title: Efficacy and safety of different doses of a slow-release corticosteroid implant for macular edema: meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  The purpose of this meta-analysis was to assess the efficacy and safety of intravitreal corticosteroid implants for macular edema.
  
  
  METHODS
  A total of 3,586 patients from previously reported randomized controlled trials were included. The meta-analysis was performed using RevMan 5.2. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated, employing random-effects or fixed-effects models according to between-study heterogeneity. The main outcome measures were the ORs for effects and safety of intravitreal corticosteroid implants.
  
  
  RESULTS
  Four eligible studies were included. Compared with the sham group, the ORs for ≥15 letter improvement of visual acuity in the high-dose and low-dose groups were 1.89 (95% CI 1.33-2.69, P=0.0004) and 1.62 (95% CI 1.10-2.41, P=0.02), respectively. The weight mean differences in central retinal thickness increases were -75.46 (95% CI -90.29, -60.63, P<0.0001) and -46.47 (95% CI -92.08, -0.86, P=0.05), respectively. However, the ORs for increased intraocular pressure in both intervention groups were higher than in the sham group, and were 11.50 (95% CI 7.24-18.28, P<0.00001) and 10.30 (95% CI 6.49-16.36, P<0.00001), respectively. The incidence of cataract was 7.25 (95% CI 5.68-9.25, P<0.00001) and 3.56 (95% CI 1.28-9.96, P=0.02) in the two intervention groups, respectively. There was no significant difference between the intervention groups except for the incidence of cataract in which the OR was 1.59 (95% CI 1.28-1.97, P<0.001).
  
  
  CONCLUSIONS
  Intravitreal corticosteroid implants are effective in treating macular edema. However, the efficacy is not related to corticosteroid dose.
authors.affiliation: Department of Ophthalmology, Shanghai Tenth People's Hospital, Shanghai, People's Republic of China ; Tongji University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Qingyu
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Department of Ophthalmology, Shanghai Tenth People's Hospital, Shanghai, People's Republic of China ; Tongji University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Mengmei
authors.initials: M
authors.lastname: He
authors.affiliation: Department of Ophthalmology, Shanghai Tenth People's Hospital, Shanghai, People's Republic of China ; Department of First Clinical Medical College, Nanjing Medical University, Nanjing, People's Republic of China.
authors.forename: Hui
authors.initials: H
authors.lastname: Shi
authors.affiliation: Department of Ophthalmology, Shanghai Tenth People's Hospital, Shanghai, People's Republic of China ; Tongji University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Qianyi
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Ophthalmology, Shanghai Tenth People's Hospital, Shanghai, People's Republic of China ; Department of First Clinical Medical College, Nanjing Medical University, Nanjing, People's Republic of China.
authors.forename: Yaru
authors.initials: Y
authors.lastname: Du
authors.affiliation: Department of Ophthalmology, Shanghai Tenth People's Hospital, Shanghai, People's Republic of China ; Tongji University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Junling
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Ophthalmology, Shanghai Tenth People's Hospital, Shanghai, People's Republic of China ; Tongji University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Chengda
authors.initials: C
authors.lastname: Ren
authors.affiliation: Department of Ophthalmology, Shanghai Tenth People's Hospital, Shanghai, People's Republic of China.
authors.forename: Ding
authors.initials: D
authors.lastname: Xu
authors.affiliation: Department of Ophthalmology, Shanghai Tenth People's Hospital, Shanghai, People's Republic of China.
authors.forename: Jing
authors.initials: J
authors.lastname: Yu
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D003692:Delayed-Action Preparations; D004343:Drug Implants; D006801:Humans; D008269:Macular Edema / Q000188:drug therapy* / Q000473:pathology; D016032:Randomized Controlled Trials as Topic
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D003692:Delayed-Action Preparations; D004343:Drug Implants
keywords: corticosteroid implant; intravitreal; macular edema; randomized controlled trial