Objective: To evaluate the efficacy and safety in treatment of ocular neovascularization by Bevacizumab versus Ranibizumab.
Methods: It was a systematic review and meta-analysis. According to evaluation guidelines of Cochrane collaboration, clinical controlled trials (CCTs) comparing Bevacizumab and Ranibizumab in treatment of ocular neovascularization were searched using Medline, EMbase, the Cochrane Library and CBM. Methodology qualities of literatures were performed by experienced researchers according to the Jadad Score. RevMan 4.2 offered by Cochrane was used to do the meta-analysis. The differences of efficacy and safety in treatment of ocular neovascularization by Bevacizumab versus Ranibizumab were analyzed through statistical test for incorporative effect (the test results were shown by Z value).
Results: Only 7 literatures came into meta-analysis (1620 eyes). The result of analysis showed that Bevacizumab could improve the BCVA and cut down the CFT in treatment of ocular neovascularization, and that Bevacizumab did not display any statistically difference in improving best-corrected visual acuity (converted to logMAR, Bevacizumab group, from -0.9031 + or - 0.0323 to -0.7635 + or - 0.0214, improving by 0.1396 + or - 0.0225; Ranibizumab group, from -0.9345 + or - 0.0194 to -0.8050 + or - 0.0221, improving by 0.1295 + or - 0.0203, Z = 0.56, P = 0.57), and cutting down the central foveal thickness [Bevacizumab group, from (325.4 + or - 52.3) microm to (269.1 + or - 21.3) microm, cutting down by (56.3 + or - 18.5) microm; Ranibizumab group, from (342.0 + or - 45.1) microm to (277.2 + or - 35.5) microm, cutting down by (67.8 + or - 23.2) microm, Z = 1.13, P = 0.26] and safety [inflammation at injection site, Bevacizumab group, 4.1% (34/823 eyes); Ranibizumab group, 3.8% (30/797 eyes), Z = 0.74, P = 0.46; subconjunctival hemorrhage, Bevacizumab group, 3.3% (27/823 eyes); Ranibizumab group, 3.4% (27/797 eyes), Z = 0.98, P = 0.33; total complications, Bevacizumab group, 10.2% (84/823 eyes); Ranibizumab group, 9.5% (76/797 eyes), chi(2) = 0.21, P = 0.65] compared with Ranibizumab.
Conclusions: Meta-analysis shows that Bevacizumab has equal efficacy and safety to Ranibizumab in treatment of ocular neovascularization. However, a high quality perspective study is still required for further analysis.