Background: Exudative, or “wet” age-related macular degeneration (wAMD), characterized by choroidal neovascularization and consequent accumulation of subretinal fluid, is the leading cause of visual loss in elderly ...Background: Exudative, or “wet” age-related macular degeneration (wAMD), characterized by choroidal neovascularization and consequent accumulation of subretinal fluid, is the leading cause of visual loss in elderly patients in Western countries. Objective: To compare the effectiveness of aflibercept vs. ranibizumab for treatment-naive wAMD patients in the real world. Methods: PubMed, Web of Science and Cochrane Library were searched to compare aflibercept with ranibizumab. 21 studies with a total of 13,004 eyes were selected and assessed in this meta-analysis. Results: Compared to ranibizumab, aflibercept was more effective in improving best-corrected visual acuity (BCVA) at 12 months (WMD: −0.04;95% CI: −0.07 to 0.00;p = 0.04). At 3 months, aflibercept was superior to ranibizumab in reducing central retinal thickness in patients with worse baseline BCVA (WMD: −36.19;95% CI: −71.47 to −0.92;p = 0.04), reducing subfoveal choroidal thickness in patients with better baseline BCVA (WMD: −12.67;95% CI: −21.33 to −4.02;p = 0.004), reducing height of subfoveal pigment epithelial detachment (WMD: −43.88;95% CI: −73.88 to −13.87;p = 0.004) and improving the incidence of “dry macula” occurrence (OR: 2.26;95% CI: 1.33 to 3.82;p = 0.003). Conclusions: Compared with ranibizumab, aflibercept showed better efficacy in improving morphological changes at 3 months and visual acuity at 12 months post treatment initiation in community clinical setting.展开更多
文摘Background: Exudative, or “wet” age-related macular degeneration (wAMD), characterized by choroidal neovascularization and consequent accumulation of subretinal fluid, is the leading cause of visual loss in elderly patients in Western countries. Objective: To compare the effectiveness of aflibercept vs. ranibizumab for treatment-naive wAMD patients in the real world. Methods: PubMed, Web of Science and Cochrane Library were searched to compare aflibercept with ranibizumab. 21 studies with a total of 13,004 eyes were selected and assessed in this meta-analysis. Results: Compared to ranibizumab, aflibercept was more effective in improving best-corrected visual acuity (BCVA) at 12 months (WMD: −0.04;95% CI: −0.07 to 0.00;p = 0.04). At 3 months, aflibercept was superior to ranibizumab in reducing central retinal thickness in patients with worse baseline BCVA (WMD: −36.19;95% CI: −71.47 to −0.92;p = 0.04), reducing subfoveal choroidal thickness in patients with better baseline BCVA (WMD: −12.67;95% CI: −21.33 to −4.02;p = 0.004), reducing height of subfoveal pigment epithelial detachment (WMD: −43.88;95% CI: −73.88 to −13.87;p = 0.004) and improving the incidence of “dry macula” occurrence (OR: 2.26;95% CI: 1.33 to 3.82;p = 0.003). Conclusions: Compared with ranibizumab, aflibercept showed better efficacy in improving morphological changes at 3 months and visual acuity at 12 months post treatment initiation in community clinical setting.
