{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T06:36:45Z","timestamp":1787726205880,"version":"build-2784847793"},"reference-count":52,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,12,16]],"date-time":"2020-12-16T00:00:00Z","timestamp":1608076800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To conduct a systematic review with network meta\u2010analysis (NMA) of randomized clinical trials (RCTs) comparing panretinal photocoagulation (PRP) versus anti\u2010vascular endothelial growth factor (VEGF) treatment alone or in combination with PRP, for proliferative diabetic retinopathy (PDR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>PubMed, Medline and Embase databases were searched for RCTs comparing PRP versus intravitreal anti\u2010VEGF therapy and\/or combined PRP and intravitreal anti\u2010VEGF for PDR. The primary outcome measures were the mean best corrected visual acuity (BCVA) change and the regression of neovascularization. Mean change of central macular thickness (CMT), the subgroup analyses of patients without diabetic macular oedema (DME) and the rate of vitreous haemorrhage and vitrectomy were secondary outcomes. Frequentist NMAs were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twelve RCTs were included. For the 12\u2010month mean BCVA change, NMA showed a better visual outcome in both the anti\u2010VEGF group and combined group compared to PRP [anti\u2010VEGF vs PRP, mean difference (MD)\u00a0=\u00a03.42; standard error (SE)\u00a0=\u00a01.5; combined vs PRP, MD\u00a0=\u00a03.92; SE\u00a0=\u00a01.65], with no difference between combined group and anti\u2010VEGF (MD\u00a0=\u00a0\u22120.50; SE\u00a0=\u00a01.87). No difference in neovascularization regression was found between PRP and anti\u2010VEGF alone or in combination with PRP, but there was significant inconsistency (p\u00a0=\u00a00.016). Subgroup analyses in patients without DME yielded no difference for the 12\u2010month visual outcome between the three interventions, but with significant inconsistency (p\u00a0=\u00a00.005).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This NMA showed limited evidence of comparable efficacy in terms of neovascularization regression between PRP and anti\u2010VEGF therapy alone or in combination with PRP, but better visual outcomes were associated with anti\u2010VEGF use. Intravitreal anti\u2010VEGF therapy could be a valid therapeutic option in association with PRP.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.14681","type":"journal-article","created":{"date-parts":[[2020,12,17]],"date-time":"2020-12-17T01:24:09Z","timestamp":1608168249000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Intravitreal anti\u2010vascular endothelial growth factors, panretinal photocoagulation and combined treatment for proliferative diabetic retinopathy: a systematic review and network meta\u2010analysis"],"prefix":"10.1111","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2639-1321","authenticated-orcid":false,"given":"Matteo","family":"Fallico","sequence":"first","affiliation":[{"name":"Department of Ophthalmology University of Catania Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2655-8574","authenticated-orcid":false,"given":"Andrea","family":"Maugeri","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d University of Catania Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Lotery","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Southampton Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Longo","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University of Catania Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5468-0978","authenticated-orcid":false,"given":"Vincenza","family":"Bonfiglio","sequence":"additional","affiliation":[{"name":"Department of Experimental Biomedicine and Clinical Neuroscience, Ophthalmology Section University of Palermo Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Russo","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University of Catania Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresio","family":"Avitabile","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University of Catania Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo","family":"Pulvirenti","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine University of Catania Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0254-7432","authenticated-orcid":false,"given":"Claudio","family":"Furino","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University of Bari Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilda","family":"Cennamo","sequence":"additional","affiliation":[{"name":"Department of Public Health University of Naples Federico II Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Barchitta","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d University of Catania Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4405-8162","authenticated-orcid":false,"given":"Antonella","family":"Agodi","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences and Advanced Technologies \u201cGF Ingrassia\u201d University of Catania Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Reibaldi","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences Eye Clinic Section University of Turin Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12,16]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1005073"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2015.4070"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006982-200603000-00024"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/IAE.0000000000002422"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2019.06.022"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1755-3768.2011.02364.x"},{"key":"e_1_2_5_8_1","unstructured":"Eylea 40mg\/ml solution for injection in a vial \u2010 Summary of Product Characteristics (SmPC) \u2010 (emc)(n.d.). 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