A comparison of the efficacy and safety of ranibizumab combined with photodynamic therapy （PDT） versus ranibizumab monotherapy for the treatment of wet age-related macular degeneration： a meta analysis
Objective To evaluate the efficacy and safety of ranibizumab combined with photodynamic therapy versus ranibizumab monotherapy for the treatment of wet age-related macular degeneration （AMD）. Methods In this meta analysis， searches were conducted in Pubmed， EMbase， Cochrane Library， CNKI， and Wanfang databases. Six randomized control trials （RCT） in the literature were selected for meta-analysis， a total of 626 eyes： a monotherapy group （323 eyes） and a combined treatment group （303 eyes）. The methodological quality was conducted according to evidence-based medicine （EBM）. The qualities of the RTCs were evaluated according to the Cochrane Handbook for Systematic Reviews of Interventions， Version 5.0. The Cochrane Collaboration′s software RevMan 5.0 was used for meta-analysis. Results The results of the meta-analysis showed the following： ①Best corrected visual acuity（BCVA）： the monotherapy group showed greater improvement in BCVA compared with the combined treatment group [WMD=-2.84， 95％CI（0.25-5.43）， P<0.05]. The incidence of people who gained ≥15 letters in the monotherapy group was higher than the combined treatment group [WMD=0.66， 95％CI（0.45-0.96）， P<0.05]. However， there was no significant difference between the two groups in the incidence of people who lost ≥15 letters [WMD=1.37， 95％CI（0.78-2.41）， P>0.05]. ②Central retinal thickness （CRT）： There was no significant difference between the two groups [WMD= -3.17， 95％CI（-25.64-31.97）， P>0.05]. ③Lesion size （LZ）： There was no significant difference between the two groups [WMD=0.24， 95％CI（-0.38-0.86）， P>0.05]. ④Injection times： There was no significant difference between the two groups [WMD=-1.00， 95％CI（-2.56～0.56）， P>0.05]. ⑤Complications： The combined treatment group had a higher probability of retinal hemorrhage than the monotherapy group [RR=2.65， 95％CI（1.04-6.71）， P<0.05]. Conclusion Meta-analysis shows that ranibizumab monotherapy is effective in achieving a BCVA gain comparable to the combined treatment regimen of ranibizumab with verteporin PDT and in wet age-related macular degenerat
蒋璐,陶继伟,洪明胜,余心洁,沈丽君. 光动力学疗法联合雷珠单抗对比雷珠单抗治疗湿性AMD有效性和安全性的Meta分析[J]. 中华眼视光学与视觉科学杂志, 2014, 16(8): 493-499.
Jiang lu,Tao Jiwei,Hong Mingsheng,Yu Xinjie,Shen Lijun. A comparison of the efficacy and safety of ranibizumab combined with photodynamic therapy （PDT） versus ranibizumab monotherapy for the treatment of wet age-related macular degeneration： a meta analysis. Chinese Journal of Optometry Ophthalmology and Visual science, 2014, 16(8): 493-499. DOI: 10.3760/cma.j.issn.1674-845X.2014.08.011
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