Zhang Jia-Ying, Zhu Xiao-Wei, Ding Xia, Lin Ming, Li Jin
Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.
Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China.
Int J Ophthalmol. 2019 Jul 18;12(7):1187-1193. doi: 10.18240/ijo.2019.07.21. eCollection 2019.
To conduct a systematic review and Meta-analysis of the published literature to evaluate the pooled prevalence rate of amblyopia in patients with congenital ptosis.
We searched the PubMed, Embase, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang Data, and Chongqing VIP databases for studies reporting the prevalence of amblyopia in patients with congenital ptosis. The reference lists of relevant studies were scanned. Heterogeneity of effect sizes across studies was tested. We calculated prevalence ratios to compare prevalence estimates for different causes of amblyopia in patients with congenital ptosis, as well as for different geographical regions, year of publication and sample size in subgroup analyses. A systematic review and Meta-analysis were performed.
We identified 29 eligible surveys with a total population of 2436. Prevalence rates of amblyopia ranged from 13.8% to 69%. We noted substantial heterogeneity in prevalence estimates for amblyopia in congenital ptosis (Cochran's significant at <0.0001; =90%). The pooled prevalence using random-effects models of 29 studies was 32.8% (95%CI: 27.3%-38.4%) in the overall population. Compared to the overall pooled prevalence, amblyopia prevalence was higher in studies in which only subjects with blepharophimosis syndrome were included.
We confirm that nearly one-third of congenital ptosis patients are suffering from or at risk for amblyopia. Patients with blepharophimosis syndrome are more likely to develop amblyopia. The identification and management of amblyopia should be integral to the treatment of congenital ptosis.
对已发表的文献进行系统评价和Meta分析,以评估先天性上睑下垂患者弱视的合并患病率。
我们检索了PubMed、Embase、Cochrane对照试验中央注册库、中国知网、万方数据和重庆维普数据库,查找报告先天性上睑下垂患者弱视患病率的研究。扫描相关研究的参考文献列表。检验各研究效应量的异质性。在亚组分析中,我们计算患病率比值,以比较先天性上睑下垂患者不同弱视病因、不同地理区域、发表年份和样本量的患病率估计值。进行了系统评价和Meta分析。
我们纳入了29项符合条件的调查,总样本量为2436例。弱视患病率在13.8%至69%之间。我们注意到先天性上睑下垂患者弱视患病率估计值存在显著异质性(Cochran's Q = 288.83,P < 0.0001;I² = 90%)。29项研究采用随机效应模型得出的总体合并患病率为32.8%(95%CI:27.3%-38.4%)。与总体合并患病率相比,仅纳入睑裂狭小综合征患者的研究中弱视患病率更高。
我们证实近三分之一的先天性上睑下垂患者患有弱视或有弱视风险。睑裂狭小综合征患者更易发生弱视。弱视的识别和管理应成为先天性上睑下垂治疗的组成部分。