Efficacy of interventions for myopia control in children: A systematic review with network meta-analyses.

IF 3 3区 医学 Q1 OPHTHALMOLOGY
Diana Chabané Schmidt, Anders Hvid-Hansen, Nina Jacobsen, Trine Møldrup Jakobsen, Per Michael Larsen, Kjersti Kristin Lindblad, Flemming Møller, Annette Slyngborg, Yousif Subhi, Line Kessel
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引用次数: 0

Abstract

To determine the effectiveness of various interventions in reducing myopia progression in children. Literature databases were searched on December 2, 2023: PubMed, Embase, the Cochrane Central, Web of Science Core Collection, BIOSIS Previews, Current Contents Connect, Data Citation Index, Derwent Innovations Index, KCI-Korean Journal Database, Preprint Citation Index, ProQuest™ Dissertations and Theses Citation Index and SciELO Citation Index. PRISMA guidelines and the Cochrane Handbook recommendations were followed. All unique interventions were analyzed individually in order to generate clinically applicable results. The main outcome was axial length progression. Secondary outcomes were incident corneal infiltrates, photophobia, development of an allergic response towards the intervention, visual acuity at near and distance and drop-out from allocated intervention/control. We identified 74 RCTs involving 12 154 participants aged 6-18 years. Network meta-analysis compared axial length after 1 year between 45 interventions and placebo or single-vision spectacles. The most effective interventions reported in weighted mean difference and 95% confidence interval were low-level red-light (-0.33 mm (-0.40, -0.25)), ortho-K with 5 mm treatment zone (-0.32 mm (-0.41, -0.24)), ortho-K with aspheric base curve (-0.29 mm (-0.37, -0.22)), atropine 1.0% (-0.28 mm (-0.30, -0.26)), combined atropine 0.01% and ortho-K (-0.24 mm (-0.37, -0.11)), spectacles with highly aspherical lenslets (-0.23 mm (-0.26, -0.19)), ortho-K with increased compression factor (-0.23 mm (-0.28, -0.17), atropine 0.05% (-0.21 mm (-0.30, -0.13)) and defocus incorporated multiple segments spectacles (-0.21 mm (-0.27, -0.15)). Photophobia and reduced near-visual acuity were reported for atropine, and lower adherence to treatment was found for atropine at 1.0%. There was no significant association between any interventions and corneal infiltrates or allergic reactions. Over 70% of the studies were conducted in Asian populations. This systematic review and network meta-analysis highlights the efficacy of various interventions, including orthokeratology lenses, atropine, highly aspherical lenslets and defocus incorporated multiple segments spectacles in slowing axial elongation in children. Low-level red-light therapy also slowed axial length progression, but further research is needed to assess the potential side effects. Future studies should include diverse populations and standardized methodologies to enhance the applicability and comparability of results.

干预措施对儿童近视控制的效果:网络荟萃分析的系统综述。
确定各种干预措施在减少儿童近视进展中的有效性。检索文献数据库:PubMed, Embase, Cochrane Central, Web of Science Core Collection, BIOSIS Previews, Current Contents Connect, Data引文索引,Derwent Innovations索引,KCI-Korean Journal Database, Preprint引文索引,ProQuest™学位论文引文索引和SciELO引文索引。遵循PRISMA指南和Cochrane手册的建议。所有独特的干预措施单独分析,以产生临床适用的结果。主要结局是轴向长度进展。次要结果是角膜浸润、畏光、对干预的过敏反应、近距离视力和从分配的干预/对照中退出。我们纳入了74项随机对照试验,涉及12 154名6-18岁的参与者。网络荟萃分析比较了45种干预措施与安慰剂或单视力眼镜1年后的眼轴长度。加权平均差和95%置信区间报告的最有效干预措施是低红灯(-0.33 mm(-0.40, -0.25))、治疗区为5 mm的ortho-K (-0.32 mm(-0.41, -0.24))、非球面基曲线的ortho-K (-0.29 mm(-0.37, -0.22))、阿托品1.0% (-0.28 mm(-0.30, -0.26))、阿托品0.01%和ortho-K (-0.24 mm(-0.37, -0.11))、高度非球面镜片眼镜(-0.23 mm(-0.26, -0.19))、ortho-K增加压缩系数(-0.23 mm(-0.28, -0.17),阿托品0.05% (-0.21 mm(-0.30, -0.13))和散焦合并多段眼镜(-0.21 mm(-0.27, -0.15))。阿托品有畏光和近视力下降的报道,阿托品的治疗依从性较低,为1.0%。任何干预措施与角膜浸润或过敏反应之间均无显著关联。超过70%的研究是在亚洲人群中进行的。本系统综述和网络荟萃分析强调了各种干预措施的有效性,包括角膜塑形镜、阿托品、高度非球面晶状体和散焦合并多节段眼镜在减缓儿童轴向伸长方面的效果。低水平红光治疗也减缓了轴向长度的进展,但需要进一步的研究来评估潜在的副作用。今后的研究应包括不同的人口和标准化的方法,以提高结果的适用性和可比性。
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
Acta Ophthalmologica
Acta Ophthalmologica 医学-眼科学
CiteScore
7.60
自引率
5.90%
发文量
433
审稿时长
6 months
期刊介绍: Acta Ophthalmologica is published on behalf of the Acta Ophthalmologica Scandinavica Foundation and is the official scientific publication of the following societies: The Danish Ophthalmological Society, The Finnish Ophthalmological Society, The Icelandic Ophthalmological Society, The Norwegian Ophthalmological Society and The Swedish Ophthalmological Society, and also the European Association for Vision and Eye Research (EVER). Acta Ophthalmologica publishes clinical and experimental original articles, reviews, editorials, educational photo essays (Diagnosis and Therapy in Ophthalmology), case reports and case series, letters to the editor and doctoral theses.
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