Ophthalmology. Retina最新文献

{"title":"Anti-VEGF Injections vs. Panretinal Photocoagulation Laser Therapy for Proliferative Diabetic Retinopathy","authors":"Marie-Michele Macaron BSc , Nader Al Sabbakh BSc , M Zaid Shami MD , Dennis Akrobetu MD , Natalie E. Bourdakos BSc , Fatma A.M. Abdulsalam MBBS , Hayato Nakanishi MBBS, MS , Christian A. Than MBBS, PhD , Sophie J. Bakri MD","doi":"10.1016/j.oret.2024.08.004","DOIUrl":"10.1016/j.oret.2024.08.004","url":null,"abstract":"<div><h3>Topic</h3><div>To evaluate the efficacy and safety of anti-VEGF and panretinal photocoagulation (PRP) for the treatment of proliferative diabetic retinopathy (PDR). The outcomes examined are changes in best-corrected visual acuity (BCVA), neovascularization (NV), central macular thickness (CMT), and adverse outcomes.</div></div><div><h3>Clinical relevance</h3><div>Diabetic retinopathy is the leading cause of blindness in working-aged adults globally. At present, no consensus has been reached on the optimal choice for the treatment of PDR.</div></div><div><h3>Methods</h3><div>Cochrane, Embase, PubMed, Scopus, Web of Science, and CiNAHL were searched for articles from their inception to June 2023 according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis. The review was registered prospectively with PROSPERO (CRD42023437778). Tool data analysis was performed using RevMan software version 5.4 (Review Manager [RevMan] [computer program], The Cochrane Collaboration, 2020). Randomized control trials (RCTs) of PDR patients treated with anti-VEGF, PRP, or a combination were included. Risk of bias was assessed using the Rob2 assessment tool (revised tool for risk of bias in randomized trials), and certainty of evidence was assessed with the Grading Recommendations Assessment, Development and Evaluation (GRADE) approach.</div></div><div><h3>Results</h3><div>Nineteen studies were included, with 1361 patients (n = 1788 eyes) treated for PDR with either anti-VEGF (n = 274), PRP (n = 482), or combination (n = 320). Our results show more favorable BCVA outcomes with anti-VEGF compared with PRP at 3 months (mean difference [MD] = 2.35 letters; 95% confidence interval [CI], 1.18–3.52; I<sup>2</sup> = 0%) and 12 months follow-up (MD = 3.39 letters; 95% CI, 0.63–6.14; I<sup>2</sup> = 26%). Combination treatment showed better BCVA outcomes compared with PRP at 12 months (MD = 4.06 letters; 95% CI, 0.26–7.86; I<sup>2</sup> = 0%). Combination showed lower CMT at 3 months (MD = −33.10 μm; 95% CI, −40.12 to −26.08; I<sup>2</sup> = 25%) and 6 months (MD = −34.28 μm; 95% CI, −55.59 to −12.97; I<sup>2</sup> = 85%) compared with PRP, but CMT results were similar at 12 months. Complete regression of total NV (NVT) was more likely with anti-VEGF compared with PRP (odds ratio = 6.15; 95% CI, 1.39–27.15; I<sup>2</sup> = 80%). Posttreatment vitreous hemorrhage, vitrectomy, and increased intraocular pressure events were similar between the anti-VEGF and combination groups compared with PRP; however, macular edema results favored the anti-VEGF over the PRP group. Using the GRADE assessment, BCVA evidence was rated to be of moderate certainty, whereas CMT and NVT evidence certainty was rated as very low.</div></div><div><h3>Conclusion</h3><div>Anti-VEGF and combination treatments could be regarded as alternative approaches to PRP alone in the management of PDR after engaging in a shared decision-making process based on patients’ adherence, diabetic","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"9 2","pages":"Pages 105-121"},"PeriodicalIF":4.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coughing-induced Ocular Content Extrusion through a Perforating Corneal Injury","authors":"Takumi Ando MD, Hiroko Terashima MD, PhD, Naota Kobayashi MD","doi":"10.1016/j.oret.2024.07.002","DOIUrl":"10.1016/j.oret.2024.07.002","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"9 2","pages":"Page e15"},"PeriodicalIF":4.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Streamlined Ophthalmologist-Led Pathway to Diagnosis and Accessibility of Genetics Testing for Patients with Inherited Retinal Dystrophies in Canada","authors":"Grace S. Yin MD, MPhil ,&nbsp;Zhuo Shao MDCM, PhD ,&nbsp;Hanna Faghfoury MDCM, FRCPC ,&nbsp;Brian G. Ballios MD, PhD","doi":"10.1016/j.oret.2024.08.007","DOIUrl":"10.1016/j.oret.2024.08.007","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the ability of a new clinical model to improve accessibility and expedite the pathway to molecular diagnosis for patients with suspected inherited retinal diseases (IRDs).