Chen Zhen-Na, Shao Yan, Li Xiao-Rong
Eye Institute & School of Optometry and Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin 300384, China.
Int J Ophthalmol. 2016 Jun 18;9(6):898-903. doi: 10.18240/ijo.2016.06.19. eCollection 2016.
To assess the feasibility of radial optic neurotomy (RON) in central retinal vein occlusion (CRVO) treatment with a Meta-analysis.
Electronic databases were searched for comprehensive articles that compared efficacy of RON with that of other treatments in CRVO. Study quality was assessed and risk ratio (RR) and 95% confidence interval (CI) with fix- or random-effects model were calculated according to the heterogeneity.
A total of 200 eyes from 5 studies were included. The results indicated that no significant differences were found between groups with and without RON in improvement of visual acuity (VA) at 6mo follow-up (pooled RR 0.51, 95%CI 0.22 to 1.18, P=0.117) while improvement of VA showed significantly favourable in patients receiving RON treatment at 12mo follow-up (pooled RR 2.27, 95%CI 1.31 to 3.95, P=0.004). For complications, RON treatment was more effective in reducing neovascular glaucoma (pooled RR 0.45, 95%CI 0.21 to 0.97, P=0.042) but was comparable in retinal detachment (pooled RR 2.41, 95%CI 0.51 to 11.39, P=0.267) and vitreous hemorrhage (pooled RR 0.91, 95%CI 0.33 to 2.46, P=0.847).
Compared with some certain treatment modalities, RON might offer better VA at 12mo and decrease the rate of neovascular glaucoma without changing the rate of retinal detachment and vitreous hemorrhage. Further studies are required considering the limitation of the research.
通过荟萃分析评估放射状视神经切开术(RON)治疗视网膜中央静脉阻塞(CRVO)的可行性。
检索电子数据库以获取比较RON与其他治疗方法在CRVO中疗效的综合文章。评估研究质量,并根据异质性计算固定效应或随机效应模型的风险比(RR)和95%置信区间(CI)。
共纳入5项研究中的200只眼。结果表明,在6个月随访时,接受RON治疗组和未接受RON治疗组在视力(VA)改善方面无显著差异(合并RR 0.51,95%CI 0.22至1.18,P = 0.117),而在12个月随访时,接受RON治疗的患者VA改善明显更优(合并RR 2.27,95%CI 1.31至3.95,P = 0.004)。对于并发症,RON治疗在降低新生血管性青光眼方面更有效(合并RR 0.45,95%CI 0.21至0.97,P = 0.042),但在视网膜脱离(合并RR 2.41,95%CI 0.51至11.39,P = 0.267)和玻璃体积血(合并RR 0.91,95%CI 0.33至2.46,P = 0.847)方面相当。
与某些特定治疗方式相比,RON可能在12个月时提供更好的视力,并降低新生血管性青光眼的发生率,而不改变视网膜脱离和玻璃体积血的发生率。考虑到本研究的局限性,需要进一步研究。