Clinical effect of intravitreal ranibizumab and laser photocoagulation on diabetic macular edema: a meta-analysis.

OBJECTIVE

To systematically evaluate the clinical effect of intravitreal ranibizumab (IVR) and laser photocoagulation on diabetic macular edema (DME).

METHOD: A systematic search was conducted of five English databases from the establishment of each database to 31 January 2024, and a meta-analysis was performed using Review Manager 5.3 software.

RESULT: A total of 1,040 patients were included across 10 articles, where 531 patients had been treated with IVR and 509 with laser photocoagulation. The results of the meta-analysis showed that visual acuity improvement in the IVR group was better than in the laser photocoagulation group. The difference was statistically significant (best corrected visual acuity [BCVA], Mean Difference (MD) = 5.69, 95% confidence interval [CI]: 4.51, 6.86, P < 0.001). There was no significant difference in BCVA based on Logarithm of the Minimum Angle of Resolution (logMAR) value (MD = -0.07, 95%CI: -0.15, -0.01, P = 0.07). The improvement of macular edema in IVR was better than in the laser photocoagulation group (central macular thickness, MD = -30.93, 95% CI: -35.18, -26.68, P < 0.001). There were more adverse reaction events in the IVR group than in the laser photocoagulation group, and the difference was statistically significant (odds ratio = 8.82, 95% CI: 3.06, 25.43, P < 0.001).

CONCLUSION

Intravitreal ranibizumab remains superior to laser photocoagulation in improving vision and reducing macular edema in DME, albeit with higher adverse events. These findings support IVR's continued relevance in contemporary practice, particularly where newer anti-vascular endothelial growth factor agents are unavailable.