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Non-Steroidal Intravitreal Injection for Noninfectious Uveitic Cystoid Macular Edema: Systematic Review and Meta-Analysis Publisher Pubmed



Kianersi F1 ; Rezaeianramsheh A1 ; Rahimi A2 ; Akhlaghi M1 ; Dehghani A1 ; Farajzadegan Z3 ; Pourazizi M1
Authors
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Authors Affiliations
  1. 1. Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Health Information Technology Research Center, Isfahan University Medical Sciences, Isfahan, Iran
  3. 3. Community and Preventive Medicine Department, Medicine Faculty, Isfahan University of Medical Sciences, Isfahan, Iran

Source: European Journal of Ophthalmology Published:2024


Abstract

Purpose: To systematically review the published manuscripts on the non-steroidal intravitreal injection for treatment of noninfectious uveitic cystoid macular edema (CME). Methods: The PubMed, Scopus, and Web of Science, Science Direct, ProQuest, Cochrane Library, ProQuest, Embase, Clinical Key, and Springer were searched for relevant articles published until May 2022. The random-effects models were used to estimate the mean difference (MD) and 95% confidence interval (CI) for postoperative central macular thickness (CMT) and visual acuity (VA) changes. VA was transformed into the logarithm of the minimum angle of resolution (LogMAR). Meta-regression was conducted for adjusting the effects of potential confounders. Results: A total of 17 relevant studies (258 eyes) were included in this meta-analysis. A significant improvement was observed in CMT in the last follow up (350.89 ± 108.43) compared to the baseline (452.3 ± 112.67) (Log MD = 1.82, 95% CI = 1.62, 2.02; I2 = 57.7%; P = 0.002). Additionally, VA also significantly improved in the last follow up (0.56 ± 0.29) compared to the baseline (0.75 ± 0.3) (Exponential MD = 0.82, 95% CI = 0.69, 0.95; I2 = 0.0%; P = 0.98). The subgroups analyzed included ten studies on anti-vascular endothelial growth factors (VEGF), three studies on infliximab, two studies on methotrexate (MTX), and two studies on diclofenac. All subgroups showed a significant improvement in both CMT and VA at the last follow-up (P < 0.05). Conclusion: Non-steroidal intravitreal injection including bevacizumab, ranibizumab, infliximab, MTX and diclofenac appears to be an effective treatment option for noninfectious uveitic CME. © The Author(s) 2023.
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