Efficacy of pars plana vitrectomy assisted by bevacizumab in the treatment of proliferative diabetic retinopathy:a systematic review
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Efficacy of pars plana vitrectomy assisted by bevacizumab in the treatment of proliferative diabetic retinopathy:a systematic review
Journal of Chongqing Medical UniversityVol. 36, Issue 12, Pages: 1476-1481(2013)
作者机构:
重庆医科大学附属第一医院眼科,重庆市眼科学重点实验室,重庆,400016
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Published:2013,
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JI Yan, ZHAO Min. Efficacy of pars plana vitrectomy assisted by bevacizumab in the treatment of proliferative diabetic retinopathy:a systematic review. [J]. Journal of Chongqing Medical University 36(12):1476-1481(2013)
DOI:
JI Yan, ZHAO Min. Efficacy of pars plana vitrectomy assisted by bevacizumab in the treatment of proliferative diabetic retinopathy:a systematic review. [J]. Journal of Chongqing Medical University 36(12):1476-1481(2013)DOI:
Efficacy of pars plana vitrectomy assisted by bevacizumab in the treatment of proliferative diabetic retinopathy:a systematic review
目的:系统评价贝伐单抗辅助玻璃体切除术(pars plana vitrectomy,PPV)治疗增生性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)的疗效。方法:计算机检索Cochrane Library、Medline、Embase、中国生物医学文献数据库(CBM)、中文科技期刊数据库(VIP)、中国期刊全文数据库(CNKI)、万方数字化期刊全文数据库,查找以贝伐单抗辅助PPV治疗PDR的随机对照试验(randomized controlled trials,RCTs)或对照试验,对纳入的实验进行质量评价,采用Rev Man 5.1软件进行Meta分析。结果:共纳入7项RCTs,包括319只眼(实验组:167只眼,对照组:152只眼)。Meta分析结果提示,实验组术后视力恢复程度较对照组好(OR=-0.37,95%CI=-0.45~-0.30,P=0.000)且手术时间较短(MD=-17.37,95%CI=-29.32~-5.42,P=0.004)。实验组术中出血、电凝次数、医源性视网膜裂孔等发生例数较对照组少,术中出血(OR=0.06,95%CI=0.02~0.18,P=0.000);电凝次数(OR=0.07,95%CI=0.02~0.22,P=0.000)医源性视网膜裂孔(MD=-17.37,95%CI=-29.32~-5.42,P=0.003);术后玻璃体再积血较对照组少(OR=0.36,95%CI=0.20~0.64,P=0.000);术后视网膜脱离,眼压升高两组无差异[视网膜脱离(OR=0.35,95%CI=0.12~1.01,P=0.050;眼压升高(OR=0.48,95%CI=0.18~1.23,P=0.130)]。结论:贝伐单抗辅助PPV治疗PDR疗效较单一PPV治疗好,并且可以减少术中、术后并发症。
Abstract
Objective:To evaluate the efficacy pars plana vitrectomy(PPV) assisted by bevacizumab in the treatment of proliferative di-abetic retinopathy(PDR). Methods:Databases of cochrane library,medline,embase,Chinese biomedical literature database(CBM),VIP,CNKI,Wanfang digital journals were searched for randomized controlled trials(RCTs) or comparative study of bevacizumab ad-juvant PPV in treatment of PDR. Quality of enrolled literatures was assessed and software of Rev Man 5.1 was employed to conduct Meta analysis. Results:A total of 8 RCTs were included,including 319 eyes(experimental group:167 eyes,control group:152 eyes). Meta analysis results suggested that the experimental group had better visual acuity recovery(OR=-0.37,95%CI=-0.45 to -0.30,P=0.000) and shorter mean operation time than controls(MD=-17.37,95%CI=-29.32 to -5.42,P=0.004). Moreover,cases having less intraoperative bleeding(OR=0.06,95%CI=0.02 to 0.18,P=0.000),endodiathermy frequency(OR=0.07,95%CI=0.02 to 0.22),P=0.000),iatrogenic retinal tear(MD=-17.37,95%CI=-29.32 to -5.42,P=0.004) and recurrent vitreous hemorrhage(OR=0.36,95%CI=0.20 to 0.64,P=0.000) were fewer in experiment group than in control group. There was no significant differences in retinal detach-ment(OR=0.35,95%CI=0.12 to 1.01,P=0.050) and intraocular pressure(OR=0.48,95%CI=0.18 to 1.23,P=0.130) between the two groups. Conclusions:Bevacizumab assisted vitrectomy for PDR is more effective than single PPV treatment and it can reduce postop-erative complications.
关键词
贝伐单抗玻璃体切除术糖尿病视网膜病变Meta分析系统评价
Keywords
bevacizumabpars plana vitrectomydiabetic retinopathyMeta analysissystematic review