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主角闭合嫌疑人的进展:系统性审查和元分析

Patrick Xiang Ji¹, Lauren Pickel¹, Michael Balas²

¹Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

Eye (London, England)

|February 5, 2025

概括

主要角关闭嫌疑人 (PACS) 的进展率为14.2%. 预防性激光外周 iridotomy (LPI) 显著降低了初级角关闭 (PAC) 的进展,但不是急性或青光眼的形式.

科学领域:

眼科医生眼科眼科
玻璃眼研究研究玻璃眼研究
预防性眼科护理预防性眼科护理

背景情况:

主要角关闭嫌疑人 (PACS) 面临发展为主角关闭 (PAC),急性角关闭 (AAC) 和主角关闭光眼 (PACG) 的风险.
预防性激光外周 iridotomy (LPI) 是一个潜在的干预措施,以防止疾病的进展在PACS患者.

研究的目的:

为了确定PACS进展到PAC,AAC和PACG的比例.
评估预防性LPI对角关闭疾病进展的影响.

主要方法:

在MEDLINE和EMBASE索引的研究的系统审查和元分析,直到2023年11月.
包括2项随机对照试验和3项涉及1997年PACS患者的观察性研究.
随机效应建模以估计患有或没有LPI的疾病进展的风险比率和置信区间.

主要成果:

总的来说,14.2%的PACS患者在平均6.2年的随访中进展到PAC,AAC或PACG.
LPI显著降低了进展到PAC的风险2.49倍 (RR: 2.49; 95% CI: 1.50-4.07; p < 0.001),需要治疗的数量 (NNT) 为15.
使用LPI,没有观察到对AAC或PACG的进展有统计学意义的减少.

结论:

预防性LPI在减少PACS向PAC的进展方面显示出显著的益处.
对于LPI在预防AAC和PACG进展方面的有效性需要进一步研究.
在PACS患者的LPI决策中,建议采用平衡的临床方法.

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