Table 1_Impact of anti-VEGF therapy on choroidal thickness in patients with retinal vein occlusion: a systematic review and meta-analysis.docx

ObjectivesTo systematically review and analyze existing literature reporting changes in choroidal thickness at 1, 3, 6, and 12 months following anti-VEGF treatment in patients with retinal vein occlusion (RVO).
MethodsA comprehensive literature search identified 16 eligible studies including a total of 545 patients and 547 eyes. Data were extracted on subfoveal choroidal thickness at baseline and at specified follow-up intervals. Meta-analyses were performed to assess pooled changes in choroidal thickness after treatment, and subgroup analyses were conducted based on anti-VEGF drug type and treatment regimen.
ResultsAt 1- and 3-month follow-up, anti-VEGF therapy was associated with a significant reduction in choroidal thickness. By 12 months, choroidal thickness tended to return toward baseline levels, suggesting potential stabilization or structural adaptation. Subgroup analyses indicated that the effects on choroidal thickness may vary among different anti-VEGF agents, with ranibizumab and aflibercept showing significant early reductions, while bevacizumab demonstrated more delayed effects. Further subgroup analyses based on RVO type showed that at 1 month, choroidal thickness was significantly reduced in branch retinal vein occlusion patients, but not in central retinal vein occlusion patients, suggesting potential differences in drug response between RVO subtypes. However, given the limited number of studies within some subgroups, these findings should be interpreted with caution.
ConclusionIn patients with RVO, anti-VEGF therapy appears to induce an early reduction in choroidal thickness, which tends to return toward baseline with longer follow-up. Subgroup analyses provided preliminary insights into the potential influence of different agents, disease subtypes, and treatment regimens. However, this study was limited by the small number of eligible studies and the heterogeneity of study designs. Therefore, the findings should be regarded as exploratory and interpreted with caution. Future prospective studies with larger sample sizes, standardized imaging protocols, and longer follow-up are needed to clarify the clinical relevance of choroidal thickness changes in RVO patients undergoing anti-VEGF therapy.
Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD 420251011228.

研究目的：系统回顾并分析现有文献，总结视网膜静脉阻塞（retinal vein occlusion, RVO）患者接受抗血管内皮生长因子（anti-VEGF）治疗后1、3、6及12个月时的脉络膜厚度变化情况。
研究方法：本研究通过全面的文献检索，最终纳入16项符合标准的研究，共涉及545例患者、547只患眼。提取所有研究中基线及各预设随访时间点的黄斑下脉络膜厚度数据；采用荟萃分析评估治疗后脉络膜厚度的合并变化情况，并依据抗血管内皮生长因子药物类型与治疗方案开展亚组分析。
研究结果：随访1个月及3个月时，抗血管内皮生长因子治疗与脉络膜厚度的显著降低相关；至随访12个月时，脉络膜厚度趋于恢复至基线水平，提示可能存在结构稳定或适应性重构。亚组分析显示，不同抗血管内皮生长因子药物对脉络膜厚度的影响存在差异：雷珠单抗（ranibizumab）与阿柏西普（aflibercept）可带来显著的早期厚度降低，而贝伐珠单抗（bevacizumab）的效应则更为滞后。基于视网膜静脉阻塞亚型的进一步亚组分析表明，随访1个月时，分支视网膜静脉阻塞患者的脉络膜厚度显著降低，而中心视网膜静脉阻塞患者未出现该变化，提示不同RVO亚型的药物应答可能存在差异。但鉴于部分亚组纳入的研究数量有限，解读本研究结果时需谨慎。
研究结论：对于视网膜静脉阻塞患者，抗血管内皮生长因子治疗可诱导脉络膜厚度早期降低，且随随访时间延长，厚度趋于恢复至基线水平。亚组分析为不同药物、疾病亚型及治疗方案的潜在影响提供了初步见解。但本研究存在局限性：纳入的符合标准的研究数量较少，且各研究的设计存在异质性。因此，本研究结果仅为探索性结论，解读时需谨慎。未来需开展样本量更大、影像检查方案标准化且随访周期更长的前瞻性研究，以明确接受抗血管内皮生长因子治疗的RVO患者脉络膜厚度变化的临床相关性。
系统评价注册信息：https://www.crd.york.ac.uk/prospero/，注册号：CRD 420251011228。