针对老年人视力障碍的查:美国预防服务工作组的最新证据报告和系统审查
Roger Chou1, Christina Bougatsos1, Rebecca Jungbauer1
1Pacific Northwest Evidence-based Practice Center, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland.
JAMA
|May 24, 2022
概括
对于与年龄相关的视力损失,有有效的治疗方法,但初级护理中的视力查没有改善视力敏度. 需要进一步的研究来评估对老年人的查益处.
科学领域:
- 眼科 眼科
- 预防医学
- 老年病学
背景情况:
- 有效的治疗方法可用于折射错误,白内障和与年龄相关的黄斑变性 (AMD).
- 之前的审查表明,视力查和老年人没有查之间的视力敏度没有差异.
研究的目的:
- 更新2016年关于老年人视力衰弱查的审查.
- 为美国预防服务工作组 (USPSTF) 的建议提供信息.
主要方法:
- 对查,湿性AMD治疗 (VEGF抑制剂) 和干性AMD治疗 (抗氧化维生素) 的随机临床试验和受控观察研究进行系统审查.
- 包括对查诊断准确性的研究.
- 搜索了包括Ovid MEDLINE和Cochrane图书馆在内的数据库,直到2022年1月.
主要成果:
- 在四项试验中,查和不查之间没有明显的视力差异.
- 查测试和问卷显示诊断的准确性不足.
- 抗氧化多种维生素降低了干燥AMD的进展.
- 在前吸烟者中,β- 胡卜素增加了肺癌的风险;增加了生殖尿路事件.
结论:
- 对于老年人视力受损的常见原因,有有效的治疗方法.
- 直接证据显示,初级保健中的视力查与改善视力结果之间没有显著的关联.
- 在更新老年人视力查指南时,USPSTF应考虑这些发现.
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