评估角膜神经病变治疗干预措施的疗效和安全性:系统性审查
Rajni Rajan1, Eve Makrai1, Ji-Hyun Lee1
1Department of Optometry and Vision Sciences, University of Melbourne, Carlton, Victoria, Australia.
The ocular surface
|April 30, 2024
概括
这次审查发现,没有足够的证据来确定角膜神经病变的治疗方法的疗效或安全性,这种疾病影响眼睛表面完整性. 标准化诊断标准和核心结果对于未来的研究和基于证据的护理至关重要.
科学领域:
- 眼科医生 眼科 眼科
- 神经学 神经学
- 临床研究 临床研究
背景情况:
- 角膜神经病,以角膜神经损伤为特征,损害眼睛表面的完整性和生活质量.
- 来自各种疾病的三神经损伤可能会导致角膜神经病变,但缺乏标准化的诊断和治疗方案.
- 缺乏标准化的标准,阻碍了角膜神经病变的有效管理和研究.
研究的目的:
- 系统地评估治疗角膜神经病变的干预措施的有效性和安全性.
- 评估各种角膜神经病治疗方法的方法质量和证据确定性.
- 发现研究中的差距,并为未来的研究提出建议.
主要方法:
- 随机对照试验 (RCT) 的系统审查,将干预措施与安慰剂或活性对照剂进行比较.
- 在Ovid MEDLINE,Embase和临床试验注册表中进行的搜索截至2022年7月.
- 使用Cochrane偏差风险2评估的方法质量,使用GRADE评估的证据确定性.
主要成果:
- 20个RCT评估了再生疗法,食补充剂,抗血糖剂等;9个RCT具有高偏差风险.
- 在不同研究中观察到角膜神经病症定义和结果指标的实质性差异.
- 没有足够的证据来证实任何干预措施的有效性或安全性,对于某些药物,证据的确定性低至非常低.
结论:
- 迫切需要对角膜神经病变的临床定义进行标准化.
- 为未来的研究,建立一套最低的核心成果指标是必不可少的.
- 标准化将改善人群表型,数据合成和基于证据的角膜神经病变的临床护理.
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