</div></div><div><h3>Design</h3><div>Retrospective cohort study of electronic patient records.</div></div><div><h3>Participants</h3><div>All patients referred to general medical genetic clinic between September 2017 and September 2019 and an ophthalmologist-led IRD clinic between October 2021 and July 2023 for suspected IRD were included.</div></div><div><h3>Methods</h3><div>The difference in timeliness and accessibility to diagnosis and genetics testing for patients referred for suspected IRDs were compared based on whether they were referred to a general medical genetics clinic or an ophthalmologist-led IRD clinic.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcomes were time to consult from referral; time from initial consult to molecular diagnosis; and the time from initial consult to genetics result disclosure and counseling. Secondary outcomes included number of prior providers investigating the chief complaint, the proportion of patients undergoing genetics testing, and the range of diagnostic investigations undertaken.</div></div><div><h3>Results</h3><div>Four hundred seventy-three patients were included, with 212 cases from a general medical genetics clinic and 261 from a medical retina clinic. The mean time from referral to initial consult was 14 months (±3.33 months) and 4 months (±3.4 months) for the general medical genetics and the ophthalmologist-led IRD clinics, respectively. The mean time from initial consult to genetics disclosure and counseling was 6 months (±3.6 months) and 3.5 months (±1.8 months) for the medical genetics and the ophthalmologist-led models, respectively. The total time from initial referral to genetics disclosure and counseling for the medical geneticist-led clinic model was 20 to 24 months. The total time from initial referral to genetics disclosure and counseling for the ophthalmologist-led retinal clinic was 5 to 8 months. The average number of prior providers seen before presenting to the ophthalmologist-led retina clinic was 2.05 (range, 1–10).</div></div><div><h3>Conclusions</h3><div>Shifting from the traditional medical genetics model to the new ophthalmologist-led IRD clinical model may improve accessibility and expedite the pathway to molecular diagnosis and subsequent gene therapy trials for patients with suspected IRDs.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"9 2","pages":"Pages 180-186"},"PeriodicalIF":4.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Providing for Proliferative Diabetic Retinopathy in Our Neighborhoods","authors":"Jonathan C. Tsui MD,&nbsp;Brian L. VanderBeek MD, MSCE","doi":"10.1016/j.oret.2024.10.009","DOIUrl":"10.1016/j.oret.2024.10.009","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"9 2","pages":"Pages 95-97"},"PeriodicalIF":4.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143133668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Redetachment Rates of Pneumatic Retinopexy versus Pars Plana Vitrectomy in Retinal Detachment","authors":"Tugche S. Chen MD(c) ,&nbsp;Yasmin Motekalem MD(c) ,&nbsp;Isabela Martins Melo MD ,&nbsp;Roxane J. Hillier MD ,&nbsp;Alan R. Berger MD ,&nbsp;Louis R. Giavedoni MD ,&nbsp;David T. Wong MD, FRCSC ,&nbsp;Filiberto Altomare MD ,&nbsp;Rajeev H. Muni MD, MSc","doi":"10.1016/j.oret.2024.08.011","DOIUrl":"10.1016/j.oret.2024.08.011","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess long-term redetachment rates of the Pneumatic Retinopexy versus Vitrectomy for the Management of Primary Rhegmatogenous Retinal Detachment Outcomes Randomized Trial (PIVOT).</div></div><div><h3>Design</h3><div>Randomized controlled trial.</div></div><div><h3>Subjects</h3><div>PIVOT trial participants.</div></div><div><h3>Methods</h3><div>This study was performed at St. Michael’s Hospital, Unity Health Toronto, Toronto, Canada. PIVOT trial participants who had undergone either pneumatic retinopexy (PnR) or pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) repair with a minimum follow-up of 2 years were assessed for long-term redetachment by chart review or telephone interview. The latter was the only accepted method for those with &lt;2 years of follow-up. Patients were only eligible if no reintervention to reattach the retina was performed within the first year of the initial procedure.</div></div><div><h3>Main Outcome Measures</h3><div>Long-term redetachment rates for PnR vs. PPV after RRD repair.