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0.01%阿托品滴眼液延缓近视进展:一项系统评价与Meta分析

Atropine 0.01% eye drops slow myopia progression: a systematic review and Meta-analysis.

作者信息

Zhao Ying, Feng Kai, Liu Rui-Bao, Pan Jin-Hua, Zhang Lai-Lin, Xu Zhu-Ping, Lu Xue-Jing

机构信息

Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan Province, China.

Beijing University of Chinese Medicine, Beijing 100029, China.

出版信息

Int J Ophthalmol. 2019 Aug 18;12(8):1337-1343. doi: 10.18240/ijo.2019.08.16. eCollection 2019.

Abstract

AIM

To evaluate the effects of atropine 0.01% on slowing myopia progression.

METHODS

We searched for relevant studies in the Cochrane Library, PubMed, Embase, Ovid, CBM, CNKI, VIP and Wan Fang Data in Chinese. A supplementary search was conducted in OpenGrey (System for Information on Grey Literature in Europe), the ISRCTN registry, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform (ICTRP) from the dates of inception to June 30, 2018.

RESULTS

Seven randomized controlled trials (RCTs) with a total of 1079 subjects were included (505 in the atropine 0.01% group and 574 in the control group). The results showed that the atropine 0.01% group exhibited significantly greater control of axial growth than the control group [MD=-0.12, 95%CI (-0.19, -0.06)]. There was also a statistically significant difference between the atropine 0.01% and control groups in the changes in axial length [MD=-0.14, 95%CI (-0.25, -0.03)], but the quality of evidence was low. There were no significant differences between the atropine 0.01% and control groups in the overall effect with respect to diopter value, change in diopter, distance vision and intraocular pressure [MD=0.08, 95%CI (-0.27, 0.42); MD=0.09, 95%CI (-0.17, 0.36); MD= -0.01, 95%CI (-0.02, 0.00); MD=0.08, 95%CI (-0.56,0.40)]. The sensitivity analysis showed that the conclusion of the Meta-analysis is relatively stable. With respect to adverse events, there were significant differences between the atropine 0.01% and control groups [OR=0.26, 95%CI (0.11, 0.61)].

CONCLUSION

Based on the available evidence, atropine 0.01% eye drops offer benefits in controlling axial growth and safety without causing significant differences in diopter values, distance vision and intraocular pressure.

摘要

目的

评估0.01%阿托品对减缓近视进展的作用。

方法

我们在中国的考克兰图书馆、PubMed、Embase、Ovid、中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普资讯(VIP)和万方数据中检索相关研究。从各数据库建库至2018年6月30日,在OpenGrey(欧洲灰色文献信息系统)、国际标准随机对照试验编号注册库(ISRCTN registry)、美国国立医学图书馆临床试验注册平台(ClinicalTrials.gov)和世界卫生组织国际临床试验注册平台(ICTRP)中进行了补充检索。

结果

纳入7项随机对照试验(RCT),共1079名受试者(0.01%阿托品组505名,对照组574名)。结果显示,0.01%阿托品组在控制眼轴增长方面显著优于对照组[平均差(MD)=-0.12,95%置信区间(CI)(-0.19,-0.06)]。0.01%阿托品组与对照组在眼轴长度变化方面也存在统计学显著差异[MD=-0.14,95%CI(-0.25,-0.03)],但证据质量较低。0.01%阿托品组与对照组在屈光度值、屈光度变化、远视力和眼压的总体效果方面无显著差异[MD=0.08,95%CI(-0.27,0.42);MD=0.09,95%CI(-0.17,0.36);MD=-0.01,95%CI(-0.02,0.00);MD=0.08,95%CI(-0.56,0.40)]。敏感性分析表明,Meta分析的结论相对稳定。关于不良事件,0.01%阿托品组与对照组之间存在显著差异[比值比(OR)=0.26,95%CI(0.11,0.61)]。

结论

基于现有证据,0.01%阿托品滴眼液在控制眼轴增长和安全性方面有益,且在屈光度值、远视力和眼压方面不会引起显著差异。

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