为糖尿病的有斑点的浮肿的 Intravitreal triamcinolone 对 intravitreal bevacizumab : 元分析

• 作者: Jian Chen Qing Zhou Ri-Jia Zhang Wen-Jie Wang Xiao-Ling Zhang Xiao-Yan Qin
• 来源期刊: 国际眼科杂志：英文版
• 学科: 医学
• 关键词: TRIAMCINOLONE BEVACIZUMAB diabeticmacular EDEMA META-ANALYSIS
• 年，卷（期）: 2013,（4）
• 页码范围: 546-552
• 页数: 7页
• 分类号: R774.5

摘要

AIM:To compare the efficacy of the sole intravitreal triamcinolone(IVT) versus intravitreal bevacizumab(IVB)alone or IVB combined with IVT in the treatment of diabetic macular edema(DME).·METHODS:Pertinent publications were identified through systematic searches of database and manually searching.Methodological quality of the literatures was valuated according to the Jadad Score.RevMan 5.1.0was used to do the meta-analysis.Heterogeneity was determined and sensitivity was conducted.·RESULTS:Six studies were ultimately included in the meta-analysis.The results of our analysis showed IVT had a statistically significant improvement in vision over the IVB at 1 month and 3 months(P【0.01).However,the reduction was not significant regarding central macular thickness(CMT) during the earlier(1 month and 3months) follow-up period(P =0.12,P =0.41,respectively).At later visit(6 months),IVT had a significant decrease in CMT when compared to IVB(P【0.01) while no significant improvement in visual acuity(VA) was observed(P =0.14).The incidence of intraocular hypertension was 13/102 in IVT group during follow-up period while 0/103 in IVB group.The difference was significant(P 【0.01).With regards to IVT versus IVB combined with IVT,there were no significant differences in CMT at 1 month(P =0.86)and 3 months(P =0.06).The incidence of intraocular hypertension was 6/67 in IVT group during follow-up period while 4/66 in IVB +IVT group.But the difference was not significant(P =0.53).·CONCLUSION:Current evidence shows IVT is superior in improving VA at earlier follow-up(1 month and 3months) and in reducing CMT at later follow-up(6months) for DME.At other time,it is in favor of IVT treatment but there are no statistically significances.However,IVT has the side-effect of ocular hypertension.There is no adequate evidence of the benefit adding IVB to IVT in contrast to IVT alone.