title: Practicability confirmation by meta-analysis of intravitreal ranibizumab compared to photodynamic therapy to treat polypoidal choroidal vasculopathy.
abstract: OBJECTIVE
  The literatures show that photodynamic therapy (PDT) and intravitreal ranibizumab (IVR) have their own specific advantages in treating polypoidal choroidal vasculopathy (PCV). Using a meta-analysis, we want to provide some suggestions for the clinical application of the two treatments to PCV patients through a comparison of the functional outcomes in a follow-up period after administration.
  
  
  METHODS
  A comprehensive literature search was performed using several databases to assemble the controlled trials of IVR and PDT. The program of RevMan version 5.0 was used to analyze the data. The effects of two treatments on PCV were evaluated by comparing weighted mean differences (WMDs) in the change of LogMar visual acuity, central retinal thickness (CRT), and the deterioration ratio for the proportions of patients with visual reductions from the baseline. Data with homogeneity among studies were analyzed using a fixed-effect meta-analysis model; otherwise, a random-effect model was applied to data with heterogeneity.
  
  
  RESULTS
  Five studies are included covering 260 cases in total in this study. The outcomes of IVR treatment compared to PDT appear to significantly improve vision, decrease the central retinal thickness (CRT), and reduce the invalidation rate. The LogMar visual acuity shifts from 0.6 to 0.3 in the following 24 months and the improvement rate of visual acuity ranges from 60-70% in IVR treated patients. However, the visual acuity improvement is moderate in the PDT group. These analyses indicate that IVR is an applicable treatment in PCV patients, although PDT is able to yield about a 35% visual acuity improvement in a short-term follow-up. Our 3-D mesh modal also confirms that IVR is able to yield better effects to treat PCV than PDT.
  
  
  CONCLUSIONS
  The analysis in this study suggests that IVR has a significant effect on the improvement of visual acuity when treating patients with PCV. Our findings clearly document that IVR can be used as a more effective therapy for long-term administration in PCV.
authors.affiliation: Southwest Eye Hospital, Southwest Hospital, Key Laboratory of Visual Damage and Repair of Chongqing, Third Military Medical University, Chongqing, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Liu
authors.affiliation: Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA.
authors.forename: Jie
authors.initials: J
authors.lastname: Ma
authors.affiliation: Southwest Eye Hospital, Southwest Hospital, Key Laboratory of Visual Damage and Repair of Chongqing, Third Military Medical University, Chongqing, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Duan
authors.affiliation: Southwest Eye Hospital, Southwest Hospital, Key Laboratory of Visual Damage and Repair of Chongqing, Third Military Medical University, Chongqing, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Southwest Eye Hospital, Southwest Hospital, Key Laboratory of Visual Damage and Repair of Chongqing, Third Military Medical University, Chongqing, China.
authors.forename: Zheng Qin
authors.initials: ZQ
authors.lastname: Yin
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D002829:Choroid / Q000098:blood supply / Q000187:drug effects / Q000473:pathology; D015862:Choroid Diseases / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D058449:Intravitreal Injections; D015233:Models, Statistical; D009389:Neovascularization, Pathologic / Q000188:drug therapy* / Q000473:pathology; D010778:Photochemotherapy / Q000379:methods*; D000069579:Ranibizumab / Q000627:therapeutic use*; D012160:Retina / Q000187:drug effects / Q000473:pathology; D012163:Retinal Detachment / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome; D014792:Visual Acuity / Q000187:drug effects
chemical_list: D020533:Angiogenesis Inhibitors; D000069579:Ranibizumab