Cochrane · systematic review · CD008721
Anti‐vascular endothelial growth factor for proliferative diabetic retinopathy
Martinez-Zapata, MJ, Salvador, I, Martí-Carvajal, AJ, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
8
current version
GRADE rated
7
No studies
1
Included studies
NR
No studies 1 · 12.5%Ungraded 0 · 0%Very low 1 · 12.5%Low 3 · 37.5%Moderate 3 · 37.5%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyAnti‐vascular endothelial growth factor (anti‐VEGF) with or without pan‐retinal photocoagulation (PRP) compared to PRP alone for proliferative diabetic retinopathy
Population: people with proliferative diabetic retinopathy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Loss of 3 or more lines of ETDRS visual acuity ‐ not reported Anti‐vascular endothelial growth factor (anti‐VEGF) with or without pan‐retinal photocoagulation (PRP) vs PRP alone | no estimate extracted | NR | No studies |
LogMAR visual acuity(logMAR scale value of 0 = 6/6 vision, higher score = worse vision) Anti‐vascular endothelial growth factor (anti‐VEGF) with or without pan‐retinal photocoagulation (PRP) vs PRP alone | no estimate extracted | 10 studies · 1172 participants | Moderate Downgraded: risk of bias |
Complete regression of new vessels (dichotomous outcome) Anti‐vascular endothelial growth factor (anti‐VEGF) with or without pan‐retinal photocoagulation (PRP) vs PRP alone | RR 1.63 [1.19, 2.24] | 5 studies · 405 participants | Moderate Downgraded: risk of bias |
Regression of new vessels (continuous outcome): mean area of fluorescein leakage (mm2) fluorescein angiography Anti‐vascular endothelial growth factor (anti‐VEGF) with or without pan‐retinal photocoagulation (PRP) vs PRP alone | no estimate extracted | 4 studies · 189 participants | Low Downgraded: risk of bias, inconsistency |
Presence of vitreous haemorrhaged Anti‐vascular endothelial growth factor (anti‐VEGF) with or without pan‐retinal photocoagulation (PRP) vs PRP alone | RR 0.72 [0.57, 0.9] | 6 studies · 1008 participants | Moderate Downgraded: risk of bias |
Need for vitrectomy Anti‐vascular endothelial growth factor (anti‐VEGF) with or without pan‐retinal photocoagulation (PRP) vs PRP alone | RR 0.67 [0.49, 0.93] | 8 studies · 1248 participants | Low Downgraded: risk of bias, imprecision |
Quality of life (VFQ‐25 General health) Anti‐vascular endothelial growth factor (anti‐VEGF) with or without pan‐retinal photocoagulation (PRP) vs PRP alone | no estimate extracted | 2 studies · 382 participants | Low Downgraded: risk of bias, imprecision |
Adverse events Anti‐vascular endothelial growth factor (anti‐VEGF) with or without pan‐retinal photocoagulation (PRP) vs PRP alone | no estimate extracted | 6 studies · 1070 participants | Very low Downgraded: risk of bias, imprecision |
Anti‐VEGF with or without laser (panretinal photocoagulation; PRP) compared with PRP alone for proliferative diabetic retinopathy
Population: people with PDR
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Loss of ≥ 3 lines of ETDRS visual acuity Anti‐VEGF with or without laser (panretinal photocoagulation; PRP) vs PRP alone | RR 0.19 [0.05, 0.81] | 1 study · 61 participants | Very low |
Gain of ≥ 3 lines of ETDRS visual acuity Anti‐VEGF with or without laser (panretinal photocoagulation; PRP) vs PRP alone | RR 6.78 [0.37, 125.95] | 1 study · 61 participants | Very low |
Visual acuity logMAR (logMAR scale value of 0 = 6/6 vision, higher score = worse vision) Anti‐VEGF with or without laser (panretinal photocoagulation; PRP) vs PRP alone | no estimate extracted | 5 studies · 373 participants | Low |
Regression of proliferative diabetic retinopathy (as measured by area of fluorescein leakage) Anti‐VEGF with or without laser (panretinal photocoagulation; PRP) vs PRP alone | no estimate extracted | 1 study · 6 participants | Ungraded |
Presence of vitreous/pre‐retinal haemorrhage Anti‐VEGF with or without laser (panretinal photocoagulation; PRP) vs PRP alone | RR 0.32 [0.16, 0.65] | 3 studies · 342 participants | Low |
Quality of life Anti‐VEGF with or without laser (panretinal photocoagulation; PRP) vs PRP alone | no estimate extracted | NR | No studies |
Adverse effects Anti‐VEGF with or without laser (panretinal photocoagulation; PRP) vs PRP alone | RR 1.09 | 3 studies · 61 participants | Ungraded |
Bevacizumab before or during vitrectomy compared with vitrectomy alone
Population: people undergoing vitrectomy for PDR
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Loss of ≥ 3 lines of ETDRS visual acuity Bevacizumab before or during vitrectomy vs vitrectomy alone | RR 0.49 [0.08, 3.14] | 3 studies · 94 participants | Low |
Gain of ≥ 3 lines of ETDRS visual acuity Bevacizumab before or during vitrectomy vs vitrectomy alone | RR 1.62 [1.2, 2.17] | 3 studies · 94 participants | Low |
Visual acuity logMAR (logMAR scale value of 0 = 6/6 vision, higher score = worse vision) Bevacizumab before or during vitrectomy vs vitrectomy alone | no estimate extracted | 6 studies · 335 participants | Low |
Regression of PDR (as measured by area of fluorescein leakage) Bevacizumab before or during vitrectomy vs vitrectomy alone | no estimate extracted | NR | No studies |
Presence of vitreous/pre‐retinal haemorrhage Bevacizumab before or during vitrectomy vs vitrectomy alone | RR 0.3 [0.18, 0.52] | 7 studies · 393 participants | Low |
Quality of life Bevacizumab before or during vitrectomy vs vitrectomy alone | no estimate extracted | NR | No studies |
Adverse effects Bevacizumab before or during vitrectomy vs vitrectomy alone | RR 2.33 | 1 study · 175 participants | Ungraded |