Meta-analysis Of The Efficacy And Safety Of Dexamethasone Implant And Ranibizumab In The Treatment Of Retinal Vein Occlusion Complicated With Macular Edema

ObjectiveTo evaluate the efficacy and safety of intravitreal injection of dexamethasone implant and intravitreal injection of ranibizumab in the treatment of retinal vein occlusion complicated with macular edema.MethodsElible studies were identified via a systematic searching of databases,including Pubmed,The Cochrane Library,EMBASE,Wanfang Database,VIP and CNKI and hand searching were also conducted,without status or other limits up to October 30,2018,Selection Criteria:Randomized clinical control trials of comparing intravitreal ranibizumab combined with Ozurdex for treating patients with RVO-associated macular edema were included,Revman 5.2 software was used for Meta-analysis.ResultsFour RCTs involving 969 eyes(with retinal vein occlusion complicated with macular edema).516 eyes were treated with ranibizumab and 453 eyes were treated with dexamethasone vitreous implant.The results showed:(1)Compared with dexamethasone vitreous implant,ranibizumab improved visual acuity correction in patients.more advantageous,6 months [SMD = 0.80,95% CI(0.53,1.08),p <0.00001],12 months [MD = 9.70,95% CI(7.36,12.04),p <0.00001].(2)Compared with dexamethasone vitreous implants,ranibizumab can better reduce the central subfield thickness of patients when the follow-up time is 6 months [SMD=-0.71,95% CI(-0.90,-0.53),p<0.00001].However,there was no statistically significant difference between the two groups when the followup time was 12 months [MD=-58.75,95% CI(-125.40,7.89),p=0.08].(3)When the observation time was 6 months,there was no significant difference in the incidence of cataract between the dexamethasone vitreous implant treatment group and the ranibizumab treatment group [OR=3.97,95% CI(0.65,24.35),p =0.14],dexamethasone vitreous implants showed a higher incidence of cataract when the observation time was 12 months [OR=0.18,95% CI(0.06,0.55),p=0.003].(4)Dexamethasone vitreous implants were more prone to postoperative intraocular pressure increase than ranibizumab [OR=6.23,95% CI(3.63,10.67),p<0.00001].ConclusionCompared with dexamethasone vitreous implants,the improvement of visual acuity of Raymondimum was more pronounced,and the CST decreased more in 6 months.Dexamethasone vitreous implants have more ocular adverse events,including cataracts and elevated intraocular pressure.But less injection is needed.