The following is a summary of “Intravitreal Injection of Anti-Vascular Endothelial Growth Factors Combined with Corticosteroids for the Treatment of Macular Edema Secondary to Retinal Vein Occlusion: A Systematic Review and Meta-Analysis,” published in the August 2023 issue of Ophthalmology by Namvar et al.
Researchers started a retrospective study to compare anti-vascular endothelial growth factor (anti-VEGF) monotherapy with anti-VEGF and corticosteroid combination therapy for macular edema caused by retinal vein occlusion (RVO).
They performed a systematic review and meta-analysis that compiled data from publications in computed databases (PubMed, Embase, Cochrane Library Central Register of Controlled Trials, ISI, and Scopus) covering the period from January 1, 2007, through November 20, 2020. Heterogeneity was evaluated by I2 statistic, and a meta-analysis was accomplished using a random-effects model.
The results showed 24 relevant studies encompassing 1,280 eyes, comprising 685 central retinal vein occlusion (CRVO) and 507 branch retinal vein occlusion (BRVO) patients. In both CRVO and BRVO cases, a combination approach demonstrated a superior improvement in best-corrected visual acuity (BCVA) at 6 months, with BRVO cases showing more notable gains. However, central macular thickness (CMT) changes did not significantly differ among treatments. No BCVA or CMT inferiority was observed in the triamcinolone subgroup compared to the slow-release dexamethasone implant subgroup in all RVO cases. Sequential treatment improved BCVA, and simultaneous treatment resulted in more significant CMT reduction, especially at 1 month post-treatment.
Investigators concluded that combination therapy with intravitreal anti-VEGF and corticosteroid may slightly improve visual acuity in retinal vein occlusion at 6 months.
Source: tandfonline.com/doi/abs/10.1080/08820538.2023.2249527