Meta-analysis Of Dexamethasone Intravitreal Implants And Anti-VEGF Drugs In The Treatment Of Macular Edema Secondary To Branch Retinal Vein Occlusion

Objective: To investigate the efficacy and safety of dexamethasone intravitreal implants and anti-VEGF drugs in the treatment of macular edema secondary to retinal vein occlusion.Method: Comprehensively search domestic and foreign databases such as China National Knowledge Infrastructure,China Science and Technology Journal Database,Wanfang Data Knowledge Service Platform,Cochrane Library,EMBASE,Pubmed,etc.The search time is from database construction to 2020.01.The study subjects were patients with macular edema secondary to retinal branch vein occlusion.The intervention measures were dexamethasone and anti-VEGF drugs.The types of studies included retrospective studies and randomized controlled studies.The length of follow-up was 6 months after treatment.The detection indicators included the best corrected visual acuity and the thickness of the fovea.The literature search was conducted according to the pre-established inclusion and exclusion criteria,and the quality evaluation was performed using the modified Jadad score sheet and the Cochrane bias risk assessment tool or the modified Newcastle-Ottawa Scale score sheet.Use Review Manager 5.3 software for data processing and Meta analysis.Results: A total of 114 articles,including two interventions of dexamethasone and anti-VEGF drugs,and finally a total of 5 studies were included.A total of 262 patients were affected,of which 127 received dexamethasone intravitreal implants(test group),and 135 received intravitreal injection of anti-VEGF drugs(control group).Meta-analysis:(1)In the first month of follow-up,the difference between the difference between the optimal intraocular lens implantation therapy and the intravitreal injection of anti-VEGF drug therapy for the best corrected visual acuity improvement in the affected eye is statistically significant [WMD =-0.13 log MAR,95% CI(-0.20,-0.06),P = 0.0005];and the difference between the differences in the thickness of the macular fovea between the two groups was not statistically significant [WMD =-40.93,95%CI(-84.92,3.06),P = 0.07];(2)At the third month of follow-up,the difference in the difference in the best corrected visual acuity between the dexamethasone treatment group and the anti-VEGF treatment group was statistically significant [WMD =-0.07 log MAR,95% CI(-0.14,0.00),P = 0.04];there is no statistically significant difference between the difference in macular fovea thickness between the dexamethasone treatment group and the anti-VEGF treatment group [WMD = 106.56,95% CI(-28.44,-241.56),P = 0.12];(3)At the 6th month of follow-up,there was no difference in the difference between the best corrected visual acuity differences between the dexamethasone group and the anti-VEGF group Significance in learning[WMD =-0.00 log MAR,95% CI(-0.09,0.09),P = 0.97];the difference in the difference in the thickness of the macular fovea between the two groups is also the same Considered significant [WMD = 26.54,95% CI(-2.54,55.57),P = 0.07].(4)During the course of treatment,the eyes in the dexamethasone treatment group all had varying degrees of IOP increase,but the increase was temporarily controllable;while the IOP in the anti-VEGF treatment group remained basically unchanged.Conclusion: Dexamethasone intravitreal implants and anti-VEGF drugs can significantly reduce macular edema secondary to branch retinal vein occlusion,improve vision,and are safe and reliable.The effect of dexamethasone in the early stage of treatment is more significant,the best corrected visual acuity is better,and the price is low,which is more acceptable to patients.