Abstract:AIM: To systematically evaluate the effectiveness and safety of subconjunctival and intravitreal injection of triamcinolone acetonide(TA)in the treatment of macular edema secondary to non-infectious uveitis.
METHODS: Databases, including Wanfang database, CNKI, VIP database, CBM, PubMed, Embase, Cochrane Library and Web of Science, were searched from the establishment to May 2022. A clinical randomized controlled trial(RCT)of TA for the treatment of non-infectious uveitis secondary to macular edema was included, with subconjunctival injection of TA in the trial group and intravitreal injection of triamcinolone acetonide(IVTA)in the control group. Review Manager 5.4 and Stata15 were used for Meta-analysis of the postoperative best corrected visual acuity(BCVA), central macular thickness(CMT), overall efficiency and adverse effects. Odds ratio(OR), weighted mean(MD)and 95% confidence interval(CI)were applied to evaluate.
RESULTS: A total of 8 studies were included. The Meta-analysis showed that subconjunctival injection of TA was better than the IVTA group in improving BCVA(MD=0.81, 95%CI: 0.60~1.01, P<0.0001), reducing CMT(MD=-48.35, 95%CI: -58.82~-37.88, P<0.0001)and in the overall efficiency(OR=3.88, 95%CI: 2.32~6.52, P<0.0001); The incidence of adverse events was lower than that of the IVTA group(OR=0.45, 95%CI: 0.32~0.62, P<0.0001).
CONCLUSION: As for the treatment of non-infectious uveitis, subconjunctival injection of TA was superior to IVTA in terms of its improved visual acuity, reduced CMT, overall efficiency and lower incidence of adverse events.