Meta-analysis of the effect of intravitreal bevacizumab versus photodynamic therapy in myopic choroidal neovascularisation_Chinese Journal of Ocular Fundus Diseases

Authors：

ZhuDan , JinZiye ,  TaoYong

The Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China;

Corresponding author：

TaoYong, Email: drtaoyong@163.com

Keywords：

Choroid diseases/therapy; Angiogenesis inhibitors/therapeutic use; Antibodies,monoclonal/therapeutic use; Photochemotherapy; Meta analysis

DOI：

10.3760/cma.j.issn.1005-1015.2014.05.020

Video：

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Objective To further compare the effect of intravitreal injection of bevacizumab (IVB) and photodynamic therapy (PDT) for the treatment of choroidal neovascularization (CNV) secondary to pathologic myopia by meta-analysis. Methods Pertinent publications were identified through systemic searches of PubMed, EMBASE and the Cochrance Controlled Trials Register. All clinical comparative studies of IVB or PDT as initial treatment for CNV secondary to pathologic myopia were included. Meta analysis of these clinical trials was performed to analyze the effect of IVB and PDT for CNV secondary to pathologic myopia. Measurements included best corrected visual acuity (BCVA) and central foveal thickness (CFT). Results A total of 6 comparative studies involving 351 eyes were included. There were 196 eyes in IVB group and 215 eyes in PDT group. Funnel plots, Egger linear regression and Begg method did not show publication bias. Compared with PDT group, at 3, 6 and 12 months after IVB treatment, BCVA significantly increased . However, change of CFT at 3, 6 and 12 months did not vary significantly between IVB group and PDT group (3 months: WMD=-22.49, 95% CI=-93.49 to 48.52, P=0.53; 6 months: WMD=-17.34, 95% CI=-56.00 to 21.31, P=0.38; 12 months: WMD=-5.32, 95% CI=-56.37 to 45.74, P=0.84). Conclusion Patients with CNV secondary to pathologic myopia experienced a significant benefit of visual improvement after IVB, but reduction in CFT after the IVB or PDT did not vary significantly.

Citation： ZhuDan, JinZiye, TaoYong. Meta-analysis of the effect of intravitreal bevacizumab versus photodynamic therapy in myopic choroidal neovascularisation. Chinese Journal of Ocular Fundus Diseases, 2014, 30(5): 509-513. doi: 10.3760/cma.j.issn.1005-1015.2014.05.020 Copy

