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Evidence summaries

Antivascular Endothelial Growth Factor for Proliferative Diabetic Retinopathy

Anti-vascular endothelial growth factors with or without panretinal photocoagulation appear to be effective for regression of new vessels and appear to reduce vitreous haemorrhage in proliferative diabetic retinopathy compared to panretinal photocoagulation alone. They also appear to increase visual acuity, but the degree of improvement is not clinically meaningful. Level of evidence: "B"

The certainty of the evidene is reduced by high or unclear risk of bias (blinding of participant and outcome assessor).

Summary

A Cochrane review [Abstract] 1 included 23 studies with a total of 2334 eyes. Bevacizumab, ranibizumab, conbercept, pegaptanib, and aflibercept were used. Anti-vascular endothelial growth factors (Anti-VEGFs) ± panretinal photocoagulation increased visual acuity compared with panretinal photocoagulation alone (mean difference (MD) -0.08 logMAR, 95% CI -0.12 to -0.04; 10 RCTS, 1172 eyes). Anti-VEGFs ± panretinal photocoagulation increased regression of new vessels (MD -4.14 mm2, 95% CI -6.84 to -1.43; I² = 75%; 4 RCTS, 189 eyes) and increased a complete regression of new vessels (RR 1.63, 95% CI 1.19 to 2.24; 5 RCTS, 405 eyes). Anti-VEGFs ± panretinal photocoagulation reduced vitreous haemorrhage (RR 0.72, 95% CI 0.57 to 0.90; 6 RCTS, 1008 eyes). Anti-VEGFs ± panretinal photocoagulation reduced the need for vitrectomy compared with eyes that received panretinal photocoagulation alone (RR 0.67, 95% CI 0.49 to 0.93; I8 RCTs, 1248 eyes).

Clinical comments

Note

Date of latest search: 2023-11-03

References

  • Martinez-Zapata MJ, Salvador I, Martí-Carvajal AJ et al. Anti-vascular endothelial growth factor for proliferative diabetic retinopathy. Cochrane Database Syst Rev 2023;3(3):CD008721. [PubMed]

Primary/Secondary Keywords