ObjectiveTo evaluate the efficacy in the treatment of age-related macular degeneration (AMD) by bevacizumab versus ranibizumab. MethodsA computerized search was conducted in the Embase, Ovid, PubMed, China National Knowledge Infrastructure (CNKI), WanFang Data and VIP database of Chinese journal. Randomized controlled trials (RCTs) comparing bevacizumab with ranibizumab for AMD from inception to November, 2013 were collected. Methodology qualifies of studies were performed by experienced reviewers according to the inclusion and exclusion criteria. Further, the materials were analyzed with software RevMan 5.2.6. Visual acuity and central foveal thickness before and 3, 6, 12 months after treatment between the two treatment methods were compared. ResultsA total of 5 RCTs were included in this meta analysis, including 1954 patients (967 patients in the bevacizumab group, 987 eyes in the ranibizumab group). There was no difference in improving visual acuity after treatment between two groups [3 months: weighted mean difference (WMD)=0.32, 95% CI: -0.84 -1.49, P=0.59; 6 months: WMD=0.47, 95% CI: -0.67 -1.62, P=0.42; 12 months: WMD=0.84, 95% CI: -0.23 -1.90, P=0.12]. There was no difference in cutting down the central foveal thickness after treatment between two groups (3 months: WMD=6.21, 95% CI: -6.23-18.65, P=0.33; 6 months: WMD=4.06, 95% CI: -6.16-14.27, P=0.44; 12 months: WMD=-5.39, 95% CI: -14.41-3.63, P=0.24). ConclusionBevacizumab has equal efficacy to ranibizumab in the treatment of AMD.
Objective To observe the neuroprotective effect of alpha;-lipoic acid (ALA) on cultured retinal ganglion cells (RGC-5) under elevated pressure in vitro. Methods Cultured RGC-5cells were divided randomly into 4 groups, including normal control group (group A), negative control group (group B), elevated pressure group (group C) and elevated pressure + ALA group (group D). The cells of group A and C were not intervened with ALA. The cells of group B were treated with 200 mu;mol/L ALA. The cells of group D were treated with different concentrations of ALA (50, 100, 200 mu;mol/L) for one hour. Then cells of group C and D were exerted to 50 mm Hg (1 mm Hg=0.133 kPa) for 24 hours, while the cells of group A and B were exerted to normal pressures for 24 hours. The cell viability was measured using the methyl thiazolyl tetrazolium (MTT) assay and apoptosis was evaluated using 4prime;,6-diamidino-2-phenylindole (DAPI) staining. Expression of MnSOD was determined by realtime polymerase chain reaction (RT-PCR) and Western blot, respectively. Results The cell viability of group B was (65.6plusmn;3.4)%, which lower than that in group D of three concentrations of ALA［(75.1plusmn;3.3)%, (81.8plusmn;2.9)%,(87.9plusmn;3.1)%］, the differences were significantly (t=5.108, 10.007, 12.513;P＜0.05). DAPI staining revealed that characteristic apoptotic changes, such as chromatin condensation,convoluted nuclei with cavitations, fragmentation of the nucleus, and apoptotic bodies appeared in RGC-5cells after 24 ours pressure. There was almost no evidence of apoptosis in group D. RT-PCR and Western blot analysis revealed that the expression of MnSOD mRNA and protein were weakly expressed in group C compared with control A (t=22.045，26.979;P＜0.01). Compared group C with group D, the level of MnSOD mRNA and protein in group D increased significantly (t=9.171, 12.267, 23.567, 7.723, 12.009, 28.198;P＜0.05).In addition, the presence of ALA was found to inhibit hydrostatic pressure induced damage of RGC-5cells in a dose-dependent manner (F=134.273,194.597;P＜0.01). Conclusion ALA can effectively improve the expression of MnSOD in RGC-5cells under the condition of elevated pressure, enhance the ability of RGC-5cells against oxidative damage.