Fu Yu, Geng Dengfeng, Liu Hua, Che Huixin
Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Ophthalmology, Liaoning Medical University, Jinzhou, Liaoning, China.
Acta Ophthalmol. 2016 Jun;94(4):346-52. doi: 10.1111/aos.12908. Epub 2015 Nov 7.
To evaluate the current evidence of the relationship between myopia, together with its structural and refractive component, and diabetic retinopathy (DR) risk.
A systematic search was performed up to April, 2015. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated employing random-effects models. Three models were used to assess the association between myopia and risk of DR: axial length (AL) (per millimetre increase) and DR; myopia (myopia versus non-myopia) and DR; refractive error (RE) (per D decrease) and DR. Publication bias of the literature was evaluated using Begg's funnel plots and Egger's test.
A total of 11 studies that met the predefined criteria were included in this meta-analysis. Overall, longer AL (per millimetre increase) was associa-ted with a significantly decreased risk of DR (combined OR, 0.75; 95% CI, 0.65-0.86; p < 0.001); myopic eyes (myopia versus non-myopia) showed a lower risk of DR (combined OR, 0.70; 95% CI, 0.58-0.85; p < 0.001). A greater degree of myopic RE (per D decrease) also revealed a significantly decreased risk of DR (combined OR, 0.89; 95% CI, 0.85-0.93; p < 0.001). The sensitivity analyses and cumulative meta-analysis showed similar results. No publication bias was detected in any of the three models.
This meta-analysis suggests that both myopic refraction and longer AL are associated with a lower risk of DR. Further studies are needed to determine exact mechanisms underpinning the protective effect of myopia against DR.
评估近视及其结构和屈光成分与糖尿病视网膜病变（DR）风险之间关系的现有证据。
截至2015年4月进行了系统检索。采用随机效应模型计算汇总比值比（OR）和95%置信区间（CI）。使用三种模型评估近视与DR风险之间的关联：眼轴长度（AL）（每增加一毫米）与DR；近视（近视与非近视）与DR；屈光不正（RE）（每降低一屈光度）与DR。使用Begg漏斗图和Egger检验评估文献的发表偏倚。
本荟萃分析共纳入11项符合预定义标准的研究。总体而言，较长的AL（每增加一毫米）与DR风险显著降低相关（合并OR，0.75；95%CI，0.65 - 0.86；p < 0.001）；近视眼睛（近视与非近视）显示DR风险较低（合并OR，0.70；95%CI，0.58 - 0.85；p < 0.001）。更大程度的近视性RE（每降低一屈光度）也显示DR风险显著降低（合并OR，0.89；95%CI，0.85 - 0.93；p < 0.001）。敏感性分析和累积荟萃分析显示了相似的结果。在这三种模型中均未检测到发表偏倚。
这项荟萃分析表明，近视屈光和较长的AL均与较低的DR风险相关。需要进一步研究以确定近视对DR保护作用的确切机制。
