Comparison of the efficacy of anti-VEGF monotherapy versus PDT and intravitreal anti-VEGF combination treatment in AMD： a Meta-analysis and systematic review

作     者：Yao Tong Ke-ke Zhao Dong Feng Manas Biswal Pei-Quan Zhao Zhao-Yang Wang Yun Zhang 

作者机构：Eye Hospital of Wenzhou Medical University Wenzhou 325027 Zhejiang Province China Department of Ophthalmology Xinhua Hospital Shanghai Jiaotong University School of Medicine Shanghai 200092China Department of Ophthalmology Shanghai Children's Medical Center Shanghai Jiaotong University School of MedicineShanghai 200127 China Department of Ophthalmology The First Affiliated Hospital of College of Medicine Zhejiang University Hangzhou 310006 Zhejiang Province China Department of Molecular Genetics University of FloridaGainesville 32610 Florida USA 

出 版 物：《International Journal of Ophthalmology(English edition)》 (国际眼科杂志（英文版）)

年 卷 期：2016年第9卷第7期

页      面：1028-1037页

核心收录：

学科分类：1002[医学-临床医学] 100212[医学-眼科学] 10[医学] 

基　　金：Supported by the National Natural Science Funds of China(No.81371040) Shanghai Pujiang Program(No.15PJD028) 

主　　题：age related macular degeneration antivascular endothelial growth factor photodynamic therapy Meta analysis 

摘      要：AIM：To compare the effect of anti-vascular endothelial growth factor（VEGF） monotherapy versus photodynamic therapy（PDT） and anti-VEGF combination treatment in age-related macular degeneration（AMD）.METHODS：A computerized online search was performed using PubMed,Web of Science and the Cochrane *** that compared anti-VEGF monotherapy with PDT and anti-VEGF combination treatment of AMD and were designed as randomized controlled trials were *** means and standard deviations of the best-corrected visual acuity（BCVA）,central retinal thickness（CRT）,number of treatments and proportions of patients who gained BCVA ≥15,10,5,or 0 letters at 12^（th） month were extracted.A systematic review and Meta-analysis of the comparison of the two approaches was conducted using Review Manager ***.A sensitivity analysis was also ***：Eight studies were *** the subgroup and sensitivity analysis was conducted,the results indicated that in the findings that included the monotherapy group and PDT（standard fluence,SF）group of Kaiser＇s study,the patients in the monotherapy group had a better BCVA compared with the combination group at 12^（th） month in the PDT（SF） subgroup[weighted mean difference（WMD）：3.54;95% Cl：0.36 to 6.73;P=0.03],and there were more patients who gained ≥15 letters of BCVA in the monotherapy group compared with the combination group in the total result[odds ratio（OR）：1.41;95% Cl：1.02 to 1.95;P=0.04].The same conclusion was obtained in the total result that included the monotherapy group and PDT（reduced fluence,RF）group of Kaiser＇s study（OR：1.56;95% CI：1.13 to 2.15;P=0.007）.However,there were no significant differences in the other indexes between the two ***：We found that anti-VEGF monotherapy is more effective on the recovery of visual acuity than combination therapy and more researches with lager sample size should be performed to study on the effect of the two therapy approaches on CRT and number of inject