</div></div><div><h3>Results</h3><div>Sixty-one participants who underwent PPV and 62 who underwent PnR were analyzed. The long-term redetachment rates were 0% and 1.61% (1/62) in the PPV and PnR groups, respectively (<em>P</em> = 0.32). The mean follow-up duration in years was 5.43 ± 3.60 vs. 5.51 ± 3.03 in the PPV and PnR groups, respectively.</div></div><div><h3>Conclusions</h3><div>There was no statistically significant difference in long-term redetachment rates for PnR vs. PPV. Both procedures are durable treatment options for RRD over an extended period, rarely requiring additional intervention for redetachment.</div></div><div><h3>Financial Disclosure(s)</h3><div>The author(s) have no proprietary or commercial interest in any materials discussed in this article.</div></div>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"9 2","pages":"Pages 122-126"},"PeriodicalIF":4.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interim Results of the Phase III Portal Extension Trial of the Port Delivery System with Ranibizumab in Neovascular Age-Related Macular Degeneration","authors":"Peter A. Campochiaro MD ,&nbsp;David Eichenbaum MD ,&nbsp;Margaret A. Chang MD, MS ,&nbsp;W. Lloyd Clark MD ,&nbsp;Jordan M. Graff MD ,&nbsp;Sophie Le Pogam PhD ,&nbsp;Melina Cavichini Cordeiro MD, MS ,&nbsp;Shamika Gune MD, MS ,&nbsp;Mel Rabena BS ,&nbsp;Natasha Singh PharmD, RPh ,&nbsp;Stephanie Lin PhD ,&nbsp;Natalia Callaway MD, MS","doi":"10.1016/j.oret.2024.05.021","DOIUrl":"10.1016/j.oret.2024.05.021","url":null,"abstract":"<div><h3>Objective</h3><div>The Port Delivery System with ranibizumab (PDS) is approved in the United States for neovascular age-related macular degeneration (nAMD). Portal (NCT03683251) is evaluating long-term safety and tolerability of the PDS in patients with nAMD who completed the phase II Ladder (NCT02510794) or phase III Archway (NCT03677934) trials.</div></div><div><h3>Design</h3><div>Multicenter, nonrandomized, open-label, extension clinical trial.</div></div><div><h3>Participants</h3><div>All-PDS safety population (N = 555) comprises patients enrolled in Portal who completed Ladder or Archway. Because of data availability, efficacy population comprises Ladder-to-Portal patients only: patients who previously received PDS 10, 40, or 100 mg/mL pro re nata (as-needed [PRN]; n = 58, 62, and 59, respectively) or monthly intravitreal ranibizumab 0.5-mg injections (monthly ranibizumab; n = 41) in Ladder and subsequently enrolled in Portal.</div></div><div><h3>Methods</h3><div>Ladder patients received PDS refill-exchanges PRN or monthly ranibizumab. Archway patients received PDS 100 mg/mL with fixed refill-exchanges every 24 weeks (Q24W) or monthly ranibizumab. Once enrolled in Portal, all patients receive PDS Q24W from day 1.</div></div><div><h3>Main Outcome Measures</h3><div>Ocular adverse events of special interest (AESIs); changes from baseline in best-corrected visual acuity (BCVA) and center point thickness (CPT); supplemental ranibizumab treatment between refill-exchange procedures; and PDS Patient Preference Questionnaire results.</div></div><div><h3>Results</h3><div>In the All-PDS safety population (mean follow-up, 111 weeks), 137 (24.7%) patients had ≥1 ocular AESI; most common were cataract (11.4%), vitreous hemorrhage (6.1%), and conjunctival thickening (bleb)/filtering bleb leak (6.3%). Endophthalmitis occurred in 11 of 555 (2.0%) patients. For Ladder-to-Portal patients previously treated with PDS 100 mg/mL or monthly ranibizumab, BCVA remained stable from baseline to month 48; mean (95% confidence interval) changes from baseline were 0.1 (−6.6 to 6.8; n = 31) and 2.3 (−9.4 to 14.1; n = 15) letters, respectively; CPT remained stable through month 48. Approximately 95% of patients did not need supplemental treatment before each refill-exchange for &gt;2 years since Portal enrollment. Of Ladder-to-Portal previous monthly ranibizumab patients, 92% preferred the PDS over injections.</div></div><div><h3>Conclusions</h3><div>Interim results from Portal suggest 4-year maintenance of visual/anatomic outcomes with PDS 100 mg/mL, with the PDS preferred to monthly injections. Long-term safety profile of the PDS is well characterized.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"9 2","pages":"Pages 144-155"},"PeriodicalIF":4.