抗生素治疗眼弓形体病的系统评价和荟萃分析：研究方案。
Antibiotic treatment for ocular toxoplasmosis: a systematic review and meta-analysis: study protocol.
机构信息
Departamento de Medicina Interna, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia.
Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia.
出版信息
Syst Rev. 2019 Jun 20;8(1):146. doi: 10.1186/s13643-019-1067-8.
BACKGROUND
Ocular toxoplasmosis (OT) is the most common cause of posterior uveitis, leading to visual impairment in a high proportion of patients. Antibiotics and corticosteroids lower the risk of permanent visual impairment by reducing the size of the retinochoroidal scar, the risk of recurrence, and the severity and duration of acute symptoms. Although OT is a very common cause of infectious posterior uveitis, its treatment remains controversial. Through our systematic review and meta-analysis, we aim to provide the best possible evidence-based information on the safety and effectiveness of the different antibiotic regimes for OT.
METHODS
This systematic review protocol has been developed based on PRISMA-P guidelines for reporting systematic reviews evaluating health care interventions. We will include all published and unpublished randomized controlled trials (RCTs) comparing different antibiotics used for the treatment of OT. We will consider changes in visual acuity, number of recurrences, improvement or worsening of ocular inflammation, size of lesion, and adverse effects as our outcomes. Screening, data extraction, and quality assessment will be undertaken by two reviewers with disagreements resolved through discussion. Studies that compared antibiotics with placebo will be excluded. The reviews will be assessed for quality and relevance. We will assess the risk of bias in five domains according to Cochrane group's tool. The type of data will dictate measures of treatment effect. We will use a random-effects model to calculate our meta-analysis, as eligible studies represent clinically varied populations of participants.
DISCUSSION
The strength of our study will lie in the exhaustive and systematic nature of the literature search, as well as in its methods for assessing quality and analyzing RCT data. Considering the controversial efficacy of the treatment for OT, our study will contribute to improving the existing evidence on the effectiveness of different antibiotics. Future studies may be conducted to increase physicians' awareness of antibiotic therapies, improving the health of patients with OT.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42018085468.
背景
眼弓形体病（OT）是后葡萄膜炎最常见的原因，导致很大一部分患者视力受损。抗生素和皮质类固醇通过缩小视网膜脉络膜瘢痕的大小、降低复发风险以及减轻急性症状的严重程度和持续时间，降低永久性视力损害的风险。尽管 OT 是传染性后葡萄膜炎的非常常见原因，但它的治疗仍然存在争议。通过我们的系统评价和荟萃分析，我们旨在提供有关治疗 OT 的不同抗生素方案的安全性和有效性的最佳循证信息。
方法
本系统评价方案是根据 PRISMA-P 指南制定的，用于报告评估医疗保健干预措施的系统评价。我们将纳入所有比较用于治疗 OT 的不同抗生素的已发表和未发表的随机对照试验（RCT）。我们将考虑视力变化、复发次数、眼部炎症的改善或恶化、病变大小以及不良反应作为我们的结局。筛查、数据提取和质量评估将由两名审阅者进行，如果存在分歧，则通过讨论解决。将排除比较抗生素与安慰剂的研究。将对综述进行质量和相关性评估。我们将根据 Cochrane 小组的工具评估五个领域的偏倚风险。数据类型将决定治疗效果的衡量标准。由于符合条件的研究代表了具有临床差异的参与者人群，因此我们将使用随机效应模型来计算荟萃分析。
讨论
我们研究的优势在于文献检索的全面性和系统性，以及评估 RCT 数据的方法。鉴于 OT 治疗的疗效存在争议，我们的研究将有助于提高关于不同抗生素有效性的现有证据。未来的研究可能会进行，以提高医生对抗生素治疗的认识，改善 OT 患者的健康状况。
系统评价注册
PROSPERO CRD42018085468。
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