Graduate Program in Collective Health, University of Brasilia, Brasília, Federal District, Brazil.
Department of Management and Incorporation of Health Technologies, Ministry of Health, Brasilia, Federal District, Brazil.
PLoS One. 2023 Nov 16;18(11):e0294398. doi: 10.1371/journal.pone.0294398. eCollection 2023.
Age-related macular degeneration (AMD) is an eye disease that occurs in patients over 50 years old. Early diagnosis enables timely treatment to stabilize disease progression. However, the fact that the disease is asymptomatic in its early stages can delay treatment until it progresses. As such, screening in specific contexts can be an early detection tool to reduce the clinical and social impact of the disease.
Assess the effectiveness of screening methods for early detection of AMD in adults aged 50 years or older.
A systematic review of comparative observational studies on AMD screening methods in those aged 50 years or older, compared with no screening or any other strategy. A literature search was conducted in the MEDLINE (via PubMed), Embase, Cochrane Library and Lilacs database.
A total of 5,290 studies were identified, three of which met the inclusion criteria and were selected for the systematic review. A total of 8,733 individuals (16,780 eyes) were included in the analysis. The screening methods assessed were based on optical coherence tomography (OCT) compared with color fundus photography, and OCT and telemedicine testing compared to a standard eye exam.
The systematized data are limited and only suggest satisfactory performance in early screening of the population at risk of developing AMD. OCT and the telemedicine technique showed promising results in AMD screening. However, methodological problems were identified in the studies selected and the level of evidence was considered low.
年龄相关性黄斑变性(AMD)是一种发生在 50 岁以上患者中的眼部疾病。早期诊断可以使疾病进展得到及时治疗而稳定下来。然而,疾病在早期无症状的事实会导致治疗延迟到疾病进展阶段。因此,在特定情况下进行筛查可以作为早期发现的工具,以降低疾病的临床和社会影响。
评估针对 50 岁及以上成年人 AMD 的早期检测的筛查方法的有效性。
对针对 50 岁及以上成年人 AMD 筛查方法的比较观察性研究进行系统评价,与不筛查或任何其他策略进行比较。在 MEDLINE(通过 PubMed)、Embase、Cochrane 图书馆和 Lilacs 数据库中进行文献检索。
共确定了 5290 项研究,其中 3 项符合纳入标准并被纳入系统评价。共有 8733 人(16780 只眼)纳入分析。评估的筛查方法基于光学相干断层扫描(OCT)与眼底彩色摄影的比较,以及 OCT 和远程医疗测试与标准眼部检查的比较。
系统数据有限,仅表明在有发生 AMD 风险的人群的早期筛查中表现出良好的性能。OCT 和远程医疗技术在 AMD 筛查中显示出有希望的结果。然而,在选择的研究中发现了方法学问题,并且证据水平被认为较低。