The following is a summary of “Efficacy of Intravitreal Injections Anti-Vascular Endothelial Growth Factor Treatment for Radiation Retinopathy: A Systematic Review and Meta-analysis,” published in the March 2024 issue of Ophthalmology by Zhuang et al.
Researchers conducted a retrospective study to evaluate the therapeutic efficacy of intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections compared to alternative treatments in managing radiation retinopathy (RR).
They searched PubMed, Embase, Web of Science, Scopus, and the Cochrane Library (December 15, 2023). This review encompassed RCTs and non-randomized studies (NRSs) focusing on best-corrected visual acuity (BCVA) in patients with RR treated with intravitreal anti-VEGF. Two independent reviewers meticulously carried out study selection and data extraction. Bias risk assessment utilized the Cochrane Risk of Bias Tool 2.0 (RoB 2.0) and Risk of Bias in NRSs of Interventions (ROBINS-I) scales. Quantification of heterogeneity was performed using Q, H, and I2 statistics. The primary endpoint was BCVA at the final observation point in each study. Secondary endpoints included central retinal thickness (CRT), foveal avascular zone (FAZ) area, and capillary density (CD) at the level of the superficial capillary plexus. Subgroup analyses were conducted to explore potential sources of heterogeneity, such as treatment duration and study design. Sensitivity analyses were undertaken to ensure the stability of the results.
The results showed that based on an analysis of 7 studies (including 3 RCTs) involving 922 patients with RR, intravitreal anti-VEGF therapy was associated with a statistically significant mean decrease in BCVA of -0.34 logMAR (95% CI: -0.39 to -0.30 logMAR; I2 = 87.70%; P<.001). Moreover, there was a substantial reduction in CRT of -34.65 μm (95% CI: -50.70 to -18.60 μm; I2 = 30.40%; P<.001). The FAZ area also exhibited a decrease by -0.69 mm2 (95% CI: -0.91 to -0.46 mm2, I2 = 0%; P<.001). A positive tendency was observed in CD at the superficial capillary plexus when comparing anti-VEGF with other therapeutic interventions.
Investigators concluded that while limited by NRSs and small size, intravitreal anti-VEGF injections show promise for improving vision and reducing fluid buildup in RR.