Department of Ophthalmology, Lishui Municipal Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang, China.
Department of Uveitis, Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.
Int Ophthalmol. 2022 May;42(5):1651-1660. doi: 10.1007/s10792-021-02131-2. Epub 2022 Mar 21.
We performed a systematic review and meta-analysis to assess the role of prophylactic laser retinopexy in preventing rhegmatogenous retinal detachment (RRD) in acute retinal necrosis (ARN).
Pubmed, Embase and Cochrane databases were searched for eligible studies from inception to July 2020. Comprehensive clinical demographics were extracted from each study by two independent investigators. A random effects model was selected to analyze the OR of RRD risk and visual outcome with 95%CI. Subsequent subgroup and sensitivity analysis were conducted to evaluate the source of heterogeneity.
A total of eight studies and 247 eyes (111 prophylactic laser retinopexy eyes and 136 eyes receiving antiviral treatment) were included in this analysis. There was moderate statistical heterogeneity across all studies. When compared with routine antiviral treatment alone, RRD risk decreased in patients receiving prophylactic laser retinopexy, however, this was not statistically significant (P = 0.09, OR = 0.42, 95%CI: 0.15-1.15). There was significant improvement in BCVA during the follow-up period in the prophylactic laser retinopexy subgroup (P = 0.01, WMD = - 0.98, 95%CI: - 1.74, - 0.22).
Based on current analysis, our results did not support convincing evidence of prophylactic laser in preventing RRD. Future studies featuring high-quality, multicenter trials will be required to correct baseline characteristics.
This meta-analysis has been retrospectively registered in Prospero (registration number: CRD42020201008).
我们进行了一项系统评价和荟萃分析，以评估预防性激光视网膜光凝术在预防急性视网膜坏死（ARN）中的孔源性视网膜脱离（RRD）中的作用。
从建库至 2020 年 7 月，我们在 Pubmed、Embase 和 Cochrane 数据库中搜索了合格的研究。两位独立的研究者从每项研究中提取全面的临床人口统计学数据。选择随机效应模型来分析 RRD 风险和视力结局的 OR，并用 95%CI 表示。随后进行了亚组和敏感性分析，以评估异质性的来源。
共有 8 项研究和 247 只眼（111 只接受预防性激光视网膜光凝术的眼和 136 只接受抗病毒治疗的眼）纳入了本分析。所有研究均存在中度统计学异质性。与单独常规抗病毒治疗相比，接受预防性激光视网膜光凝术的患者 RRD 风险降低，但无统计学意义（P=0.09，OR=0.42，95%CI：0.15-1.15）。在预防性激光视网膜光凝术亚组中，随访期间 BCVA 有显著改善（P=0.01，WMD=-0.98，95%CI：-1.74，-0.22）。
基于目前的分析，我们的结果不支持预防性激光预防 RRD 的令人信服的证据。需要开展具有高质量、多中心试验的未来研究来校正基线特征。
本荟萃分析已在 Prospero（注册号：CRD42020201008）中进行了回顾性注册。
