Department of Eye Function Laboratory, Eye Hospital, China Academy of Chinese Medical Sciences, 33 Lugu Road, Shijingshan District, Beijing, 100040, People's Republic of China.
J Transl Med. 2024 Jan 6;22(1):28. doi: 10.1186/s12967-023-04766-4.
Electrical activity has a crucial impact on the development and survival of neurons. Numerous recent studies have shown that noninvasive electrical stimulation (NES) has neuroprotective action in various retinal disorders.
To systematically review the literature on in vivo studies and provide a comprehensive summary of the neuroprotective action and the mechanisms of NES on retinal disorders.
Based on the PRISMA guideline, a systematic review was conducted in PubMed, Web of Science, Embase, Scopus and Cochrane Library to collect all relevant in vivo studies on "the role of NES on retinal diseases" published up until September 2023. Possible biases were identified with the adopted SYRCLE's tool.
Of the 791 initially gathered studies, 21 articles met inclusion/exclusion criteria for full-text review. The results revealed the neuroprotective effect of NES (involved whole-eye, transcorneal, transscleral, transpalpebral, transorbital electrical stimulation) on different retinal diseases, including retinitis pigmentosa, retinal degeneration, high-intraocular pressure injury, traumatic optic neuropathy, nonarteritic ischemic optic neuropathy. NES could effectively delay degeneration and apoptosis of retinal neurons, preserve retinal structure and visual function with high security, and its mechanism of action might be related to promoting the secretion of neurotrophins and growth factors, decreasing inflammation, inhibiting apoptosis. The quality scores of included studies ranged from 5 to 8 points (a total of 10 points), according to SYRCLE's risk of bias tool.
This systematic review indicated that NES exerts neuroprotective effects on retinal disease models mainly through its neurotrophic, anti-inflammatory, and anti-apoptotic capabilities. To assess the efficacy of NES in a therapeutic setting, however, well-designed clinical trials are required in the future.
电活动对神经元的发育和存活有至关重要的影响。最近大量研究表明，无创电刺激（NES）在各种视网膜疾病中有神经保护作用。
系统综述文献中关于体内研究，并提供 NES 对视网膜疾病的神经保护作用和机制的综合总结。
根据 PRISMA 指南，在 PubMed、Web of Science、Embase、Scopus 和 Cochrane Library 中系统检索了截至 2023 年 9 月关于“NES 在视网膜疾病中的作用”的所有相关体内研究。采用 SYRCLE 工具识别可能存在的偏倚。
最初收集的 791 项研究中，有 21 项符合纳入/排除标准，可进行全文审查。结果表明，NES（涉及全眼、经角膜、经巩膜、经眼睑、经眶电刺激）对不同的视网膜疾病具有神经保护作用，包括色素性视网膜炎、视网膜变性、高眼压损伤、外伤性视神经病变、非动脉炎性缺血性视神经病变。NES 能有效延缓视网膜神经元的变性和凋亡，保持视网膜结构和视功能，安全性高，其作用机制可能与促进神经营养因子和生长因子的分泌、减少炎症、抑制细胞凋亡有关。根据 SYRCLE 偏倚风险工具，纳入研究的质量评分为 5 至 8 分（总分 10 分）。
本系统综述表明，NES 主要通过其神经营养、抗炎和抗凋亡作用对视网膜疾病模型发挥神经保护作用。然而，未来需要设计良好的临床试验来评估 NES 在治疗中的疗效。
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