Pakistan Journal of Pharmaceutical Sciences

Abstract: Background: Despite the established role of anti-vascular endothelial growth factor (anti-VEGF) agents as first-line therapy for diabetic macular edema (DME), their therapeutic effect may be incomplete or unsustained in a proportion of patients. Objectives: This study aimed to evaluate the efficacy and safety of intravitreal conbercept (IVC) combined with traditional Chinese medicine (TCM) for the treatment of DME. Methods: A systematic search was conducted in PubMed, EMBASE, Web of Science, the Cochrane Library, Scopus, and CNKI from database inception to June 2025. Eligible randomized controlled trials (RCTs) comparing IVC combined with TCM versus IVC monotherapy were included. Results: A total of 14 studies involving 979 patients met the inclusion criteria. Compared with IVC monotherapy, IVC combined with TCM resulted in a greater reduction in central macular thickness (CMT) and significantly improved best-corrected visual acuity (BCVA) at both 3 and 6 months. However, no significant difference in BCVA was observed at 1 month (MD = -0.03; 95% CI -0.08 to 0.03; p = 0.34). The combination therapy was also associated with a significantly lower ineffectiveness rate (RR = 0.32; 95% CI 0.22-0.47; p < 0.05) and fewer adverse events (AEs) (RR = 0.67; 95% CI 0.45-1.00; p < 0.05). Conclusion: IVC combined with TCM may provide additional therapeutic benefits for patients with DME without increasing safety risks. Nevertheless, high-quality, large-scale, multicenter RCTs are still required to further confirm these findings.