SynthesisPloS one2014
Efficacy of anti-VEGF and laser photocoagulation in the treatment of visual impairment due to diabetic macular edema: a systematic review and network meta-analysis.
Synthesis in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 6 syntheses or guidelines pooled it, 70 citations in OpenAlex.
- Aflibercept versus ranibizumab for diabetic macular edema: A meta-analysis.European journal of ophthalmology · 2024Pooled it
- Comparative Efficacy, Durability and Safety of Faricimab in the Treatment of Diabetic Macular Edema: A Systematic Literature Review and Network Meta-Analysis.Advances in therapy · 2023Pooled it
- Cost Effectiveness of Treatments for Diabetic Retinopathy: A Systematic Literature Review.PharmacoEconomics · 2019Pooled it
- Anti-vascular endothelial growth factor for diabetic macular oedema: a network meta-analysis.The Cochrane database of systematic reviews · 2018Pooled it
- Anti-vascular endothelial growth factor for diabetic macular oedema: a network meta-analysis.The Cochrane database of systematic reviews · 2017Pooled it
- Systematic review and mixed treatment comparison of intravitreal aflibercept with other therapies for diabetic macular edema (DME).BMC ophthalmology · 2015Pooled it
- How early can we detect diabetic retinopathy? A narrative review of imaging tools for structural assessment of the retina.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2025Review
- Differential artery-vein analysis in OCTA for predicting the anti-VEGF treatment outcome of diabetic macular edema.Biomedical optics express · 2025Article
- Anti-VEGF therapy for the long-term management of diabetic macular edema: a treat-to-target strategy based on macular morphology.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2024Review
- Cost-Effectiveness of Faricimab in the Treatment of Diabetic Macular Oedema (DMO): A UK Analysis.PharmacoEconomics - open · 2024Article
- Müller cells and retinal angiogenesis: critical regulators in health and disease.Frontiers in cellular neuroscience · 2024Review
- Research progress on the mechanism of ferroptosis and its role in diabetic retinopathy.Frontiers in endocrinology · 2023Review
- Laser Treatment Modalities for Diabetic Retinopathy.Cureus · 2022Review
- Prediction of the Short-Term Therapeutic Effect of Anti-VEGF Therapy for Diabetic Macular Edema Using a Generative Adversarial Network with OCT Images.Journal of clinical medicine · 2022Article
- Prediction of Visual Acuity after anti-VEGF Therapy in Diabetic Macular Edema by Machine Learning.Journal of diabetes research · 2022Article
- Retinal laser services in Bhutan: a 3-year national survey.BMC ophthalmology · 2020Article
- Subthreshold micropulse laser versus intravitreal anti-VEGF for diabetic macular edema patients with relatively better visual acuity.International journal of ophthalmology · 2020Article
- Dexamethasone Implant in Patients with Diabetic Macular Edema Resistant to Anti-VEGF TherapyTurkish journal of ophthalmology · 2019Article
- The retinal pigment epithelial response after retinal laser photocoagulation in diabetic mice.Lasers in medical science · 2019Article
- Response to: Choroidal thickness changes stratified by outcome in real-world treatment of diabetic macular edema.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveCompare the efficacy of ranibizumab, aflibercept, laser, and sham in the first-line treatment of diabetic macular edema (DME) to inform technology assessments such as those conducted by the UK National Institute for Health and Care Excellence (NICE). DATA SOURCES: MEDLINE, Embase, Cochrane Library, congress abstracts, ClinicalTrials.gov registry and Novartis data on file. INCLUSION CRITERIA: Studies reporting 6- or 12-month results of randomized controlled trials (RCTs) evaluating at least two of ranibizumab 0.5 mg pro re nata, aflibercept 2.0 mg bi-monthly, laser photocoagulation or sham. Study quality was assessed based on likelihood of bias in selection, attrition, detection and performance. OUTCOME MEASURE: Improvement in best-corrected visual acuity (BCVA) measured as the proportion of patients gaining ≥10 letters on the Early Treatment Diabetic Retinopathy Study scale. The outcome was chosen following acceptance by NICE of a Markov model with 10-letter health states in the assessment of ranibizumab for DME. META-ANALYSIS: Bayesian network meta-analyses with fixed and random effects adjusted for differences in baseline BCVA or central retinal thickness.
resultsThe analysis included 1,978 patients from eight RCTs. The random effects model adjusting for baseline BCVA was the best model based on total residual. The efficacy of ranibizumab was numerically, but not statistically, superior to aflibercept (odds ratio [OR] 1.59; 95% credible interval [CrI], 0.61-5.37). Ranibizumab and aflibercept were statistically superior to laser monotherapy with ORs of 5.50 (2.73-13.16) and 3.45 (1.62-6.84) respectively. The probability that ranibizumab is the most efficacious treatment was 73% compared with 14% for aflibercept, 12% for ranibizumab plus laser, and 0% for laser. LIMITATIONS: Three of the eight RCTs included are not yet published. The models did not adjust for all potential effect modifiers.
conclusionRanibizumab was non-significantly superior to aflibercept and both anti-VEGF therapies had statistically superior efficacy to laser.
Indexed as
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What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.