Clinical Efficacy Of Anti-VEGF Drug Combined With Laser Versus Anti-VEGF Drug Alone In The Treatment Of BRVO-ME:a Meta-analysis

Background and Objective:Because the selection of treatment methods for macular oedema secondary to branch retinal vein occlusion(BRVO-ME)is still controversial,this paper aims to evaluate the efficacy and differences of two different methods(anti-VEGF drug combined with laser or anti-VEGF drug alone)in the treatment of BRVO-ME by means of meta-analysis system,so as to provide reference for clinical work.Methods:We used computers to retrieve all relevant literature published before December2019 in Cochrane Library,PubMed,EMbase,CNKI,WanFang and other databases,moreover the relevant research data would be selected and extracted,the qualified literature was selected for quality evaluation,a meta-analysis of the pooled data was conducted by using the RevMan 5.2 software.Results:A total of 6 randomized controlled trials(RCTS)were included,with a total of496 patients,including 246 in the combined group and 250 in the single drug group.The results of meta-analysis showed that:(1)Best corrected visual acuity(BCVA): the BCVA data of follow-up 1,3 and 6months showed that both groups could effectively improve the visual acuity of BRVO-ME patients,and the difference between the two groups was statistically significant(P < 0.05).The single drug group(anti-VEGF group)was superior to the combined group(anti-VEGF +laser group).(2)Central macular thickness(CMT): following up the CMT data of 1,3 and 6months,both groups could effectively reduce CMT,and there was no statistical difference between the two groups(P > 0.05).(3)Number of injections: three studies reported the number of injections at the end of the follow-up between the two groups,with statistically significant differences[WMD=-1.13,95%CI(-1.63,-0.63),Z=4.44,P < 0.00001].The combined group was superior to the single drug group.(4)Contrast sensitivity: two studies reported the contrast sensitivity of the two groups at the end of follow-up,with no statistically significant difference[WMD=0.08,95%CI(-0.02,-0.17,Z=1.59,P=0.11].(5)None of the 6 randomized controlled trials had any serious complications or were referred to.Conclusion:The intravitreal injection of anti-VEGF drug in combination with or without laser is effective in the treatment of macular edema secondary to branch retinal vein occlusion,and there are few adverse reactions.during the follow-up period(6months),combined laser therapy did not result in better functional outcomes or improved anatomical structure.Laser combined with anti-VEGF drug treatment can reduce the number of intravitreal injections of anti-VEGF drug.