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. 2024 Apr 18;17(4):729-735.
doi: 10.18240/ijo.2024.04.18. eCollection 2024.

Effectiveness of intravitreal ranibizumab for diabetic macular edema in vitrectomized versus non-vitrectomized eyes: a Meta-analysis

Yi-Heng Wang  1   2 , Qian Xu  1 , Jie Luan  1
Affiliations

Effectiveness of intravitreal ranibizumab for diabetic macular edema in vitrectomized versus non-vitrectomized eyes: a Meta-analysis

Yi-Heng Wang et al. Int J Ophthalmol. .

Abstract

Aim: To evaluate the effectiveness and safety of intravitreal ranibizumab (IVR) for diabetic macular edema (DME) in vitrectomized versus non-vitrectomized eyes.

Methods: The PubMed, EMBASE, Web of Science, Cochrane, EBSCO were comprehensively searched for studies comparing vitrectomized and non-vitrectomized eyes with DME. Clinical outcomes of best-corrected visual acuity (BCVA), central macular thickness (CMT), the mean number of intravitreal injection and adverse events were extracted and analyzed.

Results: Six studies involving 641 eyes were included. Final visual gain significantly improved and CMT significantly reduced in vitrectomized eyes at 6mo and 12mo visits (P<0.05). Although the mean reduction in CMT among non-vitrectomized eyes was significantly greater than in vitrectomized eyes at the 6mo [mean difference (MD)=53.57, 95% confidence interval (CI): 28.03 to 78.72, P<0.0001] and 12mo (MD=49.65, 95%CI: 19.58 to 79.72, P=0.01), no significant difference was detected in improvement in BCVA at either 6mo (MD=0.05, 95%CI: -0.02 to 0.13, P=0.14) or 12mo (MD=0.03, 95%CI: -0.04 to 0.09, P=0.43). Injection number of ranibizumab in non-vitrectomized eyes was significantly less than that in vitrectomized eyes during 6-month period (MD=0.60, 95%CI: 0.16 to 1.04, P=0.008), while there was no statistically significant difference between the two groups during 12mo of follow-up.

Conclusion: Evidence from current study suggests that IVR was useful for both vitrectomized group and non-vitrectomized group with DME. Although less reduction in macular thickness is found in vitrectomized group, visual improvement between two groups is similar.

Keywords: diabetic macular edema; ranibizumab; vitrectomized eye.

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Conflict of interest statement

Conflicts of Interest: Wang YH, None; Xu Q, None; Luan J, None.

Figures

Figure 1
Figure 1. Flowchart of database search and study identification.
Figure 2
Figure 2. Forest plot
A: Forest plot comparing mean BCVA after IVR at 6 and 12mo follow-up (vitrectomized group vs non-vitrectomized group); B: Forest plot comparing the mean improvement in BCVA after IVR at 6 and 12mo follow-up (vitrectomized group vs non-vitrectomized group); C: Forest plot comparing mean CMT after IVR at 6 and 12mo follow-up (vitrectomized group vs non-vitrectomized group); D: Forest plot comparing the mean reduction in CMT after IVR at 6 and 12mo follow-up (vitrectomized group vs non-vitrectomized group); E: Forest plot comparing mean BCVA at baseline with after IVR in vitrectomized group; F: Forest plot comparing mean CMT at baseline with after IVR in vitrectomized group; G: Forest plot comparing mean number of intravitreal injection at 6mo between vitrectomized group and non-vitrectomized group; H: Forest plot comparing mean number of intravitreal injection at 6mo between vitrectomized group and non-vitrectomized group after the exclusion of Bressler et al. IVR: Intravitreal ranibizumab; BCVA: Best-corrected visual acuity; CMT: Central macular thickness.
Figure 3
Figure 3. Funnel plots for the Meta-analysis
A: Mean BCVA at 6 and 12mo; B: Mean improvement in BCVA at 6 and 12mo. BCVA: Best-corrected visual acuity.
See this image and copyright information in PMC

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