Lai SC, Loh EW, Chiou DI, Hong CT. Efficacy and safety of anti-vascular endothelial growth factor agents on corneal neovascularization: A meta-analysis. World J Clin Cases 2023; 11(30): 7337-7349 [PMID: 37969435 DOI: 10.12998/wjcc.v11.i30.7337]
Corresponding Author of This Article
Chien-Tai Hong, MD, PhD, Associate Professor, Department of Neurology, School of Medicine, Shuang-Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan. ct.hong@tmu.edu.tw
Research Domain of This Article
Ophthalmology
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Oct 26, 2023; 11(30): 7337-7349 Published online Oct 26, 2023. doi: 10.12998/wjcc.v11.i30.7337
Efficacy and safety of anti-vascular endothelial growth factor agents on corneal neovascularization: A meta-analysis
Shih-Chung Lai, El-Wui Loh, Du-I Chiou, Chien-Tai Hong
Shih-Chung Lai, Du-I Chiou, Department of Ophthalmology, Shuang Ho Hospital, New Taipei City 23561, Taiwan
El-Wui Loh, Center for Evidence-Based Health Care, Department of Medical Research, Taipei Medical University Shuang Ho Hospital, New Taipei City 23561, Taiwan
El-Wui Loh, Cochrane Taiwan, Taipei Medical University, Taipei 110, Taiwan
El-Wui Loh, Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
El-Wui Loh, Department of Medical Imaging, Taipei Medical University Shuang Ho Hospital, New Taipei City 23561, Taiwan
Chien-Tai Hong, Department of Neurology, Taipei Medical University-Shuang Ho Hospital, New Taipei 23561, Taiwan
Co-corresponding authors: Du-I Chiou and Chien-Tai Hong.
Author contributions: Lai SC, Chiou DI, Loh EW, and Hong CT contributed to study conception and design; Lai SC, Chiou DI, and Loh EW contributed to data acquisition and analysis; Chiou DI and Loh EW contributed to data interpretation; Lai SC and Chiou DI contributed to manuscript writing and revision; Hong CT and Loh EW contributed to provision of resources and administrative oversight; Chiou DI and Hong CT contributed equally.
Conflict-of-interest statement: All authors declared no competing interests
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chien-Tai Hong, MD, PhD, Associate Professor, Department of Neurology, School of Medicine, Shuang-Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan. ct.hong@tmu.edu.tw
Received: July 27, 2023 Peer-review started: July 27, 2023 First decision: September 26, 2023 Revised: September 26, 2023 Accepted: October 8, 2023 Article in press: October 8, 2023 Published online: October 26, 2023 Processing time: 90 Days and 5.3 Hours
ARTICLE HIGHLIGHTS
Research background
Corneal neovascularization (CoNV) is a condition of pathological vascular ingrowth into the cornea from the limbus, causing the avascular structure to become non-transparent and further markedly threaten the visual acuity. Various treatment approaches, including anti-inflammatory drugs (e.g., steroids and immunomodulators), laser ablation, photodynamic therapy, diathermy, and ocular surface restoration, have been used in CoNV management. These approaches are not without problems.
Research motivation
Several randomized controlled trials and non-randomized trials examining the efficacy of anti-vascular endothelial growth factor (VEGF) in CoNV have been published in the past few years.
Research objectives
We conducted an updated systematic review and meta-analysis of clinical trials to examine the efficacy and safety of anti-VEGF in CoNV.
Research methods
Relevant studies published before October 2022 were identified by systematic search using PubMed, EMBASE, and Cochrane Library databases.
Research results
In this study, we found evidence demonstrating that anti-VEGF agents, mainly bevacizumab, are an effective and safe treatment for CoNV.
Research conclusions
Anti-VEGF agents significantly reduced CoNV, BCVA, and graft rejection/failure rate compared with placebo. There was a non-significant trend toward reduction of the risk of developing corneal epithelial defects in the bevacizumab group compared with placebo. Also, combined remedies with bevacizumab have better efficacy in reducing CoNV compared with single other treatments.
Research perspectives
Anti-VEGF agents reduce CoNV of all causes and prevent the corneal graft from rejection and failure in corneal transplantation patients. However, the most appropriate dosage and route of administration remain uncertain. Also, the number of human trials or studies for anti-VEGF drugs other than bevacizumab is limited. Additional trials and studies with larger sample sizes are needed to clarify these issues.
