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皮质类固醇的使用与中心性浆液性脉络膜视网膜病变:一项荟萃分析。

Corticosteroids usage and central serous chorioretinopathy: a meta-analysis.

机构信息

Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, 610041, China.

West China School of Medicine of Sichuan University, Chengdu, 610041, China.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2020 Jan;258(1):71-77. doi: 10.1007/s00417-019-04486-w. Epub 2019 Nov 16.

Abstract

PURPOSE

This meta-analysis was conducted to investigate whether usage of corticosteroids was associated with an increased risk of central serous chorioretinopathy by summarizing all available evidence.

METHODS

PubMed, EMBASE, Cochrane Library, and Web of Science databases were searched for all relevant studies published from inception to April 2019. Studies investigating the association between corticosteroids and the risk of central serous chorioretinopathy were included.

RESULTS

Six case-control studies were finally included for the meta-analysis after study selection. The results of the analysis showed that there was a significantly higher risk of central serous chorioretinopathy among patients who once used corticosteroids (N = 707) compared with individuals without the usage of corticosteroids (N = 1927) (OR 4.050, 95% CI 2.270 to 7.220, I = 59%, P < 0.001). Results were the same for taking corticosteroids orally (OR 1.650, 95% CI 1.510 to 1.810, I = 47%, P < 0.001), through injection (OR 1.660, 95% CI 1.440 to 1.910, I = 0%, P < 0.001), and through nasal spray (OR 1.910, 95% CI 1.500 to 2.420, I = 17%, P < 0.001), but not for inhaled usage (OR 1.340, 95% CI 0.900 to 1.990, I = 0%, P = 0.160).

CONCLUSIONS

In conclusion, this meta-analysis demonstrated that patients with the usage of corticosteroids had an increased risk of central serous chorioretinopathy. Patients who were prescribed with corticosteroids need greater attention to their retina health. Also, all central serous chorioretinopathy (CSC) patients should avoid the use of corticosteroids as much as they possibly can.

摘要

目的

通过汇总所有现有证据,对皮质类固醇的使用与中心性浆液性脉络膜视网膜病变风险增加之间的关系进行meta 分析。

方法

检索从建库至 2019 年 4 月PubMed、EMBASE、Cochrane 图书馆和 Web of Science 数据库中所有相关研究。纳入皮质类固醇与中心性浆液性脉络膜视网膜病变风险之间关系的研究。

结果

经过研究选择,最终有 6 项病例对照研究纳入 meta 分析。分析结果显示,与未使用皮质类固醇的个体相比,曾经使用皮质类固醇(N=707)的患者发生中心性浆液性脉络膜视网膜病变的风险显著更高(N=1927)(OR 4.050,95% CI 2.270 至 7.220,I²=59%,P<0.001)。口服(OR 1.650,95% CI 1.510 至 1.810,I²=47%,P<0.001)、注射(OR 1.660,95% CI 1.440 至 1.910,I²=0%,P<0.001)和鼻喷(OR 1.910,95% CI 1.500 至 2.420,I²=17%,P<0.001)皮质类固醇的使用风险相似,但吸入皮质类固醇的使用风险无显著增加(OR 1.340,95% CI 0.900 至 1.990,I²=0%,P=0.160)。

结论

总之,这项 meta 分析表明,使用皮质类固醇的患者发生中心性浆液性脉络膜视网膜病变的风险增加。皮质类固醇治疗的患者需要更加关注其视网膜健康。此外,所有中心性浆液性脉络膜视网膜病变(CSC)患者应尽可能避免使用皮质类固醇。

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