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bifocal Circumscribed Choroidal Hemangioma","authors":"Matteo Menean MD,&nbsp;Ayman G. Elnahry MD, PhD,&nbsp;Basil K. Williams Jr MD","doi":"10.1016/j.oret.2024.07.001","DOIUrl":"10.1016/j.oret.2024.07.001","url":null,"abstract":"","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":"9 2","pages":"Page e14"},"PeriodicalIF":4.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardization of Optical Coherence Tomography Angiography Nomenclature in Retinal Vascular Diseases: Consensus-based Recommendations.","authors":"Marion R Munk, Ferhat Turgut, Livia Faes, Damian Jaggi, K Bailey Freund, Srinivas R Sadda, Tunde Peto, Ruikang K Wang, Michael Pircher, Christine A Curcio, Jennifer Sun, Amir H Kashani","doi":"10.1016/j.oret.2025.01.015","DOIUrl":"https://doi.org/10.1016/j.oret.2025.01.015","url":null,"abstract":"<p><strong>Objective: </strong>To develop a consensus nomenclature for Optical Coherence Tomography Angiography (OCTA) findings in retinal vascular diseases (RVD).</p><p><strong>Design: </strong>Expert consensus using standardized online surveys with modified Likert scale.</p><p><strong>Participants: </strong>RVD imaging experts, OCT biomedical engineers and the members of the International Retinal Imaging Society (IntRIS) METHODS: A PubMed literature review identified quantitative and qualitative terms forming the basis for a consensus-building process using a modified Delphi method. Agreement levels were categorized as \"Accepted\" (median ≥ 6), \"Considerable Consensus\" (median 6-7, IQR ≤ 3), \"Strong Consensus\" (median ≥ 8, IQR ≤ 2), and \"Refined Strong Consensus\" (median ≥ 8, IQR ≤ 2, with ≥ 70% responses in the 8-10 range). A multidisciplinary expert panel refined the terminology through three survey rounds, leading to a final survey conducted by IntRIS members.</p><p><strong>Main outcome measures: </strong>Consensus on OCTA nomenclature in RVD RESULTS: The literature review identified 58 relevant papers, yielding 51 quantitative and 108 qualitative terms. A series of three surveys was used to refine the nomenclature framework for describing OCTA findings. The selected framework includes a generic term (\"OCTA signal\"), adjective terms (\"presence/absence\", \"decreased/increased\", \"normal/abnormal\"), and descriptive/etiologic terms (\"of unknown cause\", \"due to blockage\", \"due to non-perfusion\"). In the final survey among 44 IntRIS members, the framework achieved strong consensus for overall acceptance (median: 8.0, IQR: 7.0-9.0). The term \"OCTA signal\" met refined strong consensus criteria (median: 8.0, IQR: 8.0-9.0, with ≥ 70% of responses in the 8-10 range). Adjective terms, including \"absence/presence\" and \"increased/decreased,\" were also rated with strong consensus (median: 8.0, IQR: 7.0-9.0). Similarly, descriptive/etiologic terms achieved strong consensus (median: 8.0, IQR: 7.0-9.0). Adoption of the framework for clinical practice and scientific reporting was rated with strong consensus (clinical: median 8.0, IQR: 7.0-9.0; scientific: median 9.0, IQR: 8.5-10.0).</p><p><strong>Conclusions: </strong>This study establishes a strong consensus framework for reporting OCTA findings in RVD for clinical and scientific contexts.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Macular Atrophy in Neovascular Age-Related Macular Degeneration: A Systematic Review and Meta-Analysis.","authors":"Alessandro Berni, Andrea Coletto, Jianqing Li, Mengxi Shen, Francesco Bandello, Michele Reibaldi, Enrico Borrelli","doi":"10.1016/j.oret.2025.01.011","DOIUrl":"https://doi.org/10.1016/j.oret.2025.01.011","url":null,"abstract":"<p><strong>Topic: </strong>Macular atrophy incidence in neovascular age-related macular degeneration (AMD) patients undergoing anti-vascular endothelial growth factor (VEGF) treatment.</p><p><strong>Clinical relevance: </strong>Macular atrophy is a significant event that may occur in eyes with neovascular AMD treated with anti-VEGF therapy.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis following PRISMA guidelines (PROSPERO, CRD42024474924). A comprehensive literature search of MEDLINE, EMBASE, and Web of Science was performed up to November 1, 2023. Randomized and non-randomized studies of treatment-naïve neovascular AMD patients reporting macular atrophy incidence at 24±3 months after anti-VEGF therapy were eligible for inclusion in this review. Two independent reviewers conducted screening, data extraction, and quality assessment. For randomized controlled trials, the Cochrane Risk of Bias 2 tool was employed, while non-randomized studies were evaluated using the ROBINS-I tool. Random-effects meta-analysis models were used for quantitative synthesis, accounting for study variability. Heterogeneity was assessed with the I² statistic, and publication bias by funnel plots and Egger's test. The primary outcome was the incidence of new macular atrophy at 24 months post-anti-VEGF therapy, with secondary outcomes at 12 months. Atrophy was diagnosed using color fundus photograph (CFP), fluorescein angiography (FA), fundus autofluorescence (FAF), optical coherence tomography (OCT), or multimodal imaging.