{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T19:20:12Z","timestamp":1788981612239,"version":"build-2803163510"},"reference-count":62,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The study performed a systematic review and meta-analysis of randomized controlled trials (RCTs) assessing the efficacy and safety of intraocular injections of anti-vascular endothelial growth factor (VEGF) monotherapy versus steroid monotherapy or anti-VEGF combined with steroids for macular edema (ME) secondary to retinal vein occlusion (RVO).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library from database inception to 10 August 2025 for randomized controlled trials (RCTs) comparing anti-VEGF or steroid monotherapy with their combination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 22 randomized controlled trials (RCTs) were included. Of these, 13 trials (mean difference, \u221243.21, 95% CI, \u221276.82 to \u22129.60,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.01) compared anti-VEGF monotherapy with steroid monotherapy or combination therapy, and the results showed that anti-VEGF monotherapy was more effective in improving central macular thickness (CMT). Furthermore, seven trials used the Early Treatment Diabetic Retinopathy Study (ETDRS) letters to record changes in best-corrected visual acuity (BCVA). The pooled results (mean difference, 5.72, 95% CI, 1.82 to 9.61,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.004) indicated that anti-VEGF monotherapy was more effective compared to the other two treatments. A total of 10 trials used the standard logarithm of the minimum angle of resolution (logMAR) visual acuity (VA) chart to assess best-corrected visual acuity. The pooled results (mean difference, 0.01, 95% CI, \u22120.09 to 0.12,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.80) indicated that anti-VEGF monotherapy has no significant advantage over combination therapy or steroid drugs. A total of eight adverse events were included in the analysis: cataract, conjunctival hemorrhage, eye pain, intraocular pressure (IOP), increased lacrimation, macular edema, ocular hypertension, and reduced visual acuity. Compared to steroid monotherapy, anti-VEGF monotherapy can reduce the incidence of cataract, elevated intraocular pressure, ocular hypertension, and reduced visual acuity. In addition, compared to combination therapy, anti-VEGF monotherapy can reduce the occurrence of ocular hypertension.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This meta-analysis indicates that monotherapy with anti-VEGF drugs is more effective than the other two treatment methods in reducing CMT in patients with retinal vein occlusion. Regarding the ETDRS scores, anti-VEGF monotherapy was better than the other two treatments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:uri>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420251146756<\/jats:uri>\n                      , CRD420251146756.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1727801","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T05:45:33Z","timestamp":1768196733000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["The efficacy and safety of intraocular anti-VEGF injections versus anti-VEGF combined with steroids or steroid monotherapy for macular edema secondary to retinal vein occlusion: a systematic review and meta-analysis of randomized controlled trials"],"prefix":"10.3389","volume":"12","author":[{"given":"Han","family":"Cai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miao","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhilong","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binglong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2020\/7817542","article-title":"Intravitreal injections for macular edema secondary to retinal vein occlusion: long-term functional and anatomic outcomes","volume":"2020","author":"Maggio","year":"2020","journal-title":"J Ophthalmol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"010427","DOI":"10.7189\/jogh.09.010427","article-title":"Global epidemiology of retinal vein occlusion: a systematic review and Meta-analysis of prevalence, incidence, and risk factors","volume":"9","author":"Song","year":"2019","journal-title":"J Glob Health"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1080\/08998280.2023.2173938","article-title":"Prevalence and risk factors of retinal vein occlusion in the United States: the National Health and nutrition examination survey, 2005 to 2008","volume":"36","author":"Kalva","year":"2023","journal-title":"Proceedings"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"P288","DOI":"10.1016\/j.ophtha.2019.09.029","article-title":"Retinal vein occlusions preferred practice pattern\u00ae","volume":"127","author":"Flaxel","year":"2020","journal-title":"Ophthalmology"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1097\/01.apo.0000617924.11529.88","article-title":"Effects of switching to Aflibercept in treatment resistant macular edema secondary to retinal vein occlusion","volume":"9","author":"Spooner","year":"2020","journal-title":"Asia Pac J Ophthalmol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1016\/j.preteyeres.2017.10.006","article-title":"Mechanisms of macular edema: beyond the surface","volume":"63","author":"Daruich","year":"2018","journal-title":"Prog Retin Eye Res"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1097\/apo.0000000000000598","article-title":"Update on retinal vein occlusion","volume":"12","author":"Romano","year":"2023","journal-title":"Asia Pac J Ophthalmol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1016\/0002-9394(84)90316-7","article-title":"Argon laser photocoagulation for macular edema in branch vein occlusion. 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