Xia Duosheng, Chen Xiaomei, Zhou Qi, Xiao Shujun, Yu Yang, Wang Yadong, Du Gang, Huang Haixiang, Zhang Wenfang, Chen Yaolong
a The First People's Hospital of Lanzhou , Lanzhou , China.
b School of Basic Medicine of Lanzhou University , Lanzhou , China.
Curr Eye Res. 2017 Jun;42(6):908-917. doi: 10.1080/02713683.2016.1255335. Epub 2017 Jan 31.
The aim of this review is to evaluate the efficacy of available Purtscher's Retinopathy treatments.
In order to collect single-case reports, electronic searches were conducted in several databases including PubMed, Embase, Web of Science, China National Knowledge Infrastructure, SinoMed, VIP, and WanFang in the Electronic Theses and Dissertations Center. In VIP and Wanfang, we also traced the references of included articles. Risk of bias was evaluated using a tool adapted from the Cochrane Risk of Bias Tool. Statistical analysis was done in SPSS19.0. Evidence was evaluated and graded with GRADE system.
In total, 76 studies were included involving 88 cases and 139 eyes. Serious bias existed in 90% of the included studies. Current treatments for Purtscher's retinopathy included glucocorticoid therapy (63.29%), traditional Chinese medicine therapy (10.13%), glucocorticoid integrative medicine therapy (7.60%), and integrative medicine therapy (6.33%). Patients' eyesight with (56.83%) or without (43.17%) treatment both improved in the follow-up within 1-3 months, 4-6 months, and more than 6 months; however, conditions without treatment became better compared to the treatment groups in after 4-6 months and more than 6 months. All results were "very low" in the GRADE system. None of the studies reported adverse reactions in any patient.
Both treatment and no treatment improve vision in Purtscher's retinopathy patients, but the difference between no treatment and glucocorticoid therapy had no statistical significance. The evidence quality for this conclusion was "very low" and had large bias. Further research is required to understand the safety of Purtscher's retinopathy treatment.
本综述旨在评估现有治疗普尔夏视网膜病变的疗效。
为收集单病例报告,在多个数据库进行电子检索,包括PubMed、Embase、科学网、中国知网、中国生物医学文献数据库、维普资讯、万方数据以及学位论文数据库。在维普资讯和万方数据中,我们还追溯了纳入文章的参考文献。使用改编自Cochrane偏倚风险工具的工具评估偏倚风险。在SPSS19.0中进行统计分析。采用GRADE系统对证据进行评估和分级。
共纳入76项研究,涉及88例患者和139只眼。纳入研究的90%存在严重偏倚。目前普尔夏视网膜病变的治疗方法包括糖皮质激素治疗(63.29%)、中医治疗(10.13%)、糖皮质激素中西医结合治疗(7.60%)以及中西医结合治疗(6.33%)。在1 - 3个月、4 - 6个月以及6个月以上的随访中,接受治疗(56.83%)和未接受治疗(43.17%)的患者视力均有改善;然而,在4 - 6个月及6个月以上时,未治疗组的情况比治疗组更好。在GRADE系统中,所有结果均为“极低”。没有研究报告任何患者出现不良反应。
治疗和不治疗均可改善普尔夏视网膜病变患者的视力,但不治疗与糖皮质激素治疗之间的差异无统计学意义。该结论的证据质量“极低”且存在较大偏倚。需要进一步研究以了解普尔夏视网膜病变治疗的安全性。