Use of antivascular endothelial growth factor for diabetic macular edema

Rushmia Karim, Benjamin TangUniversity of Sydney School of Public Health, Concord Repatriation General Hospital, Concord, NSW, AustraliaBackground: Diabetic macular edema (DME) is one of the manifestations of diabetic retinopathy leading to loss of central vision and visual acuity. It manifests itse...

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Autores principales:	Rushmia Karim, Benjamin Tang
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2010
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/32004324bf97400d931336fc3bc2f35c
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spelling	oai:doaj.org-article:32004324bf97400d931336fc3bc2f35c2021-12-02T04:24:58ZUse of antivascular endothelial growth factor for diabetic macular edema1177-54671177-5483https://doaj.org/article/32004324bf97400d931336fc3bc2f35c2010-05-01T00:00:00Zhttp://www.dovepress.com/use-of-antivascular-endothelial-growth-factor-for-diabetic-macular-ede-a4492https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Rushmia Karim, Benjamin TangUniversity of Sydney School of Public Health, Concord Repatriation General Hospital, Concord, NSW, AustraliaBackground: Diabetic macular edema (DME) is one of the manifestations of diabetic retinopathy leading to loss of central vision and visual acuity. It manifests itself with swelling around the central part of the retina, the area responsible for sharp vision. Current treatment includes laser therapy and intravitreal steroids with preventative measures including diabetes control. No one treatment has guaranteed control of diabetic macular edema which leads to deteriorating visual acuity, function and quality of life in patients. Vascular endothelial growth factor (VEGF) has been shown to be a critical stimulus in the pathogenesis of macular edema secondary to diabetes.1 Antiangiogenic therapy encompassed treatment with anti-VEGF which inhibits VEGF-driven neovascularization hence macular edema leading to decreased visual acuity.Objective: For this review, we evaluated the effectiveness of intravitreal anti-VEGF in treating DME.Data sources: We identified five trials (n = 525) using electronic databases (Cochrane Central Register of Controlled Trials [Central], Medline&reg;, and Excerpta Medica Database [EMBASE&reg;]) in October 2008, supplemented by hand searching of reference lists, review articles, and conference abstracts.Methods: We included all randomized clinical trials (RCTs) evaluating any form of intravitreal anti-VEGF for treating DME. The main outcome factor was change in best-corrected visual acuity and central macular thickness. One author assessed eligibility, methodological quality, and extracted data. Meta analysis was performed when appropriate.Results: We included three trials of adequate methodological quality in our metaanalysis. Patients treated with anti-VEGF showed improvement in visual acuity of -0.17 (95% confidence interval [CI]: -0.23, -0.10) and central macular thickness -84.69 (95% CI: -117.09, -52.30). Patients treated with combined anti-VEGF and intravitreal triamcinolone showed improvement of visual acuity of -0.19 (95% CI: -0.27, -0.11) and central macular thickness mean change being &ndash;111.20 (95% CI: -148.13, -74.28).Conclusions: Anti-VEGF has been associated with an improvement in visual acuity and central macular thickness in the analysis, however trial analysis was of a short duration and further research is needed to determine long-term benefits.Keywords: anti-VEGF, diabetic macular edema, ranizubimab, Avastin&reg;, pegaptanib Rushmia KarimBenjamin TangDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2010, Iss default, Pp 493-517 (2010)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Rushmia Karim Benjamin Tang Use of antivascular endothelial growth factor for diabetic macular edema
description	Rushmia Karim, Benjamin TangUniversity of Sydney School of Public Health, Concord Repatriation General Hospital, Concord, NSW, AustraliaBackground: Diabetic macular edema (DME) is one of the manifestations of diabetic retinopathy leading to loss of central vision and visual acuity. It manifests itself with swelling around the central part of the retina, the area responsible for sharp vision. Current treatment includes laser therapy and intravitreal steroids with preventative measures including diabetes control. No one treatment has guaranteed control of diabetic macular edema which leads to deteriorating visual acuity, function and quality of life in patients. Vascular endothelial growth factor (VEGF) has been shown to be a critical stimulus in the pathogenesis of macular edema secondary to diabetes.1 Antiangiogenic therapy encompassed treatment with anti-VEGF which inhibits VEGF-driven neovascularization hence macular edema leading to decreased visual acuity.Objective: For this review, we evaluated the effectiveness of intravitreal anti-VEGF in treating DME.Data sources: We identified five trials (n = 525) using electronic databases (Cochrane Central Register of Controlled Trials [Central], Medline&reg;, and Excerpta Medica Database [EMBASE&reg;]) in October 2008, supplemented by hand searching of reference lists, review articles, and conference abstracts.Methods: We included all randomized clinical trials (RCTs) evaluating any form of intravitreal anti-VEGF for treating DME. The main outcome factor was change in best-corrected visual acuity and central macular thickness. One author assessed eligibility, methodological quality, and extracted data. Meta analysis was performed when appropriate.Results: We included three trials of adequate methodological quality in our metaanalysis. Patients treated with anti-VEGF showed improvement in visual acuity of -0.17 (95% confidence interval [CI]: -0.23, -0.10) and central macular thickness -84.69 (95% CI: -117.09, -52.30). Patients treated with combined anti-VEGF and intravitreal triamcinolone showed improvement of visual acuity of -0.19 (95% CI: -0.27, -0.11) and central macular thickness mean change being &ndash;111.20 (95% CI: -148.13, -74.28).Conclusions: Anti-VEGF has been associated with an improvement in visual acuity and central macular thickness in the analysis, however trial analysis was of a short duration and further research is needed to determine long-term benefits.Keywords: anti-VEGF, diabetic macular edema, ranizubimab, Avastin&reg;, pegaptanib
format	article
author	Rushmia Karim Benjamin Tang
author_facet	Rushmia Karim Benjamin Tang
author_sort	Rushmia Karim
title	Use of antivascular endothelial growth factor for diabetic macular edema
title_short	Use of antivascular endothelial growth factor for diabetic macular edema
title_full	Use of antivascular endothelial growth factor for diabetic macular edema
title_fullStr	Use of antivascular endothelial growth factor for diabetic macular edema
title_full_unstemmed	Use of antivascular endothelial growth factor for diabetic macular edema
title_sort	use of antivascular endothelial growth factor for diabetic macular edema
publisher	Dove Medical Press
publishDate	2010
url	https://doaj.org/article/32004324bf97400d931336fc3bc2f35c
work_keys_str_mv	AT rushmiakarim useofantivascularendothelialgrowthfactorfordiabeticmacularedema AT benjamintang useofantivascularendothelialgrowthfactorfordiabeticmacularedema
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Use of antivascular endothelial growth factor for diabetic macular edema

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