Centre for Eye Research Ireland, Technological University Dublin, Dublin, Ireland
Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Western Australia, Australia.
BMJ Open Ophthalmol. 2022 Jan 31;7(1):e000933. doi: 10.1136/bmjophth-2021-000933. eCollection 2022.
To conduct a systematic review to identify and critically appraise clinical practice guidelines on the assessment, diagnosis and management of childhood glaucoma.
A systematic literature search of databases and professional websites for clinical practice guidelines published on eye conditions between 2010 and April 2020 in English was conducted. Identified guidelines were screened for relevance to childhood glaucoma and exclusion criteria applied. Guidelines that passed the screening and quality appraisal with the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool and, if they achieved a mean score of ≥45 and ≥3 on subsets of 9 and 5 AGREE II items, respectively, were selected for inclusion and data extracted using a standardised form.
Following screening and critical appraisal, three guidelines were included for data extraction. None of the three guidelines was specifically developed for childhood glaucoma. A consistent recommendation was that children should undergo some form of eye screening examination or a comprehensive eye assessment to detect paediatric eye disease. Children at high risk of childhood glaucoma should undergo additional screening. One clinical practice guideline recommended interventions for childhood glaucoma consisting of tube surgery and topical beta-blockers or carbonic anhydrase inhibitors. Recommended interventions for childhood glaucoma were based on low-quality to moderate-quality evidence or expert opinion.
Based on our selection criteria, we did not identify any high-quality clinical practice guidelines specifically targeted at childhood glaucoma. This is compounded by the lack of high-quality evidence on childhood glaucoma.
对评估、诊断和治疗儿童青光眼的临床实践指南进行系统评价，以确定并批判性地评估这些指南。
系统检索了 2010 年至 2020 年 4 月期间发表的关于眼部疾病的英文临床实践指南数据库和专业网站，筛选出与儿童青光眼相关的指南，并应用排除标准进行排除。通过评估指南研究和评估工具（AGREE II）对通过筛选和质量评估的指南进行评估，如果其在 9 个和 5 个 AGREE II 项目的子集上的平均得分分别≥45 和≥3，则选择纳入并使用标准化表格提取数据。
经过筛选和批判性评估，有 3 项指南纳入了数据提取。这 3 项指南均不是专门针对儿童青光眼制定的。一致的建议是，儿童应进行某种形式的眼部筛查检查或全面的眼部评估，以发现小儿眼病。儿童青光眼高危患者应进行额外的筛查。有一项临床实践指南建议对儿童青光眼进行干预，包括管手术和局部β受体阻滞剂或碳酸酐酶抑制剂。对儿童青光眼的推荐干预措施是基于低质量到中等质量的证据或专家意见。
根据我们的选择标准，我们没有发现任何专门针对儿童青光眼的高质量临床实践指南。这与儿童青光眼缺乏高质量证据有关。
