Comparison of Surgical Decompression and Steroid Therapy for the Management of Traumatic Optic Neuropathy: A Systematic Review and Meta-Analysis.

IF 1.7 Q2 EDUCATION & EDUCATIONAL RESEARCH

Community College Review Pub Date : 2023-12-01 Epub Date: 2022-11-28 DOI:10.1177/19433875221142682

Sameer Pandey, Gosla S Reddy, Ashi Chug, Ashutosh Dixit, Balgovind S Raja

{"title":"Comparison of Surgical Decompression and Steroid Therapy for the Management of Traumatic Optic Neuropathy: A Systematic Review and Meta-Analysis.","authors":"Sameer Pandey, Gosla S Reddy, Ashi Chug, Ashutosh Dixit, Balgovind S Raja","doi":"10.1177/19433875221142682","DOIUrl":null,"url":null,"abstract":"Study design: A systematic review and meta-analysis.Objective: Treatment of traumatic optic neuropathy (TON) has been a subject of debate for many decades due to the scarcity of evidence-based treatment protocols. This review compares surgical decompression (SD) and steroid therapy (ST) as treatment approaches in TON patients.Methods: A PRISMA-guided systematic review using PubMed, Embase, Ovid and Scopus databases was performed till the last search date of July 31st 2021. The outcome of interest was an improvement in visual acuity. A meta-analysis of the odds ratio was performed using a random-effect model and sub-group analysis based upon criteria for assessment of improvement in visual acuity.Results: Sixteen studies (including 1046 patients) were included in the review. The review could identify 590 patients treated with SD and 456 treated with ST. In addition, there was a second cohort of patients presenting with NLP (no light perception). A meta-analysis with a sub-group analysis revealed that there was statistically no significant difference between the two treatment approaches in terms of improvement in VA.Conclusions: There is no difference in treatment results of SD or ST for TON. Several treatment protocols and different criteria for assessing visual acuity led to difficulty in generating evidence for selecting the correct treatment approach.","PeriodicalId":46564,"journal":{"name":"Community College Review","volume":"12 1","pages":"306-316"},"PeriodicalIF":1.7000,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10693263/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Community College Review","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/19433875221142682","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/11/28 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"EDUCATION & EDUCATIONAL RESEARCH","Score":null,"Total":0}

引用次数: 0

Abstract

Study design: A systematic review and meta-analysis.

Objective: Treatment of traumatic optic neuropathy (TON) has been a subject of debate for many decades due to the scarcity of evidence-based treatment protocols. This review compares surgical decompression (SD) and steroid therapy (ST) as treatment approaches in TON patients.

Methods: A PRISMA-guided systematic review using PubMed, Embase, Ovid and Scopus databases was performed till the last search date of July 31st 2021. The outcome of interest was an improvement in visual acuity. A meta-analysis of the odds ratio was performed using a random-effect model and sub-group analysis based upon criteria for assessment of improvement in visual acuity.

Results: Sixteen studies (including 1046 patients) were included in the review. The review could identify 590 patients treated with SD and 456 treated with ST. In addition, there was a second cohort of patients presenting with NLP (no light perception). A meta-analysis with a sub-group analysis revealed that there was statistically no significant difference between the two treatment approaches in terms of improvement in VA.

Conclusions: There is no difference in treatment results of SD or ST for TON. Several treatment protocols and different criteria for assessing visual acuity led to difficulty in generating evidence for selecting the correct treatment approach.

查看原文本刊更多论文

手术减压和类固醇治疗外伤性视神经病变的比较:系统回顾和荟萃分析。

研究设计:系统回顾和荟萃分析。目的:由于缺乏基于证据的治疗方案，创伤性视神经病变(TON)的治疗已经争论了几十年。本综述比较了手术减压(SD)和类固醇治疗(ST)作为治疗TON患者的方法。方法:使用PubMed、Embase、Ovid和Scopus数据库进行prisma引导的系统评价，最后检索日期为2021年7月31日。结果是视力的改善。采用随机效应模型和基于视力改善评估标准的亚组分析对优势比进行meta分析。结果:16项研究(包括1046例患者)纳入本综述。该综述确定了590名接受SD治疗的患者和456名接受st治疗的患者。此外，还有第二组患者出现NLP(无光感知)。一项亚组分析的荟萃分析显示，两种治疗方法在va改善方面无统计学差异。结论:SD和ST治疗TON的治疗结果无差异。几种治疗方案和评估视力的不同标准导致难以产生选择正确治疗方法的证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Community College Review EDUCATION & EDUCATIONAL RESEARCH-

CiteScore

2.40

自引率

7.70%

发文量

期刊介绍： The Community College Review (CCR) has led the nation for over 35 years in the publication of scholarly, peer-reviewed research and commentary on community colleges. CCR welcomes manuscripts dealing with all aspects of community college administration, education, and policy, both within the American higher education system as well as within the higher education systems of other countries that have similar tertiary institutions. All submitted manuscripts undergo a blind review. When manuscripts are not accepted for publication, we offer suggestions for how they might be revised. The ultimate intent is to further discourse about community colleges, their students, and the educators and administrators who work within these institutions.