成年人青光眼查:美国预防服务工作组的最新证据报告和系统审查
Roger Chou1, Shelley Selph1,2, Ian Blazina1
1Pacific Northwest Evidence-based Practice Center, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland.
JAMA
|May 24, 2022
概括
目前的玻璃眼查方法缺乏益处的证据,可能会增加像跌倒这样的风险. 虽然治疗可以减缓进展,但视力或生活质量的改善尚未得到证实.
科学领域:
- 眼科 眼科
- 预防医学
- 公共卫生
背景情况:
- 之前在2013年进行的系统审查发现,对成年人进行初级开角眼 (OAG) 查的益处和危害的证据不足.
- 美国预防服务工作组 (USPSTF) 要求更新证据以提供查建议.
研究的目的:
- 进行对青光眼查的最新系统审查,以告知USPSTF.
- 评估成年人初级开角青光眼查的益处和危害.
主要方法:
- 搜索了Ovid MEDLINE,Cochrane控制试验中心注册表和Cochrane系统审查数据库,截至2021年2月,监测到2022年1月.
- 包括对查,转诊和治疗的随机临床试验 (RCT),以及对查测试诊断准确性的研究.
- 数据抽象和质量评估由两个研究人员独立进行.
主要成果:
- 其中包括83项研究. 一个RCT在查虚弱老年人的视力结果上没有发现差异,但增加了跌倒风险.
- 诊断准确度有所不同:光谱域光连贯断层扫描 (SD-OCT) 显示出高灵敏度和特异性;汉弗瑞视野分析仪具有良好的灵敏度和特异性;度测量具有低灵敏度.
- 医学治疗和选择性激光形术与眼内压力降低和青光眼的进展有关,但不一定改善视力敏度或生活质量.
结论:
- 仅有有限的直接证据表明青光眼查的益处,没有证实与改善视觉结果的关联.
- 查测试可以识别患有青光眼的个体,治疗可能会减缓进展,但缺乏改善生活质量或功能的证据.
- 需要进一步的研究来确定青光眼查对成年人群的净益处和危害.
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