治疗疱疹性角膜炎的抗病毒和抗炎治疗干预:系统综述。

IF 1.7 4区 医学 Q3 OPHTHALMOLOGY
Ophthalmic epidemiology Pub Date : 2024-06-01 Epub Date: 2023-05-15 DOI:10.1080/09286586.2023.2213324
Xiaole Li, Manav Nayeni, Monali S Malvankar-Mehta
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引用次数: 0

摘要

目的:疱疹性基质角膜炎(HSK)是一种免疫介导的角膜炎症,发生于单纯疱疹病毒感染之后。本文旨在系统识别和比较治疗 HSK 的干预措施及其对患者的治疗效果:本系统性综述遵循 PRISMA 方法。搜索在线数据库以获取所有相关论文。两位独立审稿人筛选了 168 条记录。共纳入 7 篇论文,并进行了数据提取。进行了定性分析:与仅接受阿昔洛韦治疗的患者相比,接受磷酸泼尼松龙和阿昔洛韦治疗的HSK患者治疗成功率更高,治疗失败时间明显更长(P P = .002)。与对照组(泼尼松龙)相比,他克莫司治疗组的 BCVA 改善幅度更大(P 结论):皮质类固醇和抗病毒药物只有同时使用时才能最有效地治疗 HSK。口服阿昔洛韦的疗效与软膏相似,但口服更方便。如果减少皮质类固醇激素的浓度和使用频率,并连续使用至少 10 周,则可获得更大的治疗效果。氟比洛芬、环孢素-A 和他克莫司等抗炎药物对治疗 HSK 安全有效。未来的长期随访和研究性临床试验将有助于深入了解这些潜在替代药物的治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Antiviral and Anti-Inflammatory Therapeutic Interventions for Treating Herpes Stromal Keratitis: A Systematic Review.

Purpose: Herpes stromal keratitis (HSK) is an immune-mediated corneal inflammation that occurs after a herpes simplex virus infection. This paper aims to systematically identify and compare interventions for treating HSK and their patient outcomes.

Methods: This systematic review followed the PRISMA methodology. Online databases were searched to obtain all relevant papers. Two independent reviewers screened through 168 records. Seven papers were included and used for data extraction. A qualitative analysis was conducted.

Results: HSK patients receiving prednisolone phosphate and acyclovir showed a higher treatment success rate and significantly longer time to failure compared to patients receiving only acyclovir (P < .001). No difference in resolution time was found between oral and topical acyclovir. Between groups receiving dexamethasone and flurbiprofen, resolution occurred in 93% and 67% of patients, and BCVA (LogMAR) improved from 1.0 to 0.30 and 0.48, respectively. BCVA improved in both cyclosporine-A (P < .001) and its control (prednisolone) groups (P = .002). A tacrolimus treatment group showed greater improvement in BCVA compared to its control (prednisolone) group (P < .001).

Conclusion: Corticosteroids and antivirals managed HSK most effectively only when used concurrently. Oral acyclovir showed similar effectiveness to its ointment counterpart, a preferable alternative for easier administration. Corticosteroid use could induce greater therapeutic benefits when tapered in concentration and frequency and administrated for at least 10 weeks. Anti-inflammatory drugs including flurbiprofen, cyclosporine-A, and tacrolimus could be safe and effective for treating HSK. Future long-term follow-up and RCTs could provide insights on the therapeutic benefits of these potential alternatives.

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来源期刊
Ophthalmic epidemiology
Ophthalmic epidemiology 医学-眼科学
CiteScore
3.70
自引率
5.60%
发文量
61
审稿时长
6-12 weeks
期刊介绍: Ophthalmic Epidemiology is dedicated to the publication of original research into eye and vision health in the fields of epidemiology, public health and the prevention of blindness. Ophthalmic Epidemiology publishes editorials, original research reports, systematic reviews and meta-analysis articles, brief communications and letters to the editor on all subjects related to ophthalmic epidemiology. A broad range of topics is suitable, such as: evaluating the risk of ocular diseases, general and specific study designs, screening program implementation and evaluation, eye health care access, delivery and outcomes, therapeutic efficacy or effectiveness, disease prognosis and quality of life, cost-benefit analysis, biostatistical theory and risk factor analysis. We are looking to expand our engagement with reports of international interest, including those regarding problems affecting developing countries, although reports from all over the world potentially are suitable. Clinical case reports, small case series (not enough for a cohort analysis) articles and animal research reports are not appropriate for this journal.
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