Anti-VEGF therapies in the treatment of choroidal neovascularisation secondary to non-age related macular degeneration: a systematic review

Stuart, Arabella, Ford, John, Duckworth, Suzy, Jones, Colin and Pereira, Augustine (2015) Anti-VEGF therapies in the treatment of choroidal neovascularisation secondary to non-age related macular degeneration: a systematic review. BMJ Open, 5 (4). ISSN 2044-6055

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Abstract

Objectives The aim of this study is to systematically review the evidence for anti-VEGF therapy in choroidal neovascularisation secondary to conditions other than age related macular degeneration. Data sources MEDLINE, MEDLINE in-process, EMBASE and CENTRAL databases and conference abstracts were searched (from inception to Jan 2014). Study eligibility criteria, participants and interventions Randomised and non-randomised comparative studies with follow-up of at least six months were included were used to assess clinical effectiveness. Study appraisal and synthesis method Risk of bias was assessed using Cochrane risk of bias tool and modified Newcastle-Ottawa scale. Meta-analysis was not possible due to methodological heterogeneity. Results Sixteen studies met the inclusion criteria (1,091 eyes; 963 pathological myopia, 74 other conditions). There was large variation in risk of bias across studies. An improvement in best-corrected visual acuity in anti-VEGF arms over comparators was reported in all studies. The proportion of patients improving by at least 15 letters in anti-VEGF arms ranged from 27.3 - 70%. There were no significant differences between bevacizumab and ranibizumab. Limitations Due to the rarity of choroidal neovascularisation secondary to conditions other than age related macular degeneration or pathological myopia, there are unlikely to ever be sufficiently powered trials in these populations Conclusions Bevacizumab and ranibizumab appear to be effective in improving visual acuity for patients with choroidal neovascularisation secondary to conditions other than age related macular degeneration. The evidence base is strongest for choroidal neovascularisation secondary to pathological myopia, however based on current evidence and likely pharmacological pathways clinicians should consider treatment with either bevacizumab or ranibizumab for rarer causes.

Item Type: Article
Additional Information: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Pure Connector
Date Deposited: 23 Mar 2015 12:44
Last Modified: 21 Apr 2020 23:56
URI: https://ueaeprints.uea.ac.uk/id/eprint/52783
DOI: 10.1136/bmjopen-2015-007746

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