Intravitreal anti-vascular endothelial growth factor, laser photocoagulation, or combined therapy for diabetic macular edema: A systematic review and network meta-analysis

AI Generated Summary*

A network meta-analysis pooled 13 randomized trials (2,432 eyes) comparing anti-VEGF injections, laser photocoagulation, and their combination for diabetic macular edema, tracking best-corrected visual acuity and central macular thickness at 6 and 12 months. At 6 months, anti-VEGF monotherapy gained more letters than combination (mean difference 1.5; 95% CI 0.084 to 2.7) and laser (6.3; 5.1 to 7.6). By 12 months, monotherapy and combination no longer differed in acuity (0.1; -1.7 to 1.5), and their thickness reduction was similar at both time points, though each outperformed laser. Simulation rankings placed combination first for thickness reduction. On that basis and given long-term treatment needs, the authors recommend combined therapy, while noting few trials and inconsistent laser protocols.

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