A Meta-Analysis of Cardiovascular Events Associated with Intravitreal Anti-VEGF Treatment in Patients with Retinal Vein Occlusion

ABSTRACT

Purpose: Retinal vein occlusion is associated with an increased risk of cardiovascular diseases. Anti-vascular endothelial growth factor has been widely used as a treatment option. However, the systemic safety of intravitreal anti-vascular endothelial growth factor for retinal vein occlusion patients is still unclear.

Materials and Methods: A meta-analysis was conducted to investigate all randomized controlled trials published up to February 2019 of retinal vein occlusion patients who received intravitreal anti-vascular endothelial growth factor vs. control treatments. Fixed effect models were used and results were reported as odds ratios and 95% confidence intervals.

Results: Eight trials that evaluated 2320 patients were retrieved. Anti-vascular endothelial growth factor did not significantly increase the risks of cardiovascular events (odds ratio,1.54; 95% confidence interval, 0.66–3.57), hypertension (odds ratio, 0.92; 95% confidence interval, 0.63–1.33), or heart rate disorders (odds ratio,1.53; 95% confidence interval, 0.37–6.28) when compared with control treatment. Subgroup analyses did not show a significant increase of cardiovascular events in aflibercept (odds ratio,1.96; 95% confidence interval, 0.44–8.81) vs. ranibizumab trials (odds ratio, 1.47; 95% confidence interval, 0.54–4.02); 0.5 mg ranibizumab trials (odds ratio, 1.73; 95% confidence interval, 0.61–4.96) vs. 0.3 mg ranibizumab trials (odds ratio, 0.70; 95% confidence interval, 0.14–3.59); nor branch retinal vein occlusion (odds ratio, 1.32; 95% confidence interval, 0.40–4.33) vs. central retinal vein occlusion trials (odds ratio, 1.93; 95% confidence interval, 0.59–6.29).

Conclusions: Intravitreal administration of anti-vascular endothelial growth factor did not significantly increase the risks of cardiovascular events, hypertension or heart rate disorders in retinal vein occlusion patients.

KEYWORDS:

• Anti-VEGF
• cardiovascular events
• intravitreal administration
• meta-analysis
• retinal vessel occlusion

Declaration of interest statement

None of the authors has any financial/conflicting interests to disclose.

Authors’ contributions

Pingting Zhong and Xiaohong Yang: conception and design. Pingting Zhong and Miao He: data collection, analysis, and interpretation. Pingting Zhong and Miao He: article drafting. Honghua Yu, Qiaowei Wu, Qingsheng Peng, Manqing Huang, and Yunlian Xue: final approval of the version to be published. All authors revised the article critically for important intellectual content. All authors read and approved the final manuscript.

Supplementary Material

Supplemental data for this article can be accessed here.

Additional information

Funding

This work was supported by Project of Investigation on Health Status of Employees in Financial Industry in Guangzhou [Z012014075] (Xiaohong Yang).