SynthesisBMJ open2019
Anti-vascular endothelial growth factor treatment for retinal conditions: a systematic review and meta-analysis.
Synthesis in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 2 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
42 citing papers in PubMed, 2 syntheses or guidelines pooled it, 80 citations in OpenAlex.
- Non-physician delivered intravitreal injection service: A systematic review of safety, implementation, training and patient experience.Acta ophthalmologica · 2026Pooled it
- Impact of anti-VEGF therapy versus laser therapy on mortality and treatment outcomes in retinopathy of prematurity: A systematic review and meta-analysis.Acta ophthalmologica · 2026Pooled it
- Association between screening duration and treatment outcomes in the clinical trials of ranibizumab and aflibercept for neovascular age-related macular degeneration.Scientific reports · 2026Trial
- Pre-operative versus post-operative intravitreal aflibercept injection for management of DME in patients undergoing cataract surgery.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2023Trial
- Trial
- Clinical Outcomes After Same-Agent Double-Dose Anti-VEGF Escalation in Eyes with a Suboptimal Response to Standard-Dose Treatment for Exudative Macular Diseases: A Real-World Pre-Post Study.Journal of clinical medicine · 2026Article
- Intravitreal Brolucizumab for Diabetic Macular Edema: Outcomes in Treatment-Naive and Anti-VEGF-Switched Eyes over 48 Weeks.Journal of clinical medicine · 2026Article
- Efficiency of anti-vascular endothelial growth factor drug switch in patients who did not respond to a series of bevacizumab injections.Indian journal of ophthalmology · 2026Article
- VEGF and Neurotrophins Interaction in the Retinal Neurovascular Unit Homeostasis: A Target for Ocular Disease Treatment and Management.Pharmaceutical research · 2026Review
- Aflibercept and Brolucizumab in Diabetic Macular Edema: A Focused Review of Efficacy, Safety, and Clinical Considerations.Biomedicines · 2026Review
- An assessment of anti-VEGF drugs safety based on real-world data: from popularity to spontaneous reporting in eudravigilance database.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2025Article
- Article
- Dose-Related Side Effects of Intravitreal Injections of Humanized Anti-Vascular Endothelial Growth Factor in Rats: Glial Cell Reactivity and Retinal Ganglion Cell Loss.Investigative ophthalmology & visual science · 2024Article
- The protective effect of DNase I in retinal vein occlusion.Biomolecules & biomedicine · 2024Article
- Article
- Aflibercept or ranibizumab for diabetic macular edema.Medical hypothesis, discovery & innovation ophthalmology journal · 2024Article
- Binocular metamorphopsia in patients with branch retinal vein occlusion: a multi-center study.International ophthalmology · 2023Article
- The Challenges and Therapeutic Prospects in Eye Disease.Journal of personalized medicine · 2023Article
- Emerging therapeutic strategies for unmet need in neovascular age-related macular degeneration.Journal of translational medicine · 2023Review
- Faricimab: Transforming the Future of Macular Diseases Treatment - A Comprehensive Review of Clinical Studies.Drug design, development and therapy · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors at 3 institutions in 1 country.
Funding
Abstract
objectivesTo evaluate the comparative effectiveness and safety of intravitreal bevacizumab, ranibizumab and aflibercept for patients with choroidal neovascular age-related macular degeneration (cn-AMD), diabetic macular oedema (DMO), macular oedema due to retinal vein occlusion (RVO-MO) and myopic choroidal neovascularisation (m-CNV).
designSystematic review and random-effects meta-analysis.
methodsMultiple databases were searched from inception to 17 August 2017. Eligible head-to-head randomised controlled trials (RCTs) comparing the (anti-VEGF) drugs in adult patients aged ≥18 years with the retinal conditions of interest. Two reviewers independently screened studies, extracted data and assessed risk of bias.
results19 RCTs involving 7459 patients with cn-AMD (n=12), DMO (n=3), RVO-MO (n=2) and m-CNV (n=2) were included. Vision gain was not significantly different in patients with cn-AMD, DMO, RVO-MO and m-CNV treated with bevacizumab versus ranibizumab. Similarly, vision gain was not significantly different between cn-AMD patients treated with aflibercept versus ranibizumab. Patients with DMO treated with aflibercept experienced significantly higher vision gain at 12 months than patients receiving ranibizumab or bevacizumab; however, this difference was not significant at 24 months. Rates of systemic serious harms were similar across anti-VEGF agents. Posthoc analyses revealed that an as-needed treatment regimen (6-9 injections per year) was associated with a mortality increase of 1.8% (risk ratio: 2.0 [1.2 to 3.5], 2 RCTs, 1795 patients) compared with monthly treatment in cn-AMD patients.
conclusionsIntravitreal bevacizumab was a reasonable alternative to ranibizumab and aflibercept in patients with cn-AMD, DMO, RVO-MO and m-CNV. The only exception was for patients with DME and low visual acuity (<69 early treatment diabetic retinopathy study [ETDRS] letters), where treatment with aflibercept was associated with significantly higher vision gain (≥15 ETDRS letters) than bevacizumab or ranibizumab at 12 months; but the significant effects were not maintained at 24 months. The choice of anti-VEGF drugs may depend on the specific retinal condition, baseline visual acuity and treatment regimen. PROSPERO REGISTRATION NUMBER: CRD42015022041.
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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.