神经血管与年龄相关的黄斑退化中的黄斑缩:系统性审查和元分析
Alessandro Berni1, Andrea Coletto2, Jianqing Li3
1Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
Ophthalmology. Retina
|January 22, 2025
概括
黄斑缩是治疗抗VEGF治疗的新血管与年龄相关的黄斑退化 (AMD) 患者的常见并发症,在24个月后发生29%. 这一系统性审查强调了对AMD管理的持续监测和研究的需要.
科学领域:
- 眼科医生 眼科 眼科
- 视网膜疾病 视网膜疾病
- 医疗成像医学成像
背景情况:
- 神经血管与年龄相关的黄斑变性 (AMD) 是视力丧失的主要原因.
- 抗VEGF疗法是新血管AMD的标准治疗方法.
- 黄斑缩是AMD及其治疗的潜在并发症.
研究的目的:
- 在接受抗VEGF治疗的新血管AMD患者中确定黄斑缩的发病率.
- 通过系统性审查和元分析,综合现有研究的证据.
- 为了评估治疗后12个月和24个月的发病率.
主要方法:
- 按照PRISMA指南进行系统审查和元分析.
- 在 MEDLINE,EMBASE 和 Web of Science 的文献搜索到 2023 年 11 月.
- 包括未经治疗的新血管AMD患者的随机和非随机研究.
- 使用Cochrane风险偏差2和ROBINS-I工具进行质量评估.
- 随机效应的元分析,以汇集发病率.
- 使用各种成像方式 (OCT, fundus摄影等) 诊断缩. ) 的情况.
主要成果:
- 包含3013只眼睛的11项研究被纳入了元分析.
- 黄斑缩的综合24个月发生率为29% (95%CI:20%-38%).
- 发病率因新血管化类型而异:类型1/2的26%,类型3的49%.
- 12个月的综合发病率为11% (95%CI:4%-18%).
- 证据的确定性被评估为低.
结论:
- 黄斑缩是治疗抗VEGF治疗的新血管AMD患者的显著和潜在的常见并发症.
- 高异质性和研究设计的局限性影响了研究结果的确定性.
- 需要使用一致的方法进行进一步的研究,以澄清缩发病率和风险因素.
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