• Medientyp: E-Artikel
  • Titel: Treatment of myopic choroidal neovascularization: a network meta-analysis and review
  • Beteiligte: Glachs, Laura; Embacher, Stefan; Berghold, Andrea; Wildner, Brigitte; Michelitsch, Monja; Tscherne, Anna; Wedrich, Andreas; Posch-Pertl, Laura
  • Erschienen: Springer Science and Business Media LLC, 2023
  • Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology
  • Sprache: Englisch
  • DOI: 10.1007/s00417-023-06271-2
  • ISSN: 0721-832X; 1435-702X
  • Schlagwörter: Cellular and Molecular Neuroscience ; Sensory Systems ; Ophthalmology
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  • Beschreibung: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Purpose</jats:title> <jats:p>This is, to our knowledge, the first network meta-analysis aiming to compare all treatment modalities for myopic choroidal neovascularization (CNV).</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>After the electronic databases were searched, two independent reviewers screened titles, abstracts, full-texts, and extracted information. Primary endpoints were change in visual outcome and central retinal thickness. We used a network meta-analysis to compare treatment outcomes in the early (≤ 6 months) and late (&gt; 6 months) phase.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>We included 34 studies (2,098 eyes) in our network meta-analysis. In the early phase, the use of anti-VEGF led to a gain of 14.1 letters (95% CI, 10.8–17.4) compared to untreated patients (<jats:italic>p</jats:italic> &lt; 0.0001), 12.1 letters (95% CI, 8.3–15.8) to photodynamic therapy (PDT) (<jats:italic>p</jats:italic> &lt; 0.0001), 7.5 (95% CI, 1.2–13.8) letters to intravitreal triamcinolone acetonide (TCA) (<jats:italic>p</jats:italic> = 0.019), and − 2.9 letters (95% CI, − 6.0–0.2) to the combination of anti-VEGF and PDT (<jats:italic>p</jats:italic> = 0.065). In the later phase, these results were largely maintained. There were no significant differences in visual outcomes between patients treated with 1 + PRN and 3 + PRN. However, the 1 + PRN group received 1.8 (SD 1.3), while the 3 + PRN group received 3.2 (SD 0.9) injections within 12 months (<jats:italic>p</jats:italic> &lt; 0.0001).</jats:p> </jats:sec><jats:sec> <jats:title>Conclusion</jats:title> <jats:p>This network meta-analysis confirms that anti-VEGF is the most effective treatment for myopic CNV using the 1 + PRN treatment strategy.</jats:p> </jats:sec>