1.	Neelam K, Cheung CM, Ohno-Matsui K, et al. Choroidal neovascularization in pathological myopia[J]. Prog Retin Eye Res, 2012, 31:495-525.
2.	Chan WM, Lai TY, Chan KP, et al. Changes in aqueous vascular endothelial growth factor and pigment epithelial-derived factor levels following intravitreal bevacizumab injections for choroidal neovascularization secondary to age-related macular degeneration or pathologic myopia[J]. Retina, 2008, 28:1308-1313.
3.	Mandal S, Venkatesh P, Sampangi R, et al. Intravitreal bevacizumab (Avastin) as primary treatment for myopic choroidal neovascularization[J]. Eur J Ophthalmol, 2007, 17:620-626.
4.	Yamamoto I, Rogers AH, Reichel E, et al. Intravitreal bevacizumab (Avastin) as treatment for subfoveal choroidal neovascularisation secondary to pathological myopia[J]. Br J Ophthalmol, 2007, 91:157-160.
5.	Gharbiya M, Giustolisi R, Allievi F, et al. Choroidal neovascularization in pathologic myopia:intravitreal ranibizumab versus bevacizumab——a randomized controlled trial[J]. Am J Ophthalmol, 2010, 149:458-464.
6.	Sakaguchi H, Ikuno Y, Gomi F, et al. Intravitreal injection of bevacizumab for choroidal neovascularisation associated with pathological myopia[J]. Br J Ophthalmol, 2007, 91:161-165.
7.	Arias L, Planas N, Prades S, et al. Intravitreal bevacizumab (Avastin) for choroidal neovascularisation secondary to pathological myopia:6-month results[J]. Br J Ophthalmol, 2008, 92:1035-1039.
8.	Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials:is blinding necessary?[J]. Control Clin Trials,1996,17:1-12.
9.	Baba T, Kubota-Taniai M, Kitahashi M, et al. Two-year comparison of photodynamic therapy and intravitreal bevacizumab for treatment of myopic choroidal neovascularisation[J]. Br J Ophthalmol,2010,94:864-870.
10.	Hayashi K, Ohno-Matsui K, Teramukai S, et al. Comparison of visual outcome and regression pattern of myopic choroidal neovascularization after intravitreal bevacizumab or after photodynamic therapy[J]. Am J Ophthalmol,2009,148:396-408.
11.	Ikuno Y, Nagai Y, Matsuda S, et al. Two-year visual results for older Asian women treated with photodynamic therapy or bevacizumab for myopic choroidal neovascularization[J]. Am J Ophthalmol,2010,149:140-146.
12.	El Matri L, Kort F, Chebil A, et al. Intravitreal bevacizumab versus photodynamic therapy for myopic choroidal neovascularization in a North-African population[J]. Graefe's Arch Clin Exp Ophthalmol,2011,249:1287-1293.
13.	Matsuo M, Honda S, Matsumiya W, et al. Comparison between anti-vascular endothelial growth factor therapy and photodynamic therapy for myopic choroidal neovascularization[J]. Eur J Ophthalmol,2012,22:210-215.
14.	Yoon JU, Byun YJ, Koh HJ. Intravitreal anti-VEGF versus photodynamic therapy with verteporfin for treatment of myopic choroidal neovascularization[J]. Retina,2010,30:418-424.
15.	Brancato R, Pece A, Avanza P, et al. Photocoagulation scar expansion after laser therapy for choroidal neovascularization in degenerative myopia[J]. Retina,1990,10:239-243.
16.	Hayashi K, Ohno-Matsui K, Teramukai S, et al. Photodynamic therapy with verteporfin for choroidal neovascularization of pathologic myopia in Japanese patients:comparison with nontreated controls[J]. Am J Ophthalmol,2008,145:518-526.
17.	Moshfeghi DM, Kaiser PK, Grossniklaus HE, et al. Clinicopathologic study after submacular removal of choroidal neovascularmembranes treated with verteporf in ocular photodynamic therapy[J]. Am J Ophthalmol,2003,135:343-350.
18.	Gharbiya M, Allievi F, Mazzeo L, et al. Intravitreal bevacizumab treatment for choroidal neovascularization in pathologic myopia:12-month results[J]. Am J Ophthalmol,2009,147:84-93.
19.	Milani P, Massacesi A, Ciaccia S, et al. Only first intravitreal bevacizumab injection achieves statistically significant visual improvement in nafive myopic choroidal neovascularization[J]. Clin Ophthalmol,2012,6:1885-1894.
20.	Ruiz-Moreno JM, Gomez-Ulla F, Montero JA, et al. Intravitreous bevacizumab to treat subfoveal choroidal neovascularization in highly myopic eyes:short-term results[J]. Eye (Lond),2009,23:334-338.
21.	Kuo JZ, Ong FS, Yeung L, et al. Predictive factors for visual outcome to intravitreal bevacizumab in young Chinese patients with myopic choroidal neovascularization[J]. Retina,2011,31:1835-1840.
22.	Ng DS, Kwok AK, Chan CW. Anti-vascular endothelial growth factor for myopic choroidal neovascularization[J]. Clin Exp Ophthalmol,2012,40:98-110.
23.	Lai TY, Luk FO, Lee GK, et al. Long-term outcome of intravitreal anti-vascular endothelial growth factor therapy with bevacizumab or ranibizumab as primary treatment for subfoveal myopic choroidal neovascularization[J]. Eye(Lond),2012,26:1004-1011.
24.	Hayashi K, Ohno-Matsui K, Shimada N, et al. Intravitreal bevacizumab on myopic choroidal neovascularization that was refractory to or had recurred after photodynamic therapy[J]. Graefe's Arch Clin Exp Ophthalmol,2009,247:609-618.

