{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:06:08Z","timestamp":1790697968981,"version":"4.1.0"},"reference-count":57,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T00:00:00Z","timestamp":1728518400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T00:00:00Z","timestamp":1728518400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of VitreoRetinal Diseases"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>\n                    <jats:bold>Purpose:<\/jats:bold>\n                    To compare the safety and efficacy of antivascular endothelial growth factor (anti-VEGF) monotherapy vs anti-VEGF and steroid combination therapy in treatment-na\u00efve and treatment-resistant patients with diabetic macular edema (DME).\n                    <jats:bold>Methods:<\/jats:bold>\n                    A systematic literature search was conducted from January 2005 to December 2022. Sixteen randomized control trials (RCTs) published in English that reported the efficacy or safety of monotherapy and combination therapy in patients with DME were included.\n                    <jats:bold>Results:<\/jats:bold>\n                    The 16 RCTs included 1166 eyes. Monotherapy was associated with a significantly better best-corrected visual acuity (BCVA) at the final follow-up (weighted mean difference [WMD], \u22120.04 logMAR; 95% CI, \u22120.07 to \u22120.02;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2008=\u2008.002;\n                    <jats:italic toggle=\"yes\">I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2008=\u20080%). No significant differences were observed in the change in BCVA between groups at the final observation. Monotherapy was associated with a significantly smaller change in retinal thickness at the final follow-up (WMD, 37.63 \u03bcm; 95% CI, 11.67-63.60;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2008=\u2008.005;\n                    <jats:italic toggle=\"yes\">I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2008=\u200878%) and with a significantly lower risk for intraocular pressure\u2013related adverse events (AEs) (risk ratio, 0.27; 95% CI, 0.15-0.46;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2008\u2264\u2008.001;\n                    <jats:italic toggle=\"yes\">I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2008=\u20080%). The risk for cataract-related AEs was not significantly different between groups (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2008=\u2008.06). The results in treatment-na\u00efve patients were similar. In treatment-resistant patients, the change in retinal thickness at the final follow-up was similar between groups (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2008=\u2008.14), but the risk for cataract-related AEs was significantly lower in the monotherapy group in 2 RCTs (risk ratio, 0.09; 95% CI, 0.01-0.66;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2008=\u2008.02;\n                    <jats:italic toggle=\"yes\">I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2008=\u20080%).\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    The changes in BCVA were similar despite combination therapy being associated with greater changes in retinal thickness. However, increased complications were seen with combination therapy. Most results in treatment-na\u00efve patients and treatment-resistant patients were similar.\n                  <\/jats:p>","DOI":"10.1177\/24741264241280597","type":"journal-article","created":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T02:46:52Z","timestamp":1728614812000},"page":"70-83","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Anti-VEGF Monotherapy vs Anti-VEGF and Steroid Combination Therapy for Diabetic Macular Edema: A Meta-analysis"],"prefix":"10.1177","volume":"9","author":[{"given":"Justin","family":"Grad","sequence":"first","affiliation":[{"name":"Michael DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amin","family":"Hatamnejad","sequence":"additional","affiliation":[{"name":"Michael DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohan","family":"Dadak","sequence":"additional","affiliation":[{"name":"Michael DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simrat","family":"Sodhi","sequence":"additional","affiliation":[{"name":"University of Cambridge, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7583-2640","authenticated-orcid":false,"given":"Niveditha","family":"Pattathil","sequence":"additional","affiliation":[{"name":"Vitreous Retina Macula Specialists of Toronto, Etobicoke, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Netan","family":"Choudhry","sequence":"additional","affiliation":[{"name":"Vitreous Retina Macula Specialists of Toronto, Etobicoke, ON, Canada"},{"name":"Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada"},{"name":"Cleveland Clinic Canada, Toronto, ON, Canada"},{"name":"Retina Consultants of Texas, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,10,10]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0002-9394(99)00033-1"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1755-3768.2019.8268"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2015.03.024"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.4239\/wjd.v2.i6.98"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0161-6420(95)31052-4"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1985.01050120030015"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.4103\/tjo.tjo_16_20"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1096105"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2011.01.031"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/archophthalmol.2012.393"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2011.12.039"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2015.5346"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2017.6565"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2006.02.065"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.18240\/ijo.2016.10.10"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.oret.2022.10.008"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-1313.2010.00766.x"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/9781119536604"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39489.470347.AD"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S22103"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.3980\/j.issn.1672-5123.2019.1.01"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.issn.0366-6999.2011.03.006"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/112067210801800614"},{"issue":"3","key":"e_1_3_2_25_2","first-page":"841","article-title":"Intravitreal bevacizumab with or without triamcinolone for refractory diabetic macular oedema","volume":"35","author":"Synek S","year":"2011","unstructured":"Synek S, Vesel\u00fd P. 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