Chaudhary Rishika, Dretzke Janine, Scott Robert, Logan Ann, Blanch Richard
Queen Elizabeth Hospital, Birmingham, UK.
Neurotrauma Research Group, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
Syst Rev. 2016 Jul 8;5(1):107. doi: 10.1186/s13643-016-0284-7.
Proliferative vitreoretinopathy (PVR) is a known complication of retinal detachment surgery. It has been postulated that the establishment of PVR involves inflammatory and ischaemic processes. Surgical and clinical risk factors contribute to making certain patients more vulnerable to developing PVR. The objective of this systematic review is to identify and appraise the evidence on clinical and surgical risk factors and their utility in predicting the occurrence or worsening of PVR post-surgery.
Electronic databases and grey literature will be searched dating from 1980. Studies will be eligible if they include patients that underwent retinal reattachment surgery for rhegmatogenous retinal detachment (RRD), with and without PVR, and where risk factors were measured before or during surgery. Screening, data extraction and quality assessment will be performed independently by two reviewers using pre-defined criteria. Should any models be identified, we will liaise with the Cochrane prognostic group to help define the most appropriate quality assessment criteria based on the PROBLAST tool which is in development. All findings will be tabulated and narratively synthesised. Studies presenting models or adjusted data will likely be more informative than studies reporting unadjusted results for a single risk factor. When clinically and methodologically appropriate, random effects meta-analysis will be performed.
This review will systematically and comprehensively retrieve evidence to evaluate the clinical and surgical risk factors associated with PVR. The identified evidence may aid standardisation of clinical practice and more effective management for improving patient outcomes following RRD surgery and will provide a clear reference point for vitreoretinal surgeons.
PROSPERO CRD42016035848.
增殖性玻璃体视网膜病变（PVR）是视网膜脱离手术已知的并发症。据推测，PVR的发生涉及炎症和缺血过程。手术和临床风险因素会使某些患者更容易发生PVR。本系统评价的目的是识别和评估有关临床和手术风险因素的证据及其在预测术后PVR发生或恶化方面的效用。
将检索1980年以来的电子数据库和灰色文献。如果研究纳入了因孔源性视网膜脱离（RRD）接受视网膜复位手术的患者，无论有无PVR，且在手术前或手术期间测量了风险因素，则该研究符合纳入标准。两名评价者将使用预先定义的标准独立进行筛选、数据提取和质量评估。如果识别出任何模型，我们将与Cochrane预后组联系，以帮助根据正在开发的PROBLAST工具确定最合适的质量评估标准。所有结果将列表并进行叙述性综合。呈现模型或调整后数据的研究可能比报告单一风险因素未调整结果的研究更具信息性。在临床和方法学合适的情况下，将进行随机效应荟萃分析。
本评价将系统全面地检索证据，以评估与PVR相关的临床和手术风险因素。所识别的证据可能有助于临床实践的标准化和更有效的管理，以改善RRD手术后的患者结局，并将为玻璃体视网膜外科医生提供明确的参考点。
PROSPERO CRD42016035848。
