Data from: Comparison of the efficacy and safety of drug therapies for macular edema secondary to central retinal vein occlusion

Objectives: To evaluate the efficacy and safety of anti-vascular
endothelial growth factor (VEGF) agents and corticosteroids for the
treatment of macular edema (ME) secondary to central retinal vein
occlusion (CRVO). Design: Systematic review and network meta-analysis.
Participants: Patients from previously reported randomized controlled
trials (RCTs) comparing anti-VEGF and corticosteroids for the treatment of
ME secondary to CRVO. Methods: Literature searches were conducted using
PubMed, Medline, Embase, Cochrane Library, and clinicaltrials.gov until
March 2017. Therapeutic effects were estimated using the proportions of
patients gaining/losing ≥15 letters, best-corrected visual acuity (BCVA),
and central retinal thickness (CRT). Treatment safety was estimated using
the proportions of adverse events, namely increased intraocular pressure
(IOP), cataracts, vitreous hemorrhage (VH), and retinal tear. The software
ADDIS (version 1.16.8) was used for analysis. Treatment effect and safety
of different drugs could be ranked based on simulation. Results: Eleven
RCTs comprising 2060 patients were identified. Regarding patients gaining
≥15 letters, aflibercept and ranibizumab were significantly more effective
than sham/placebo at 6 months. Regarding patients losing ≥15 letters at 6
months, ranibizumab showed significant improvement compared to
dexamethasone. Aflibercept, bevacizumab, or ranibizumab showed greater
improvements in BCVA than sham/placebo at 6 months. Intravitreal
ranibizumab injection demonstrated greater CRT reduction than both sham
and dexamethasone did. Dexamethasone had a higher risk of increased IOP
than aflibercept and ranibizumab. Ranibizumab demonstrated a greater risk
of cataracts than dexamethasone. Aflibercept and ranibizumab demonstrated
low incidence of VH and retinal tear, respectively. Aflibercept had a
slight advantage over ranibizumab as assessed by benefit-risk analysis.
Conclusions: Anti-VEGF agents have advantages in the treatment of ME
secondary to CRVO. Aflibercept and ranibizumab showed marked BCVA
improvement and CRT reduction. Aflibercept may have a slight advantage
over ranibizumab. The results of this study can serve as a reference for
clinicians to provide patient-tailored treatment.