Safety and Efficacy of a Treat-and-Extend Regimen of Anti-Vascular Endothelial Growth Factor Agents for Diabetic Macular Edema or Macular Edema Secondary to Retinal Vein Occlusion: A Systematic Review and Meta-Analysis

Ophthalmic Surg Lasers Imaging Retina. 2023 Mar;54(3):131-138. doi: 10.3928/23258160-20230221-04. Epub 2023 Mar 1.

Abstract

[Box: see text] Background and Objective: This meta-analysis evaluates treat-and-extend regimens relative to monthly and as-needed (prn) regimens using anti-vascular endothelial growth factor agents for diabetic macular edema and macular edema secondary to retinal vein occlusion.

Materials and methods: Comparative studies evaluating a treat-and-extend regimen relative to a monthly or prn regimen with anti-vascular endothelial growth factor therapy for diabetic macular edema or macular edema secondary to retinal vein occlusion were included following a systematic literature search.

Results: Seven studies of 984 eyes were included. Relative to a monthly regimen, treat-and-extend was similar for change in best-corrected visual acuity at final follow-up (P = .59) and had a lower number of injections (P < .00001). Relative to a prn regimen, treat-and-extend was similar for change in best-corrected visual acuity at final follow-up (P = .84) and was associated with a higher number of injections (P = .02).

Conclusion: This meta-analysis found that a treat-and extend regimen was nonsignificantly different compared to monthly and prn regimens in efficacy and safety end points. [Ophthalmic Surg Lasers Imaging Retina 2023;54(3):131-138.].

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Diabetes Mellitus* / drug therapy
  • Diabetic Retinopathy* / complications
  • Diabetic Retinopathy* / diagnosis
  • Diabetic Retinopathy* / drug therapy
  • Endothelial Growth Factors / therapeutic use
  • Humans
  • Intravitreal Injections
  • Macular Edema* / diagnosis
  • Macular Edema* / drug therapy
  • Macular Edema* / etiology
  • Ranibizumab / therapeutic use
  • Retinal Vein Occlusion* / complications
  • Retinal Vein Occlusion* / diagnosis
  • Retinal Vein Occlusion* / drug therapy
  • Treatment Outcome

Substances

  • Angiogenesis Inhibitors
  • Endothelial Growth Factors
  • Ranibizumab
  • VEGFA protein, human