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Vitreomacular adhesion or vitreomacular traction may affect antivascular endothelium growth factor treatment for neovascular age-related macular degeneration
  1. Ping Xie1,
  2. Xinhua Zheng1,2,
  3. Yingqing Yu2,
  4. Xiaojian Ye1,
  5. Zizhong Hu1,
  6. Dongqing Yuan1,
  7. Qinghuai Liu1
  1. 1Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
  2. 2Department of Ophthalmology, Wuxi Children’s Hospital, Wuxi, Jiangsu, China
  1. Correspondence to Dr Qinghuai Liu, Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical 29 University, Guangzhou Road 300, Nanjing 210029, Jiangsu, China; liuqh{at}njmu.edu.cn

Abstract

Objective The aim of this review is to determine whether vitreomacular adhesion (VMA) or vitreomacular traction (VMT) has an influence on the outcomes of antivascular endothelium growth factor (anti-VEGF) treatment neovascular age-related macular degeneration (nAMD).

Methods A systematic literature search was performed in Pubmed.gov, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang, SinoMed and ClinicalTrials.gov up to 30 June 2016 to identify eligible studies.

Results Nine studies and 2212 participants were finally identified. At month 6, the mean improvement in best-corrected visual acuity (BCVA) and mean decline in central retinal thickness (CRT) of the VMA/VMT(+) group was less than that of the VMA/VMT(-) group (95% CI −3.05 to –0.96 letters, p=0.0002; 15.53 to 32.98 μm, p<0.00001; respectively); at month 12, there was a small or only marginally significant difference (−0.01 to 2.00 letters, p=0.05; 0.17 to 23.7 μm, p=0.05; respectively) between the groups. During the 12 months, however, the VMA/VMT(+) group required more injections ((0.25 to 0.95), p=0.0008).

Conclusions In using anti-VEGF drugs to treat nAMD, clinicians should take into account the fact that concurrent VMA or VMT might antagonise the efficacy of anti-VEGF drugs during the early stage of treatment.

  • drugs
  • macula
  • vitreous.

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Footnotes

  • Contributors PX and XZ contributed equally and are coauthors of this paper, who composed the manuscript. QL is the corresponding author, having designed the study and revised the manuscript. YY and XY participated in data extraction. ZH and DY carried out the statistical analysis. All authors read and approved the final manuscript.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Any interested reader may make an inquiry of additional unpublished data to corresponding authors via email.

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