Comparative effectiveness results
| Condition | Treatment vs comparator | Outcome* | No of RCTs (no of patients) | Baseline ETDRS letters†~Snellen equivalent | Treatment effect Mean (range)† | Comparator effect Mean (range)† | Risk ratio or mean difference
estimate (95% CI) | I2‡ (%) |
| cn-AMD | Bevacizumab vs ranibizumab | Vision gain | 9 (3245) | 57 (35 to 61)~20/80 | 22% (12 to 33) | 23% (14 to 29) | 0.95 (0.84 to 1.07) | 0 |
| Vision loss | 10 (3302) | 60 (35 to 61)~20/63 | 6% (0 to 11) | 7% (4 to 14) | 0.91 (0.7 to 1.19) | 4 | ||
| BCVA change | 8 (3064) | 56 (35 to 61)~20/80 | 7.2 (4.1 to 15.2) | 5.9 (0.6 to 11.4) | −0.03 (−1.08 to 1.02) | 0 | ||
| Aflibercept vs ranibizumab | Vision gain | 2 (1815) | 54 (53 to 55)~20/80 | 32% (30 to 34) | 32% (31 to 34) | 0.99 (0.81 to 1.22) | 52 | |
| Vision loss | 2 (1815) | 54 (53 to 55)~20/80 | 5% (5 to 5) | 6% (5 to 6) | 0.90 (0.60 to 1.350) | 0 | ||
| BCVA change | 2 (1793) | 54 (53 to 55)~20/80 | 8.8 (8.3 to 9.4) | 8.8 (8.1 to 9.4) | −0.05 (−2.5 to 2.4) | 66 | ||
| DMO | Bevacizumab vs ranibizumab | Vision gain | 1 (376) | 65~20/50 | 35% | 37% | 0.94 (0.72 to 1.23) | NA |
| Vision loss | 1 (376) | 65~20/50 | 3% | 2% | 0.48 (0.12 to 1.91) | NA | ||
| BCVA change | 2 (456) | 59 (54 to 65)~20/63 | 10.3 (10.0 to 10.5) | 12.1 (11.9 to 12.3) | −2.0 (−3.9 to 0.1) | 0 | ||
| Bevacizumab vs aflibercept | Vision gain | 1 (386) | 65~20/50 | 35% | 39% | 1.06 (0.80 to 1.38) | NA | |
| Vision loss | 1 (376) | 65~20/50 | 2% | 3% | 2.08 (0.52 to 8.33) | NA | ||
| BCVA change | 1 (386) | 65~20/50 | 10.0 (SD: 11.8) | 12.8 (SD: 12.4) | −2.7 (−5.2 to 0.3) | NA | ||
| Aflibercept vs ranibizumab | Vision gain | 1 (392) | 65~20/50 | 39% | 37% | 1.06 (0.73 to 1.22) | NA | |
| Vision loss | 1 (392) | 65~20/50 | 2% | 2% | 0.63 (0.15 to 2.61) | NA | ||
| BCVA change | 2 (462) | 56 (47 to 65)~20/80 | 16.2 (12.8 to 19.6) | 14.0 (12.3 to 15.7) | 1.4 (-1.6 to 4.3) | 27 | ||
| RVO-MO | Bevacizumab vs ranibizumab | Vision gain | 1 (74) | 56~20/80 | 59% | 59% | 1.00 (0.68 to 1.45) | NA |
| BCVA change | 1 (77) | 56~20/80 | 15.6 | 18.1 | −2.5 (−8.0 to 5.0) | NA | ||
| Bevacizumab vs aflibercept | Vision gain | 1 (358) | 50~20/100 | 65% | 61% | 1.06 (0.91 to 1.25) | NA | |
| BCVA change | 1 (348) | 50~20/100 | 18.6 | 18.9 | 1.5 (−1.2 to 4.2) | NA | ||
| m-CNV | Bevacizumab vs ranibizumab | Vision gain | 1 (32) | 30~20/250 | 62% | 56% | 1.11 (0.63 to 1.96) | NA |
| Vision loss | 1 (32) | 30~20/250 | 0% | 0% | 0% | NA | ||
| BCVA change | 2 (80) | 42 (30 to 55)~20/160 | 12.2 (8.5 to 15.9) | 13.4 (9.5 to 17.3) | −1.3 (−6.5 to 4.0) | 0 |
*In terms of outcomes, vision gain was defined as a gain in BCVA of ≥15 EDTRS letters, vision loss of ≥15 EDTRS letters and visual acuity was expressed using ETDRS letters (with conversion, if necessary). The main analysis was conducted with outcomes at the longest follow-up duration for each RCT.
†Mean (range) were derived across control groups of the included RCTs.
‡I2 <75 was interpreted as low evidence of substantial variation across included RCTs.
BCVA, best-corrected visual acuity; cn-AMD, choroidal neovascular age-related macular degeneration; DMO, diabetic macular oedema; ETDRS, early treatment diabetic retinopathy study; m-CNV, myopic choroidal neovascularisation; NA, not applicable; RCT, randomised controlled trials; RVO-MO, macular oedema due to retinal vein occlusion.