Ophthalmology in China ›› 2013, Vol. 22 ›› Issue (1): 62-66.

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Comparison of efficacy and complications in treatment of macular edema secondary to branch retinal vein occlusion by intravitreal bevacizumab with intravitreal triamcinolone acetonide for first priority: a meta-analysis

MA Nan1, LI Dan2, GAO Fu-lin1, ZHAO Hong-wei1, BAI Feng-hua1, HU Lian-na1   

  1. 1. Department of Ophthalmology, 306th Hospital of PLA, Beijing 100101, China; 2. Department of Clinical Laboratory Medicine, 306th Hospital of PLA, Beijing 100101, China
  • Received:2012-09-12 Online:2013-01-25 Published:2013-01-30
  • Contact: HU Lian-na, Email: hulianna57@yahoo.com.cn

Abstract: Objective To evaluate the efficacy and safety in treatment of macular edema (ME) secondary to branch retinal vein occlusion (BRVO) by intravitreal bevacizumab(IVB) with intravitreal triamcinolone acetonide(IVT) for first priority. Design Meta-analysis. Participants Published literature in Medline (1966-2012), EMbase (1966-2011), Cochrane library (2011) and CBM (1979-2011) which comparing IVB with IVT in treatment of ME secondary to BRVO for first priority. Methods According to evaluation guidelines of Cochrane collaboration, clinical controlled trials (CCTs) were searched using Medline, EMbase, the Cochrane Library and CBM. Methodology evaluation of publications was performed by experienced researchers according to the Jadad Score. RevMan 5.1 offered by Cochrane was used to do the meta-analysis. Main Outcome Measures Central macular thickness (CMT), best corrected visual acuity (BCVA) and adverse events. Results Only 8 publications (376 eyes) were included into this meta-analysis. No significant difference in either CMT (P=0.22) or BCVA (P=0.06) was observed between IVB and IVT group. Adverse event rates (mainly elevation of intraocular pressure and progression of cataracts) in IVT group was 20 times (95%CI, 8.3-50 times) more than IVB group (P=0.000).  Conclusion This meta-analysis shows that IVT group had an equal reduced CMT and BCVA compared with IVB group in treatment of ME secondary to BRVO, while the adverse event rates were much frequent than in the IVB group. More high quality prospective studies are still required for further analysis. (Ophthalmol CHN, 2013, 22: 62-66)

Key words: bevacizumab, triamcinolone, branch retinal vein occlusion, macular edema, meta-analysis