近视牵引性黄斑病变的黄斑扣带疗法：全面系统回顾与元分析》。

IF 4.1 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology Pub Date : 2024-10-17 DOI:10.1016/j.ajo.2024.10.008

Hashem Abu Serhan , Abdullah Ahmed , Mahrukh Chaudhry , Zain Ali Nadeem , Fakiha Ahmed , Usama Hussain Kamal , Ameen Alkhateeb , Ayman G. Elnahry

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引用次数: 0

摘要

目的近视牵引性黄斑病变是视力损伤和失明的主要原因，尤其是在亚洲人群中。随着近视在全球造成的负担不断增加，了解有效的治疗方案至关重要。本系统性综述和荟萃分析评估了黄斑扣带术在治疗近视牵引性黄斑病变中的疗效。方法按照PRISMA指南进行了系统性综述和荟萃分析。在 PubMed、Cochrane Library 和 EMBASE 数据库中搜索了截至 2024 年 7 月的相关研究。纳入标准包括报告黄斑扣带治疗近视牵引性黄斑病变结果的研究。主要结果包括最佳矫正视力 (BCVA) 和轴长的变化、视网膜再粘连率和黄斑孔闭合率。统计分析采用随机效应模型，异质性采用I²统计量进行评估。结果13项研究（482只眼）符合纳入标准。在所有随访期内均观察到 BCVA 有显著改善，其中长期结果的改善最为显著（平均差：0.38 logMAR；95% CI：0.28 至 0.47）。轴长显示出持续的减少，长期平均减少 2.88 mm（95% CI：2.54 至 3.21）。汇总的长期视网膜再附着率为94%（95% CI：86-97%），而长期全厚度黄斑孔闭合率为72%（95% CI：55-85%）。结论：黄斑扣带术对近视牵引性黄斑病变的治疗效果很好，包括改善视力、缩短轴长、提高视网膜再附着率和黄斑孔闭合率。这些研究结果支持黄斑扣带作为近视牵引性黄斑病变治疗方案的有效性。不过，还需要进一步的标准化长期研究来证实这些结果，并探索潜在的联合疗法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Macular Buckling for Myopic Traction Maculopathy: A Comprehensive Systematic Review and Meta-Analysis

Purpose

Myopic traction maculopathy (MTM) is a major cause of visual impairment and blindness, particularly in Asian populations. With the global burden of myopia on the rise, understanding effective treatment options is crucial. This systematic review and meta-analysis evaluate the efficacy of macular buckling in the management of MTM.

Design

A systematic review and meta-analysis.

Methods

A systematic review and meta-analysis were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Cochrane Library, and EMBASE databases were searched for relevant studies up to July 2024. Inclusion criteria encompassed studies reporting outcomes of macular buckling for MTM. Primary outcomes included changes in best-corrected visual acuity and axial length, retinal reattachment rate, and macular hole closure rate. Random-effect models were used for statistical analysis, with heterogeneity assessed using the I² statistic. The pooled results were reported as mean difference or proportion with corresponding 95% confidence intervals (CIs) for each outcome.

Results

Thirteen studies (482 eyes) met the inclusion criteria. Significant improvements in best-corrected visual acuity were observed across all follow-up periods, with the most substantial improvement in long-term outcomes (mean difference: 0.38 logarithm of the minimum angle of resolution; 95% CI: 0.28-0.47). Axial length showed consistent reductions, with a mean long-term reduction of 2.88 mm (95% CI: 2.54-3.21). The pooled long-term retinal reattachment rate was 94% (95% CI: 86%-97%), while the long-term full thickness macular hole closure rate was 72% (95% CI: 55%-85%). Heterogeneity varied across outcomes and follow-up periods, ranging from low to high.

Conclusions

Macular buckling demonstrates promising outcomes for MTM, including improved visual acuity, reduced axial length, high retinal reattachment rates, and favorable macular hole closure rates. These findings support the efficacy of macular buckling as a treatment option for MTM. However, further standardized, long-term studies are needed to confirm these results and explore potential combination therapies.

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来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.