Alhassan Mahmoud B, Rabiu Mansur, Agbabiaka Idris O
Clinical Ophthalmology, The National Eye Centre, Western Bye Pass, Nnamdi Azikiwe Way, Kaduna, Kaduna State, Nigeria, PMP 2267.
Cochrane Database Syst Rev. 2014 Jan 22;2014(1):CD006131. doi: 10.1002/14651858.CD006131.pub3.
Mooren's ulcer is a chronic, painful peripheral ulcer of the cornea. Its cause is unknown but it can or will lead to loss of vision if untreated. Severe pain is common in patients with Mooren's ulcer and the eye(s) may be intensely reddened, inflamed and photophobic, with tearing. The disease is rare in the northern hemisphere but more common in southern and central Africa, China and the Indian subcontinent. There are a number of treatments used such as anti-inflammatory drugs (steroidal and non-steroidal), cytotoxic drugs (topical and systemic), conjunctivectomy and cornea debridement (superficial keratectomy). There is no evidence to show which is the most effective amongst these treatment modalities.
The aim of this systematic review is to assess the effectiveness of the various interventions (medical and surgical) for Mooren's ulcer.
We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2013, Issue 5), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to June 2013), EMBASE (January 1980 to June 2013), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to June 2013), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 4 June 2013.
We planned to include randomised controlled trials (RCTs) or discuss any prospective non-RCTs in the absence of any RCTs. The trials included would be of people of any age or gender diagnosed with Mooren's ulcer and all interventions (medical and surgical) would be considered.
Two authors screened the search results independently; we found no studies that met our inclusion criteria.
As we found no studies that met our inclusion criteria, we highlighted important considerations for conducting RCTs in the future in this area.
AUTHORS' CONCLUSIONS: We found no evidence in the form of RCTs to assess the treatment effect for the various interventions for Mooren's ulcer. High quality RCTs that compare medical or surgical interventions across different demographics are needed. Such studies should make use of various outcome measures, (i.e. healed versus not healed, percentage of area healed, speed of healing etc.) as well as ensuring high quality randomisation and data analysis, as highlighted in this review .
蚕蚀性角膜溃疡是一种慢性、疼痛性的周边角膜溃疡。其病因不明，但如果不治疗，会导致视力丧失。蚕蚀性角膜溃疡患者常伴有严重疼痛，眼睛可能会极度充血、发炎、畏光并流泪。这种疾病在北半球较为罕见，但在非洲南部和中部、中国以及印度次大陆更为常见。目前有多种治疗方法，如抗炎药物（甾体类和非甾体类）、细胞毒性药物（局部和全身用药）、结膜切除术和角膜清创术（浅层角膜切除术）。尚无证据表明这些治疗方式中哪种最为有效。
本系统评价旨在评估针对蚕蚀性角膜溃疡的各种干预措施（药物和手术）的有效性。
我们检索了Cochrane中心对照试验注册库（CENTRAL，其中包含Cochrane眼科和视力组试验注册库）（《Cochrane图书馆》2013年第5期）、Ovid MEDLINE、Ovid MEDLINE在研及其他未索引的引用文献、Ovid MEDLINE每日更新、Ovid OLDMEDLINE（1946年1月至2013年6月）、EMBASE（1980年1月至2013年6月）、拉丁美洲和加勒比地区卫生科学文献数据库（LILACS）（1982年1月至2013年6月）、对照试验元注册库（mRCT）（www.controlled-trials.com）、ClinicalTrials.gov（www.clinicaltrials.gov）以及世界卫生组织国际临床试验注册平台（ICTRP）（www.who.int/ictrp/search/en）。在电子检索试验时，我们未设置任何日期或语言限制。我们最后一次检索电子数据库是在2013年6月4日。
我们计划纳入随机对照试验（RCT），若没有RCT，则讨论任何前瞻性非RCT。纳入的试验对象为任何年龄和性别的被诊断为蚕蚀性角膜溃疡的患者，所有干预措施（药物和手术）均在考虑范围内。
两位作者独立筛选检索结果；我们未发现符合纳入标准的研究。
由于未找到符合纳入标准的研究，我们强调了未来在该领域开展RCT的重要考虑因素。
我们未找到RCT形式的证据来评估针对蚕蚀性角膜溃疡的各种干预措施的治疗效果。需要高质量的RCT来比较不同人群中的药物或手术干预。此类研究应采用多种结局指标（即愈合与否、愈合面积百分比、愈合速度等），并确保高质量的随机化和数据分析，正如本评价中所强调的那样。
