Anti-vascular endothelial growth factor for diabetic macular oedema: a network meta-analysis

Virgili, Gianni; Parravano, Mariacristina; Evans, Jennifer R; Gordon, Iris; Lucenteforte, Ersilia

doi:10.1002/14651858.cd007419.pub6

Cited by 142 publications

(145 citation statements)

References 103 publications

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“…2 Current treatments involve anti-VEGF therapies alone or combined with another medication or laser photocoagulation. 3,4 Autonomic innervation of the eye includes sympathetic and parasympathetic pathways via different nerves, including those originating from the superior cervical ganglion (SCG) and pterygopalatine ganglion. 5 Several lines of evidence suggest a critical role of the sympathetic nervous system in maintaining ocular vascular homeostasis.…”

Section: Purposementioning

confidence: 99%

Sympathetic Effects of Internal Carotid Nerve Manipulation on Choroidal Vascularity and Related Measures

Martinez-Camarillo

Spee

Chen

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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Section: Purposementioning

confidence: 99%

Sympathetic Effects of Internal Carotid Nerve Manipulation on Choroidal Vascularity and Related Measures

Martinez-Camarillo

Spee

Chen

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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“…[5][6][7] Multiple large-scale randomized clinical trials concerning the safety of intravitreal anti-VEGF injections revealed no significant increase in systemic risk focused on serious adverse events (cerebrovascular accident, ischemic heart disease, systemic thromboembolism, etc.). [8][9][10][11] However, there are few studies on proteinuria after intravitreal bevacizumab (IVB) injection in patients with diabetes. 12,13 Recently, there was a case series reporting worsened proteinuria after multiple IVB injections in patients with diabetes.…”

Section: Introductionmentioning

confidence: 99%

Effect of a Single Intravitreal Bevacizumab Injection on Proteinuria in Patients With Diabetes

Younghae

Kim

Byeon

et al. 2020

Trans. Vis. Sci. Tech.

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Citation: Chung Y-R, Kim YH, Byeon H-E, Jo DH, Kim JH, Lee K. Effect of a single intravitreal bevacizumab injection on proteinuria in patients with diabetes. Trans Vis Sci Tech. 2020;9(4):4, https://doi.org/10. 1167/tvst.9.4.4 Purpose: Proteinuria is the second most common complication after hypertension after systemic administration of bevacizumab. Therefore we aimed to analyze the effect of intravitreal bevacizumab (IVB) injection on proteinuria in patients with diabetes. Methods:Patients scheduled to receive IVB injection from May 1, 2018, to December 31, 2018, were prospectively enrolled. In total, 53 patients with diabetes (26 with nonproliferative diabetic retinopathy and 27 with proliferative diabetic retinopathy) and 37 patients without diabetes were included. Urine tests were performed within 1 month of and 7 ± 1 days after IVB injection. Urinary protein, creatinine, and albumin concentrations were quantitatively measured, and urinary protein-to-creatinine ratio and urinary albumin-to-creatinine ratio (UACR) were calculated from these data before and after IVB injection. Results:The mean urinary microalbumin concentrations and urinary protein-tocreatinine ratio were significantly higher in patients with diabetes, both before and after IVB injection. There were no differences between patients with nonproliferative diabetic retinopathy and proliferative diabetic retinopathy. About 80% of patients with diabetes showed improved albuminuria or at least no harmful effect in terms of albuminuria. Patients with deteriorated baseline UACR showed more residual increase in UACR after IVB injection (P < 0.05 in all groups). Conclusions:Close monitoring of renal function after IVB might be needed in patients with diabetes according to the severity of nephropathy.Translational Relevance: Our results may provide information regarding the renal function of IVB-treated patients with diabetes.

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“…VA at baseline has previously been described as an independent predictor of visual and structural outcomes following treatment with anti-angiogenic therapy in DME. 24 The median BCVA was 60 letters in this cohort. This cut off was used to stratify our results accordingly.…”

Section: Outcomes Stratified By Baseline Visual Acuitymentioning

confidence: 68%

<p>Two Year Visual Acuity and Structural Outcomes in Patients with Diabetic Macular Oedema Treated with Intravitreal Aflibercept – A Retrospective Cohort Study</p>

Kern¹,

Schiefelbein²,

Fu³

et al. 2020

OPTH

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Purpose: To assess visual and anatomical outcomes of intravitreal aflibercept for clinically significant diabetic macular oedema (DME). Methods: For this retrospective single-center cohort study at a tertiary referral center, we performed a data warehouse query to identify 117 treatment-naive patients (139 eyes) undergoing intravitreal treatment with aflibercept for DME between January 2014 and May 2018. Changes in best-corrected visual acuity (BCVA) values (as measured with ETDRS letters), central retinal thickness (CRT) and total macular volume (TVOL) are reported over a two-year period at various time-points. Results: The total number of injections per study eye was 5.5 ± 1.4 after one and 8.7 ± 2.2 injections after two years. Baseline visual acuity (VA) was 60.1 ± 14.5 letters. A gain of 4.8 and 9.2 letters from baseline was observed after one and two years, respectively (both p ≤ 0.01). In comparison to the mean CRT at baseline (419 ± 174 µm), a CRT decrease was observed after one and two years of treatment (298 ± 115 µm and 319 ± 119 µm, respectively; both p ≤ 0.01). Similarly, TVOL decreased from 10.12 ± 2.05 mm 3 to 8.96 ± 0.96 mm 3 and 9.01 ± 1.29 mm 3 (both p ≤ 0.01). Conclusion: This study demonstrates that treating DME with intravitreal aflibercept yields positive functional and structural outcomes over a two-year period. However, we observed fewer injection numbers, along with inferior VA and structural outcomes than has been reported in randomized clinical trials. Our results show similar results as in patients treated with ranibizumab due to DME in real-life settings.

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Anti-vascular endothelial growth factor for diabetic macular oedema: a network meta-analysis

Abstract: Anti-vascular endothelial growth factor for diabetic macular oedema: a network meta-analysis.

Cited by 142 publications

References 103 publications

Sympathetic Effects of Internal Carotid Nerve Manipulation on Choroidal Vascularity and Related Measures

Sympathetic Effects of Internal Carotid Nerve Manipulation on Choroidal Vascularity and Related Measures

Effect of a Single Intravitreal Bevacizumab Injection on Proteinuria in Patients With Diabetes

<p>Two Year Visual Acuity and Structural Outcomes in Patients with Diabetic Macular Oedema Treated with Intravitreal Aflibercept – A Retrospective Cohort Study</p>

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