Surgical management, use and efficacy of adjuvant dyes in idiopathic epiretinal membranes: a systemic review with network meta-analysis.

IF 1.9 Q2 OPHTHALMOLOGY
Miguel A Quiroz-Reyes, Erick A Quiroz-Gonzalez, Miguel A Quiroz-Gonzalez, Virgilio Lima-Gomez
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引用次数: 0

Abstract

Background: The epiretinal membrane (ERM) is a nonvascular fibrocellular tissue formed by cellular metaplasia and proliferation at the vitreoretinal surface and is generally treated by pars plana vitrectomy (PPV) with or without internal limiting membrane (ILM) peeling. This network meta-analysis aimed to compare the efficacy of all available ERM removal interventions and assessed the use and efficacy of surgical dyes in managing idiopathic ERMs.

Methods: MEDLINE, EMBASE, Cochrane CENTRAL, and the US National Library of Medicine were searched (June 28, 2023). Clinical studies that included patients with ERMs were included. Randomized controlled trials (RCTs) were also appraised using Cochrane risk of bias (ROB).

Results: Ten RCTs and ten non-RCTs were included in this study. A pairwise meta-analysis between ERM removal and combined ERM and ILM removal showed no significant difference in visual outcome (change in BCVA) 1 year postintervention (MD = - 0.0034, SE = 0.16, p = 0.832). Similarly, there was no significant difference in the central macular thickness postoperatively between the two groups (MD = - 4.95, SE = 11.11, p = 0.656) (Q = 4.85, df = 3, p = 0.182, I2 = 41.21%). The difference in ERM recurrence between the groups was also not statistically significant (OR = 4.64, p = 0.062, I2 = 0). In a network meta-analysis, there was no significant difference in visual outcomes between ERM removal only and other treatment modalities: combined ILM and ERM removal (MD = 0.039, p = 0.837) or watchful waiting (MD = 0.020, p = 0.550). In a network meta-analysis, there was no significant difference in the visual outcomes between ERM removal alone and dye-stained combined ERM and ILM peeling (MD = 0.122, p = 0.742 for brilliant blue G; BBG and MD = 0.00, p = 1.00 for membrane blue-dual; MBD). The probability of being a better surgical dye for better visual outcomes was 0.539 for the MBD group and 0.396 for the BBG group. The recurrence of ERM was not significantly different when the ILM was stained with any of the dyes. No study was judged on ROB assessment as having low ROB in all seven domains.

Conclusion: The two types of surgical modalities provided comparable efficacy, with no significant differences between the outcomes. Among the dye-assisted ILM peeling methods, the membrane blue-dual dye was the most effective in providing better structural and functional outcomes.

辅助染料在特发性视网膜前膜中的手术处理、使用和疗效:一项基于网络荟萃分析的系统综述。
背景:视网膜前膜(ERM)是一种由玻璃体视网膜表面细胞化生和增殖形成的非血管纤维细胞组织,通常通过平面部玻璃体切除术(PPV)治疗,并伴有或不伴有内限制膜(ILM)剥离。该网络荟萃分析旨在比较所有可用的ERM去除干预措施的疗效,并评估手术染料在治疗特发性ERM中的使用和疗效。方法:检索MEDLINE、EMBASE、Cochrane CENTRAL和美国国家医学图书馆(2023年6月28日)。纳入了包括erm患者的临床研究。随机对照试验(rct)也采用Cochrane偏倚风险(ROB)进行评价。结果:本研究纳入10项随机对照试验和10项非随机对照试验。对ERM切除与联合ERM和ILM切除的两两meta分析显示,干预后1年视力结果(BCVA变化)无显著差异(MD = - 0.0034, SE = 0.16, p = 0.832)。同样,两组术后黄斑中央厚度差异无统计学意义(MD = - 4.95, SE = 11.11, p = 0.656) (Q = 4.85, df = 3, p = 0.182, I2 = 41.21%)。两组间ERM复发率差异无统计学意义(OR = 4.64, p = 0.062, I2 = 0)。在一项网络荟萃分析中,仅去除ERM与其他治疗方式:ILM和ERM联合去除(MD = 0.039, p = 0.837)或观察等待(MD = 0.020, p = 0.550)之间的视觉结果无显著差异。在网络荟萃分析中,单独去除ERM与染色联合去除ERM和ILM的视觉结果无显著差异(亮蓝色G的MD = 0.122, p = 0.742;膜蓝双组BBG和MD = 0.00, p = 1.00;MBD)。在MBD组和BBG组中,作为手术染料获得更好视力结果的概率分别为0.539和0.396。用任何一种染料染色ILM时,ERM的复发率无显著差异。没有研究被判断为在所有七个领域的低ROB评估。结论:两种手术方式疗效相当,预后无显著差异。在染料辅助的ILM剥离方法中,膜蓝双染料在提供更好的结构和功能结果方面是最有效的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.50
自引率
4.30%
发文量
81
审稿时长
19 weeks
期刊介绍: International Journal of Retina and Vitreous focuses on the ophthalmic subspecialty of vitreoretinal disorders. The journal presents original articles on new approaches to diagnosis, outcomes of clinical trials, innovations in pharmacological therapy and surgical techniques, as well as basic science advances that impact clinical practice. Topical areas include, but are not limited to: -Imaging of the retina, choroid and vitreous -Innovations in optical coherence tomography (OCT) -Small-gauge vitrectomy, retinal detachment, chromovitrectomy -Electroretinography (ERG), microperimetry, other functional tests -Intraocular tumors -Retinal pharmacotherapy & drug delivery -Diabetic retinopathy & other vascular diseases -Age-related macular degeneration (AMD) & other macular entities
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