Ford, John A., Clar, C., Lois, Noemi, Barton, Samantha, Thomas, Sian, Court, Rachel A., Shyangdan, D. and Waugh, Norman (2014) Treatments for macular oedema following central retinal vein occlusion : systematic review. BMJ Open, Volume 4 (Number 2). Article Number e004120. doi:10.1136/bmjopen-2013-004120 ISSN 2044-6055.

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Abstract

Objectives To review systematically the randomised controlled trial (RCT) evidence for treatment of macular oedema due to central retinal vein occlusion (CRVO).

Data sources MEDLINE, EMBASE, CDSR, DARE, HTA, NHSEED, CENTRAL and meeting abstracts (January 2005 to March 2013).

Study eligibility criteria, participants and interventions RCTs with at least 12 months of follow-up assessing pharmacological treatments for CRVO were included with no language restrictions.

Study appraisal and synthesis methods 2 authors screened titles and abstracts and conducted data extracted and Cochrane risk of bias assessment. Meta-analysis was not possible due to lack of comparable studies.

Results 8 studies (35 articles, 1714 eyes) were included, assessing aflibercept (n=2), triamcinolone (n=2), bevacizumab (n=1), pegaptanib (n=1), dexamethasone (n=1) and ranibizumab (n=1). In general, bevacizumab, ranibizumab, aflibercept and triamcinolone resulted in clinically significant increases in the proportion of participants with an improvement in visual acuity of ≥15 letters, with 40–60% gaining ≥15 letters on active drugs, compared to 12–28% with sham. Results for pegaptanib and dexamethasone were mixed. Steroids were associated with cataract formation and increased intraocular pressure. No overall increase in adverse events was found with bevacizumab, ranibizumab, aflibercept or pegaptanib compared with control. Quality of life was poorly reported. All studies had a low or unclear risk of bias.

Item Type:	Journal Article
Subjects:	R Medicine > RE Ophthalmology
Divisions:	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):	Eye -- Diseases -- Treatment, Edema -- Treatment, Retina -- Blood vessels -- Diseases, Systematic reviews (Medical research)
Journal or Publication Title:	BMJ Open
Publisher:	BMJ
ISSN:	2044-6055
Official Date:	2014
Dates:	Date Event 2014 Published
Volume:	Volume 4
Number:	Number 2
Article Number:	Article Number e004120
DOI:	10.1136/bmjopen-2013-004120
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)

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