</p><p><strong>Results: </strong>Twenty-three studies met the inclusion criteria for qualitative analysis, with 11 included in the meta-analysis (N=3,013 eyes). The pooled 24-month incidence of macular atrophy was 29% (95% confidence interval [CI]:20%-38%,I²=93%). Subgroup analysis revealed incidence rates of 26% (95% CI:15%-37%,I²=88%) for 814 eyes with Type 1/2 macular neovascularization (MNV), 49% (95% CI:18%-80%,I²=92%) for Type 3 MNV (N=230 eyes), and 29% (95% CI:18%-40%,I²=96%) for all MNV types (N=2,131 eyes). The pooled 12-month incidence among 2,214 eyes was 11% (95% CI:4%-18%,I²=93%). The certainty of evidence regarding the incidence of macular atrophy after anti-VEGF treatment, as assessed by GRADE, was low.</p><p><strong>Conclusions: </strong>While this meta-analysis has limitations, including a moderate risk of bias in non-randomized studies, inconsistencies in the results indicated by high heterogeneity, and imprecision due to the different imaging modalities used to diagnose macular atrophy, our results suggest that macular atrophy could be a common complication in neovascular AMD patients receiving anti-VEGF therapy.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A meta-analysis of intravitreal ranibizumab versus laser photocoagulation for the treatment of retinopathy of prematurity.","authors":"Abed A Baiad, Catherine Sun, Grace S Yin, Marko M Popovic, Rajeev H Muni, Kamiar Mireskandari, Peter J Kertes","doi":"10.1016/j.oret.2025.01.012","DOIUrl":"https://doi.org/10.1016/j.oret.2025.01.012","url":null,"abstract":"<p><strong>Purpose: </strong>Laser photocoagulation (LPC) has been a traditional treatment for retinopathy of prematurity (ROP). However, intravitreal anti-VEGF agents such as bevacizumab and ranibizumab (IVR) have also been increasingly used. This meta-analysis aims to rigorously compare IVR to LPC in the treatment of ROP.</p><p><strong>Methods: </strong>Medline, Embase and Cochrane CENTRAL were used to identify studies comparing IVR monotherapy to LPC (PROSPERO ID: CRD42023390855). The primary outcome was ROP regression. Secondary outcomes included likelihood of additional treatment, time from treatment to reactivation or re-treatment, refractive outcomes and adverse events such as retinal detachment, cataract, macular dragging/ectopia, vitreous or retinal hemorrhage, glaucoma, and endophthalmitis. A random effects meta-analysis was designed.</p><p><strong>Results: </strong>2361 articles were identified. 1947 eyes from 7 cohort studies, 1 case-control study and 2 RCTs were included with a median follow-up of 21 months (range: 11-75 months). There was no significant difference in disease regression between IVR and LPC (risk ratio [RR]=0.96, 95% confidence interval [CI] [0.83, 1.10], p=0.52), however, eyes that underwent IVR were associated with a higher likelihood of requiring additional treatment (RR= 2.70, CI= [1.55, 4.68], p<0.001). Although less frequent, retreatment occurred earlier with LPC compared to IVR (weighted mean difference (WMD)= -4.29 weeks, CI= [-6.48, -2.10], p<0.001). Furthermore, eyes that received IVR had a lower refractive error, with a WMD of -0.93 diopters (CI= [-1.54, -0.32], p=0.003) at a median age of assessment of 5.0 years (range 1.5-6.3 years). There was no difference in the rate of adverse events between LPC and IVR (p>0.05 for RD, MDR, VH and cataract). Quality of evidence was rated moderate for likelihood and time of additional treatment, as well as refractive error, but was considered low for disease regression and adverse events.</p><p><strong>Conclusion: </strong>Compared to LPC, IVR was associated with a higher likelihood of requiring additional treatment but a lower risk of myopia. More studies are needed to evaluate dose-response relationships and temporal trends in ROP regression following these treatments.</p>","PeriodicalId":19501,"journal":{"name":"Ophthalmology. Retina","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}