the fixed effect model was used for analysis. The evaluation indicators were best corrected visual acuity (BCVA), center macular thickness (CMT), and the number of injections. Results According to the search strategy, 461 articles were initially retrieved, and 21 articles were finally included for meta-analysis. A total of 1156 patients were enrolled, of which 576 were treated with anti-VEGF drugs combined with laser photocoagulation (combined treatment group), and 580 were treated with anti-VEGF drugs alone (drug treatment group). Meta-analysis results showed that there was no statistically significant difference in BCVA and CMT between the drug treatment group and the combination treatment group at 6, 9, and 12 months after treatment (BCVA: WMD =-0.82, 95%CI -2.38-0.74, P=0.30; CMT: WMD=-3.12, 95%CI -17.25-11.01, P=0.67). For patients with branch retinal vein occlusion and ME, combined therapy can reduce the number of injections more effectively than drug therapy alone (WMD=-0.80, 95% CI -1.18--0.42, Z=4.10, P<0.000 1). Conclusion Compared with pure intravitreal injection of anti-VEGF drugs, combined retinal laser photocoagulation can not better improve BCVA and CMT in patients with RVO and ME. For patients with branch retinal vein occlusion and ME, combined retinal laser photocoagulation can effectively reduce the resistance. The number of VEGF injections.

Citation: Huang Jiang, Zou Weijie, Ji Xiaoyan, Hua Wumei, Xu Sen, Du Yuanyuan, Zhou Chen, Xu Guoxu, Zhang Ji. Comparison of the efficacy of anti-vascular endothelial growth factor drugs with or without retinal laser photocoagulation for macular edema secondary to retinal vein occlusion: a systematic review. Chinese Journal of Ocular Fundus Diseases, 2021, 37(9): 715-722. doi: 10.3760/cma.j.cn511434-20210622-00334 Copy

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