1. Neelam K, Cheung CM, Ohno-Matsui K, et al. Choroidal neovascularization in pathological myopia[J]. Prog Retin Eye Res, 2012, 31:495-525.
2. Chan WM, Lai TY, Chan KP, et al. Changes in aqueous vascular endothelial growth factor and pigment epithelial-derived factor levels following intravitreal bevacizumab injections for choroidal neovascularization secondary to age-related macular degeneration or pathologic myopia[J]. Retina, 2008, 28:1308-1313.
3. Mandal S, Venkatesh P, Sampangi R, et al. Intravitreal bevacizumab (Avastin) as primary treatment for myopic choroidal neovascularization[J]. Eur J Ophthalmol, 2007, 17:620-626.
4. Yamamoto I, Rogers AH, Reichel E, et al. Intravitreal bevacizumab (Avastin) as treatment for subfoveal choroidal neovascularisation secondary to pathological myopia[J]. Br J Ophthalmol, 2007, 91:157-160.
5. Gharbiya M, Giustolisi R, Allievi F, et al. Choroidal neovascularization in pathologic myopia:intravitreal ranibizumab versus bevacizumab——a randomized controlled trial[J]. Am J Ophthalmol, 2010, 149:458-464.
6. Sakaguchi H, Ikuno Y, Gomi F, et al. Intravitreal injection of bevacizumab for choroidal neovascularisation associated with pathological myopia[J]. Br J Ophthalmol, 2007, 91:161-165.
7. Arias L, Planas N, Prades S, et al. Intravitreal bevacizumab (Avastin) for choroidal neovascularisation secondary to pathological myopia:6-month results[J]. Br J Ophthalmol, 2008, 92:1035-1039.
8. Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials:is blinding necessary?[J]. Control Clin Trials,1996,17:1-12.
9. Baba T, Kubota-Taniai M, Kitahashi M, et al. Two-year comparison of photodynamic therapy and intravitreal bevacizumab for treatment of myopic choroidal neovascularisation[J]. Br J Ophthalmol,2010,94:864-870.
10. Hayashi K, Ohno-Matsui K, Teramukai S, et al. Comparison of visual outcome and regression pattern of myopic choroidal neovascularization after intravitreal bevacizumab or after photodynamic therapy[J]. Am J Ophthalmol,2009,148:396-408.
11. Ikuno Y, Nagai Y, Matsuda S, et al. Two-year visual results for older Asian women treated with photodynamic therapy or bevacizumab for myopic choroidal neovascularization[J]. Am J Ophthalmol,2010,149:140-146.
12. El Matri L, Kort F, Chebil A, et al. Intravitreal bevacizumab versus photodynamic therapy for myopic choroidal neovascularization in a North-African population[J]. Graefe's Arch Clin Exp Ophthalmol,2011,249:1287-1293.
13. Matsuo M, Honda S, Matsumiya W, et al. Comparison between anti-vascular endothelial growth factor therapy and photodynamic therapy for myopic choroidal neovascularization[J]. Eur J Ophthalmol,2012,22:210-215.
14. Yoon JU, Byun YJ, Koh HJ. Intravitreal anti-VEGF versus photodynamic therapy with verteporfin for treatment of myopic choroidal neovascularization[J]. Retina,2010,30:418-424.
15. Brancato R, Pece A, Avanza P, et al. Photocoagulation scar expansion after laser therapy for choroidal neovascularization in degenerative myopia[J]. Retina,1990,10:239-243.
16. Hayashi K, Ohno-Matsui K, Teramukai S, et al. Photodynamic therapy with verteporfin for choroidal neovascularization of pathologic myopia in Japanese patients:comparison with nontreated controls[J]. Am J Ophthalmol,2008,145:518-526.
17. Moshfeghi DM, Kaiser PK, Grossniklaus HE, et al. Clinicopathologic study after submacular removal of choroidal neovascularmembranes treated with verteporf in ocular photodynamic therapy[J]. Am J Ophthalmol,2003,135:343-350.
18. Gharbiya M, Allievi F, Mazzeo L, et al. Intravitreal bevacizumab treatment for choroidal neovascularization in pathologic myopia:12-month results[J]. Am J Ophthalmol,2009,147:84-93.
19. Milani P, Massacesi A, Ciaccia S, et al. Only first intravitreal bevacizumab injection achieves statistically significant visual improvement in nafive myopic choroidal neovascularization[J]. Clin Ophthalmol,2012,6:1885-1894.
20. Ruiz-Moreno JM, Gomez-Ulla F, Montero JA, et al. Intravitreous bevacizumab to treat subfoveal choroidal neovascularization in highly myopic eyes:short-term results[J]. Eye (Lond),2009,23:334-338.
21. Kuo JZ, Ong FS, Yeung L, et al. Predictive factors for visual outcome to intravitreal bevacizumab in young Chinese patients with myopic choroidal neovascularization[J]. Retina,2011,31:1835-1840.
22. Ng DS, Kwok AK, Chan CW. Anti-vascular endothelial growth factor for myopic choroidal neovascularization[J]. Clin Exp Ophthalmol,2012,40:98-110.
23. Lai TY, Luk FO, Lee GK, et al. Long-term outcome of intravitreal anti-vascular endothelial growth factor therapy with bevacizumab or ranibizumab as primary treatment for subfoveal myopic choroidal neovascularization[J]. Eye(Lond),2012,26:1004-1011.
24. Hayashi K, Ohno-Matsui K, Shimada N, et al. Intravitreal bevacizumab on myopic choroidal neovascularization that was refractory to or had recurred after photodynamic therapy[J]. Graefe's Arch Clin Exp Ophthalmol,2009,247:609-618.

Chinese Journal of Ocular Fundus Diseases

Meta-analysis of the effect of intravitreal bevacizumab versus photodynamic therapy in myopic choroidal neovascularisation

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