Mohamed Quresh Amir, Ross Adam, Chu Colin Jonathan
Ophthalmology Department, Gloucestershire NHS Foundation Trust, Gloucester, UK.
BMJ Clin Evid. 2011 May 25;2011:0702.
Diabetic retinopathy is the most common cause of blindness in the UK, with older people and those with worse diabetes control, hypertension, and hyperlipidaemia being most at risk. Diabetic retinopathy can cause microaneurysms, haemorrhages, exudates, changes to blood vessels, and retinal thickening.
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments in people with diabetic retinopathy? What are the effects of treatments for vitreous haemorrhage? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2010 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
We found 58 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
In this systematic review we present information relating to the effectiveness and safety of the following interventions: peripheral retinal laser photocoagulation, focal and grid laser photocoagulation for maculopathy, corticosteroids for macular oedema, vascular endothelial growth factor inhibitors, and vitrectomy for vitreous haemorrhage.
在英国,糖尿病视网膜病变是导致失明的最常见原因,老年人以及糖尿病控制较差、患有高血压和高脂血症的人群风险最高。糖尿病视网膜病变可导致微动脉瘤、出血、渗出、血管改变和视网膜增厚。
我们进行了一项系统评价,旨在回答以下临床问题:治疗对糖尿病视网膜病变患者有何影响?治疗玻璃体出血有何效果?我们检索了:截至2010年6月的Medline、Embase、Cochrane图书馆及其他重要数据库(Clinical Evidence评价会定期更新,请查看我们的网站获取本评价的最新版本)。我们纳入了来自美国食品药品监督管理局(FDA)和英国药品与保健品监管局(MHRA)等相关组织的危害警示。
我们发现58项系统评价、随机对照试验或观察性研究符合我们的纳入标准。我们对干预措施的证据质量进行了GRADE评估。
在本系统评价中,我们提供了以下干预措施有效性和安全性的相关信息:周边视网膜激光光凝术、黄斑病变的局灶性和格栅样激光光凝术、黄斑水肿的皮质类固醇治疗、血管内皮生长因子抑制剂以及玻璃体出血的玻璃体切除术。