Skip to content Skip to navigation
University of Warwick
  • Study
  • |
  • Research
  • |
  • Business
  • |
  • Alumni
  • |
  • News
  • |
  • About

University of Warwick
Publications service & WRAP

Highlight your research

  • WRAP
    • Home
    • Search WRAP
    • Browse by Warwick Author
    • Browse WRAP by Year
    • Browse WRAP by Subject
    • Browse WRAP by Department
    • Browse WRAP by Funder
    • Browse Theses by Department
  • Publications Service
    • Home
    • Search Publications Service
    • Browse by Warwick Author
    • Browse Publications service by Year
    • Browse Publications service by Subject
    • Browse Publications service by Department
    • Browse Publications service by Funder
  • Help & Advice
University of Warwick

The Library

  • Login
  • Admin

Current treatments in diabetic macular oedema : systematic review and meta-analysis

Tools
- Tools
+ Tools

Ford, John A., Lois, Noemi, Royle, Pamela, Clar, C., Shyangdan, D. and Waugh, Norman (2013) Current treatments in diabetic macular oedema : systematic review and meta-analysis. BMJ Open, Volume 3 (Number 3). Article no. e002269. doi:10.1136/bmjopen-2012-002269 ISSN 2044-6055.

[img]
Preview
Text
WRAP_Royle_BMJ_ review.pdf - Published Version
Available under License Creative Commons Attribution Non-commercial Share Alike.

Download (2202Kb) | Preview
Official URL: http://dx.doi.org/10.1136/bmjopen-2012-002269

Request Changes to record.

Abstract

Objectives: The aim of this systematic review is to
appraise the evidence for the use of anti-VEGF drugs and steroids in diabetic macular oedema (DMO) as assessed by change in best corrected visual acuity (BCVA), central macular thickness and adverse events
Data source: MEDLINE, EMBASE, Web of Science with Conference Proceedings and the Cochrane Library (inception to July 2012). Certain conference abstracts and drug regulatory web sites were also searched.
Study eligibility criteria, participants and interventions: Randomised controlled trials were used to assess clinical effectiveness and observational trials were used for safety. Trials which assessed triamcinolone, dexamethasone, fluocinolone,
bevacizumab, ranibizumab, pegaptanib or aflibercept in
patients with DMO were included.
Study appraisal and synthesis methods: Risk of bias was assessed using the Cochrane risk of bias tool. Study results are narratively described and, where appropriate, data were pooled using random effects
meta-analysis.
Results: Anti-VEGF drugs are effective compared to
both laser and placebo and seem to be more effective
than steroids in improving BCVA. They have been
shown to be safe in the short term but require frequent
injections. Studies assessing steroids (triamcinolone,
dexamethasone and fluocinolone) have reported mixed
results when compared with laser or placebo. Steroids
have been associated with increased incidence of
cataracts and intraocular pressure rise but require
fewer injections, especially when steroid implants are
used.
Limitations: The quality of included studies varied
considerably. Five of 14 meta-analyses had moderate
or high statistical heterogeneity.
Conclusions and implications of key findings:
The anti-VEGFs ranibizumab and bevacizumab have
consistently shown good clinical effectiveness without
major unwanted side effects. Steroid results have been
mixed and are usually associated with cataract
formation and intraocular pressure increase. Despite
the current wider spectrum of treatments for DMO,
only a small proportion of patients recover good vision
(≥20/40), and thus the search for new therapies needs
to continue.

Item Type: Journal Article
Subjects: R Medicine > R Medicine (General)
R Medicine > RE Ophthalmology
R Medicine > RM Therapeutics. Pharmacology
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) > Warwick Evidence
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Blindness -- Etiology, Systematic reviews (Medical research), Endocrine glands -- Diseases, Diabetes -- Complications, Diabetic retinopathy, Vascular endothelial growth factors, Meta-analysis
Journal or Publication Title: BMJ Open
Publisher: BMJ
ISSN: 2044-6055
Official Date: 2013
Dates:
DateEvent
2013Published
Volume: Volume 3
Number: Number 3
Page Range: Article no. e002269
DOI: 10.1136/bmjopen-2012-002269
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 24 December 2015
Date of first compliant Open Access: 24 December 2015

Request changes or add full text files to a record

Repository staff actions (login required)

View Item View Item

Downloads

Downloads per month over past year

View more statistics

twitter

Email us: wrap@warwick.ac.uk
Contact Details
About Us