Evidence map›Paper›PMID 36369263›Full record

SynthesisEye (London, England)2023

Role of anti-vascular endothelial growth factor in the management of non-proliferative diabetic retinopathy without centre-involving diabetic macular oedema: a meta-analysis of trials.

Varun Chaudhary, Gurkaran S Sarohia, Mark R Phillips, Daniel Park, Jim Xie, Dena Zeraatkar, Matthew Fung, Lehana Thabane, Anat Loewenstein, Frank G Holz and 7 more

Open access · greenAbstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Eye (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
0.2field-weighted citation impact, top 49% 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

7 citing papers in PubMed, 4 citations in OpenAlex.

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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

17 authors at 12 institutions in 6 countries.

Varun ChaudharyDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada. vchaudh@mcmaster.ca.ORCID 0000-0002-9988-4146
Gurkaran S SarohiaDepartment of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, AB, Canada.
Mark R PhillipsDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.ORCID 0000-0003-0923-261X
Daniel ParkMichael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
Jim XieMichael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
Dena ZeraatkarDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Matthew FungMichael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
Lehana ThabaneDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Anat LoewensteinDivision of Ophthalmology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.ORCID 0000-0002-7706-1165
Frank G HolzDivision of Ophthalmology, University of Bonn, Bonn, Germany.ORCID 0000-0001-8019-9272
Sunir J GargMid Atlantic Retina, The Retina Service of Wills Eye Hospital, Philadelphia, PA, USA.
Peter K KaiserCole Eye Institute, Cleveland Clinic, Cleveland, OH, USA.
Mohit BhandariDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Robyn H GuymerCentre for Eye Research Australia Royal, Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia.ORCID 0000-0002-9441-4356
Samantha Fraser-BellMacular Research Group, Save Sight Institute, University of Sydney, Sydney, NSW, Australia.
Sobha SivaprasadNIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, UK.
Charles C WykoffRetina Consultants of Texas, Retina Consultants of America, Houston, TX, USA.
Impact · CAMcMaster University · CACleveland Clinic · USMethodist Hospital · USNIHR Moorfields Biomedical Research Centre · GBSt. Joseph Hospital · USTel Aviv University · ILThe University of Melbourne · AUThe University of Sydney · AUUniversity of Alberta · CAUniversity of Bonn · DEWills Eye Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This systematic review and meta-analysis investigated the impact of anti-vascular endothelial growth factor (VEGF) treatment in management of eyes with non-proliferative diabetic retinopathy (NPDR) without centre involving diabetic macular oedema (CI-DMO). We searched multiple databases for all randomised clinical trials (RCTs) that evaluated anti-VEGF treatment versus observation in eyes with NPDR without CI-DMO. Data was collected for six outcomes (best corrected visual acuity (BCVA) improvement, diabetic retinopathy severity score (DRSS), central subfield thickness, progression to vision threatening complications (VTCs), ocular adverse events and quality of life measures). Risk of bias was assessed using Cochrane risk-of-bias tool for randomised trials (RoB 2) and certainty of evidence was assessed using Grade of Recommendations, Assessment, Development and Evaluation (GRADE). We identified a total of 2 unique RCTs that compared aflibercept and sham to treat a total of 811 eyes. For BCVA change, there was a small, clinically insignificant benefit for aflibercept treatment at year 2 (MD 0.70, 95% CI 0.02-1.38, GRADE rating: MODERATE). DRSS demonstrated a statistically significant improvement with aflibercept use at year 2 (RR 3.76, 95% CI 2.75-5.13, GRADE rating: MODERATE). VTCs were significantly less in aflibercept arm at year 2 (RR 0.30, 95% CI 0.23-0.40, GRADE rating: MODERATE). In conclusion, aflibercept treatment versus observation in eyes with NPDR without CI-DMO can result in reduced risk of development of VTCs and regression of DRSS score over 2 years. Future trials are needed to increase the precision of the treatment effect and to provide data on quality-of-life metrics.PROSPERO Registration: CRD42021288608.

Indexed as

Diabetes MellitusDiabetic RetinopathyMacular EdemaAngiogenesis InhibitorsBevacizumabEndothelial Growth FactorsHumansLaser CoagulationRanibizumabVascular Endothelial Growth Factor AAngiogenesis InhibitorsBevacizumabEndothelial Growth FactorsRanibizumabVascular Endothelial Growth Factor A

Identifiers

PMID36369263
PMCPMC10333362
OpenAlexW4308834988

What OpenQuestion holds

Textmetadata
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.