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慢性中心性浆液性脉络膜视网膜病变的盐皮质激素受体拮抗剂。

Mineralocorticoid receptor antagonists in chronic central serous chorioretinopathy.

机构信息

Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Proyecto Epistemonikos, Santiago, Chile.

Proyecto Epistemonikos, Santiago, Chile; Departamento de Oftalmología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. Email:

出版信息

Medwave. 2020 Sep 29;20(8):e8036. doi: 10.5867/medwave.2020.08.8035.

Abstract

INTRODUCTION

Central serous chorioretinopathy consists of the leakage of fluid from the choroid and its accumulation into the subretinal space. Its chronic form is associated with permanent vision loss. Mineralocorticoid receptor antagonists are an alternative treatment for this condition, although there is no clear evidence about their effectiveness.

METHODS

We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach.

RESULTS AND CONCLUSIONS

We identified three systematic reviews including 22 studies overall and four of them are randomized trials. We concluded that in chronic central serous chorioretinopathy, mineralocorticoid receptor antagonists probably make little or no difference to best-corrected visual acuity. We are uncertain whether this intervention reduces subretinal fluid height because the certainty of the evidence is very low. Furthermore, this intervention may make little or no difference in terms of adverse effects, but the certainty of the evidence is low.

摘要

简介

中心性浆液性脉络膜视网膜病变是脉络膜从渗漏到其积累到视网膜下空间的液体。其慢性形式与永久性视力丧失有关。盐皮质激素受体拮抗剂是治疗这种疾病的一种替代方法,尽管关于其疗效尚无明确证据。

方法

我们在 Epistemonikos 中进行了搜索,这是一个最大的健康系统评价数据库,它通过筛选多个信息来源(包括 MEDLINE、EMBASE、Cochrane 等)来维护。我们从系统评价中提取数据,重新分析原始研究的数据,进行荟萃分析,并使用 GRADE 方法生成发现摘要表。

结果与结论

我们确定了 3 项系统评价,共纳入 22 项研究,其中 4 项为随机试验。我们的结论是,在慢性中心性浆液性脉络膜视网膜病变中,盐皮质激素受体拮抗剂对最佳矫正视力可能没有影响或影响很小。我们不确定这种干预是否会降低视网膜下液高度,因为证据的确定性非常低。此外,这种干预在不良反应方面可能没有影响或影响很小,但证据的确定性较低。

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