The 12- and 24-Month Effects of Intravitreal Ranibizumab, Aflibercept, and Bevacizumab on Intraocular Pressure

Nanji, Keean; Sarohia, Gurkaran S.; Kennedy, Kevin; Ceyhan, Tiandra; McKechknie, Tyler; Phillips, Mark; Devji, Tahira; Thabane, Lehana; Kaiser, Peter; Sarraf, David; Sivaprasad, Sobha; Wykoff, Charles C.; Bakri, Sophie J.; Sheidow, Tom; Bhandari, Mohit; Chaudhary, Varun

doi:10.1016/j.ophtha.2021.11.024

Cited by 10 publications

(12 citation statements)

References 60 publications

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“…Another meta-analysis of 74 published studies reported similar findings [17]. A recent network meta-analysis of 26 randomized controlled trials did not find sustained increases in IOP at 12 and 24 months [18]. It appears that the evidence suggests no significant risk for IOP rise at 1 and 2 years with intravitreal anti-VEGF treatment.…”

Section: Anti-vascular Endothelial Growth Factormentioning

confidence: 82%

Complications of intravitreal injections: 2022

Patel

Chaudhary

2022

Current Opinion in Ophthalmology

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Purpose of reviewThis review highlights the complications of both intravitreal injection procedure as well as different intravitreal medications including antivascular endothelial growth factors, antibiotics, antivirals, antifungals, methotrexate, and steroids. Techniques for reducing rates of endophthalmitis will also be discussed. Recent findingsIntravitreal vancomycin can cause hemorrhagic occlusive retinal vasculitis resulting in severe vision loss. Intravitreal brolucizumab is associated with intraocular inflammation and retinal vasculitis resulting in significant vision loss. Face mask use by both patient and physician is not associated with increased risk of endophthalmitis and may decrease culture positive endophthalmitis.

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Section: Anti-vascular Endothelial Growth Factormentioning

confidence: 82%

Complications of intravitreal injections: 2022

Patel

Chaudhary

2022

Current Opinion in Ophthalmology

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“…A: Aflibercept, R5: 0.5 mg Ranibizumab, R3: 0.3 mg Ranibizumab, B: Bevacizumab, and C: control. Adapted from [3].…”

Section: Methods Of Analysismentioning

confidence: 99%

“…exist, the NMA can calculate an indirect comparison of B vs. C [3]. Finally, a network estimate is determined by weighting the direct and indirect estimates, creating a blended result that takes both direct and indirect evidence into consideration.…”

Section: Key Pointsmentioning

confidence: 99%

Understanding network meta-analysis methodology for the ophthalmologist

Phillips,

Chaudhary

2024

Current Opinion in Ophthalmology

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Purpose of review Over the past decade, the number of studies published using network meta-analyses (NMAs) has rapidly increased, and there have been continued advancements to further advance this analysis approach. Due to the fast moving and changing landscape in the infancy of NMA methodology, there is a lack of consistency and standardization for this approach. This article aims to summarize the crucial components of an NMA for both future readers, and for potential NMA authors. Recent findings Key components of NMAs include, but are not limited to, reporting the proposed analysis methods, assessment of risk of bias within the included studies, reporting the overall quality of the available evidence, and defining the parameters in which the results will be presented. Although NMA allows for a comprehensive evaluation of all available treatment options for a given condition, we believe that there is importance in ensuring clear understanding and appropriate interpretation of results to inform clinical practice. Summary While many components of NMA mirror those of traditional pairwise meta-analysis, there are many novel methodologies that are specific to this approach. It is imperative that future NMAs follow guidance from key methodology groups, as these provide valuable tools for conducting and reporting NMAs.

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“…There are no available clinical trials (head-to head trials) to clearly state the best treatment for RVO patients. Some economic studies show better costeffectiveness for Ranibizumab compared with A ibercept(52); however, network meta-analysis showed slightly better visual outcomes for A ibercept compared with Ranibizumab(53), while others show no difference between available anti-VEGF in e cacy (54)(55)(56) or in IOP (57). Recently anti-VEGF available like Faricimab are being evaluated in RVO (BALATON and COMINO clinical trials)(58), or Bevacizumab in some available case reports (59).…”

Section: Guideline Clinical Recommendation Meta-synthesismentioning

confidence: 99%

Systematic review of clinical practice guidelines for the diagnosis and management of retinal vein occlusion

Galvez-Olortegui,

Bouchikh-El Jarroudi,

Silva-Ocas

et al. 2024

Eye

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Background/Objectives:To assess the Clinical Practice Guidelines (CPG) for the diagnosis and management of Retinal Vein Occlusion (RVO). Methods:A systematic review of CPGs for the diagnosis and management of RVO, published between January-2010 and April-2022, was carried out with a search in databases, metasearch engines, CPG development institutions, ophthalmology associations and CPG repositories.CPGs in English/Spanish were selected, and 5 authors evaluated them independently, using the Appraisal of Guidelines for Research and Evaluation(AGREE-II) instrument. An individual assessment of each CPG by domain(AGREE-II), an overall assessment of the guide, and its use with or without modi cations was performed. Additionally, a meta-synthesis of the recommendations for the most relevant outcomes was carried out. Results:5/6 CPGs scored low in domain 3(rigour of development), and the highest score(mean 62%) was for domain 4(clarity of presentation). 2019 American guideline (PPP) presented the best score(40.4%) in domain 3. When evaluating the overall quality of the CPGs analyzed, all CPGs could be recommended with modi cations. In the meta-synthesis, anti-VEGF therapy is the rst-choice therapy for macular edema associated with RVO, but there is no clear recommendation about the type of anti-VEGF therapy to choose. Recommendations for diagnosis and follow-up are similar among CPGs evaluated. Conclusion:Most CPGs for the diagnosis and management of retinal vein occlusion have a low methodological quality evaluated according to the AGREE-II. PPP has the higher score in the domain "Rigour of Development". Among the CPGs evaluated, there is no clear recommendation on the type of anti-VEGF therapy to choose.

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The 12- and 24-Month Effects of Intravitreal Ranibizumab, Aflibercept, and Bevacizumab on Intraocular Pressure

Cited by 10 publications

References 60 publications

Complications of intravitreal injections: 2022

Complications of intravitreal injections: 2022

Understanding network meta-analysis methodology for the ophthalmologist

Systematic review of clinical practice guidelines for the diagnosis and management of retinal vein occlusion

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