Efficacy and safety of anti-vascular endothelial growth agents for the treatment of polypoidal choroidal vasculopathy: A systematic review and meta-analysis |
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| Affiliation: | 1. Michael DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada;2. Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada;3. Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada;4. John and Liz Tory Eye Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada;5. Department of Ophthalmology, St. Michael’s Hospital/Unity Health Toronto, Toronto, Ontario, Canada;1. The Second Hospital of Hebei Medical University, Ophthalmology Department, Shijiazhuang, China;2. Beijing Tongren Hospital of Capital Medical University, Ophthalmology Department, Beijing, China;3. Moorfields Eye Hospitals UAE, Abu Dhabi, United Arab Emirates;1. Callahan Eye Hospital, Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, AL, USA;2. Wilmer Eye Institute, Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, USA;1. South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia;2. Save Sight Institute, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Australia;3. Adelaide Skin & Eye Centre, South Australia, Australia;4. Department of Dermatology, Royal Adelaide Hospital, The University of Adelaide, Adelaide, South Australia, Australia;5. Clinpath Laboratories, Adelaide, South Australia, Australia;1. Mayo Clinic, Department of Ophthalmology, Rochester, Minnesota, USA;2. Mayo Clinic, Department of Physiology and Biomedical Engineering, Rochester, Minnesota, USA |
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| Abstract: | There remains limited agreement regarding the efficacy and safety of different antivascular endothelial growth factor (anti-VEGF) agents for the management of polypoidal choroidal vasculopathy (PCV). Our meta-analysis compares different anti-VEGF agents for PCV treatment. Ovid MEDLINE, EMBASE, and Cochrane Library were systematically searched from January 2000 to July 2022. We included articles comparing the efficacy and safety of different anti-VEGF agents, specifically bevacizumab (BEV), ranibizumab (RAN), aflibercept AFL), and brolucizumab (BRO), for patients with PCV. 10,440 studies were identified, 122 underwent full-text review, and seven were included. One study was a randomized trial, and six were observational studies. Ranibizumab and aflibercept were associated with a similar best-corrected visual acuity (BCVA) at the last visit in three observational studies (P = 0.10), similar retinal thickness at the last visit in two observational studies (P = 0.85). One observational study comparing BEV versus RAN found comparable outcomes for final BCVA, retinal thickness, and polyp regression. One randomized trial on BRO versus AFL found comparable outcomes for improvement in BCVA, while anatomical outcomes favored BRO. The available evidence suggests that final BCVA is comparable across different anti-VEGF agents, however, further investigation is warranted due to paucity of evidence. |
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| Keywords: | Polypoidal choroidal vasculopathy Treat-and-extend As-needed Anti-VEGF Neovascular age-related macular degeneration |
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