Evidence map›Paper›PMID 29784048›Full record

SynthesisBMC ophthalmology2018

A meta-analysis of the effect of a dexamethasone intravitreal implant versus intravitreal anti-vascular endothelial growth factor treatment for diabetic macular edema.

Ye He, Xin-Jun Ren, Bo-Jie Hu, Wai-Ching Lam, Xiao-Rong Li

Open access · goldAbstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC ophthalmology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 69 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
69citing papers in PubMed, 12 pooled it
12.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

69 citing papers in PubMed, 12 syntheses or guidelines pooled it, 124 citations in OpenAlex.

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  9. Efficacy and safety of single-dose dexamethasone implantation for patients with persistent diabetic macular edema: a systematic review and meta-analysis.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2022
    Pooled it
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  11. Intravitreal steroids for macular edema in diabetes.The Cochrane database of systematic reviews · 2020
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  18. Response to anti-VEGF injections for diabetic macular edema among patients on chronic exogenous insulin therapy.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026
    Article
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9 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 2 countries.

Ye HeDepartment of Retina, Tianjin Medical University Eye Hospital, 251 Fukang Road, Tianjin, 300384, China.
Xin-Jun RenDepartment of Retina, Tianjin Medical University Eye Hospital, 251 Fukang Road, Tianjin, 300384, China.
Bo-Jie HuDepartment of Retina, Tianjin Medical University Eye Hospital, 251 Fukang Road, Tianjin, 300384, China.
Wai-Ching LamDepartment of Ophthalmology, The University of Hong Kong, Hong Kong, China.
Xiao-Rong LiDepartment of Retina, Tianjin Medical University Eye Hospital, 251 Fukang Road, Tianjin, 300384, China. xiaorli@163.com.
Tianjin Medical University Eye Hospital · CNTianjin Medical University · CNUniversity of Hong Kong · HK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis meta-analysis evaluated the effectiveness and safety of dexamethasone (DEX) implant and intravitreal anti-vascular endothelial growth factor (VEGF) treatment for diabetic macular edema (DME).

methodsThe PubMed, Embase, clinicaltrials.gov website and Cochrane Library databases were comprehensively searched for studies comparing DEX implant with anti-VEGF in patients with DME. Best-corrected visual acuity (BCVA), central subfield thickness (CST) and adverse events were extracted from the final eligible studies. Review Manager (RevMan) 5.3 for Mac was used to analyze the data and GRADE profiler were used to access the quality of outcomes.

resultsBased on four randomized clinical trials assessing a total of 521 eyes, the DEX implant can achieve visual acuity improvement for DME at rates similar to those achieved via anti-VEGF treatment (mean difference [MD] = - 0.43, P = 0.35), with superior anatomic outcomes at 6 months (MD = - 86.71 μm, P = 0.02), while requiring fewer injections, in comparison to anti-VEGF treatment. Although the mean reduction in CST did not showed significant difference at 12 months (MD = - 33.77 μm, P = 0.21), the significant in BCVA from baseline to 12 months supported the anti-VEGF treatment (MD = - 3.26, P < 0.00001). No statistically significant differences in terms of the serious adverse events. However, use of the DEX implant has higher risk of intraocular pressure elevation and cataract than anti-VEGF treatment.

conclusionsCompared with anti-VEGF, DEX implant improved anatomical outcomes significantly. However, this did not translate to improved visual acuity, which may be due to the progression of cataract. Therefore, the DEX implant may be recommended as a first chioce for select cases, such as for pseudophakic eyes, anti-VEGF-resistant eyes, or patients reluctant to receive intravitreal injections frequently.

Indexed as

Drug ImplantsAngiogenesis InhibitorsAnti-Inflammatory AgentsBevacizumabDelayed-Action PreparationsDexamethasoneDiabetic RetinopathyGlucocorticoidsHumansIntravitreal InjectionsMacular EdemaRanibizumabVascular Endothelial Growth Factor AVisual AcuityAngiogenesis InhibitorsAnti-Inflammatory AgentsBevacizumabDelayed-Action PreparationsDexamethasoneDrug ImplantsGlucocorticoidsRanibizumabVascular Endothelial Growth Factor AAnti-VEGFDexamethasone implantDiabetic macular edemaMeta-analysisOzurdex

Identifiers

PMID29784048
PMCPMC5963018
OpenAlexW2807562910

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.