Meta-Analysis of Anti-VEGF Agents for Diabetic Retinopathy Surgery

A systematic review and network meta-analysis of 22 randomized controlled trials involving 1,388 patients (1,416 eyes) compares the efficacy and safety of four anti-VEGF agents combined with pars plana vitrectomy for proliferative diabetic retinopathy. The analysis, conducted by Songjie Lu, includes outcomes such as intraoperative bleeding rate, postoperative vitreous hemorrhage, and changes in best-corrected visual acuity.

Use Cases

• Compare the odds ratios for intraoperative bleeding rate across bevacizumab (IVB), ranibizumab (IVR), conbercept (IVC), and aflibercept (IVA) to identify the most effective agent.
• Analyze the surface under the cumulative ranking curve (SUCRA) values for postoperative vitreous hemorrhage to rank treatment efficacy.
• Evaluate the mean difference in surgery duration associated with IVB to assess its impact on surgical efficiency.
• Examine the odds ratios for iatrogenic retinal breaks to determine which anti-VEGF agent best reduces this surgical complication.

Strengths

• Includes data from 22 randomized controlled trials, a substantial evidence base for a meta-analysis.
• Analyzes five distinct treatment regimens across 1,388 patients, providing comparative effectiveness data.
• Employs rigorous methodology including network meta-analysis, RoB 2 tool for bias assessment, and GRADE framework for evidence quality.

Limitations

• The underlying data is aggregated from published studies; individual patient-level data is not available for deeper analysis.
• As a systematic review, its findings are constrained by the quality, heterogeneity, and publication bias of the included primary studies.
• The dataset is a 1.2 MB PDF file, limiting direct computational analysis without manual extraction or text parsing.

Provenance

Source

Systematic search of PubMed, EMBASE, the Cochrane Library, and Web of Science.

Collection Method

Network meta-analysis of randomized controlled trials.

Time Range

Trials published up to November 1, 2025.

Freshness

Last updated March 25, 2026, with literature search current up to November 1, 2025.

Geography

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