Alotaibi Ghadi F, Seraj Hadeel, AlMulihi Qasem A, Alkhawajah Amnah A, Eshbeer Salman G, Alghamdi Arwa A, AlTowairqi Arwa M, Aloufi Shahad S, Alshubayni Azizah M
Faculty of Medicine, Taif University, Taif, SAU.
Ophthalmology, King Abdulaziz University, Jeddah, SAU.
Cureus. 2024 Jun 13;16(6):e62292. doi: 10.7759/cureus.62292. eCollection 2024 Jun.
Many studies have evaluated different treatments for ischemic central retinal vein occlusion (CRVO). Nevertheless, improvement and complication rates vary significantly. This systematic review aimed to evaluate the efficacy of laser therapy in treating ischemic CRVO compared with a control group using other treatments. The databases of PubMed, Google Scholar, and ClinicalTrials.gov were searched using a variety of keywords, including "ischemic central retinal vein occlusion," "CRVO," "laser," and "panretinal photocoagulation." After data extraction, each study's quality was assessed using the methodological index for nonrandomized studies (MINORS) or grading of recommendations, assessment, development, and evaluation or GRADE standards. A sum of 195 abstracts were reviewed, and seven clinical trials were eventually chosen. Of these, four were prospective studies, two were randomized controlled studies, and only one was a retrospective study. The assessment of potential biases in our included studies revealed that all these studies demonstrated moderate or high quality. Two studies were selected for meta-analysis, and the results showed no significant difference in visual acuity (VA) outcomes between the treated and the control groups (P = 0.17). In the remaining five studies, laser therapy was found to be more effective at neovascular complications, with a higher rate of neovascular glaucoma (NVG), iris neovascularization (NVI), neovascularisation at disc (NVD), and retinal neovascularization in the group without laser treatments. This review suggests that laser therapy is essential in preventing neovascular complications, such as NVG, NVI, NVD, and retinal neovascularization rather than improving VA. In addition, the combination of laser photocoagulation and intravitreal injection (IVI) improved VA, but further studies are required.
许多研究评估了缺血性视网膜中央静脉阻塞（CRVO）的不同治疗方法。然而，改善率和并发症发生率差异很大。本系统评价旨在评估与使用其他治疗方法的对照组相比，激光治疗缺血性CRVO的疗效。使用包括“缺血性视网膜中央静脉阻塞”“CRVO”“激光”和“全视网膜光凝”等多种关键词，检索了PubMed、谷歌学术和ClinicalTrials.gov数据库。数据提取后，使用非随机研究方法学指数（MINORS）或推荐分级、评估、制定与评价（GRADE）标准对每项研究的质量进行评估。共审查了195篇摘要，最终选择了7项临床试验。其中，4项为前瞻性研究，2项为随机对照研究，只有1项为回顾性研究。对纳入研究的潜在偏倚评估显示，所有这些研究均显示为中度或高质量。选择了2项研究进行荟萃分析，结果显示治疗组和对照组之间的视力（VA）结果无显著差异（P = 0.17）。在其余5项研究中，发现激光治疗在新生血管并发症方面更有效，在未接受激光治疗的组中，新生血管性青光眼（NVG）、虹膜新生血管形成（NVI）、视盘新生血管形成（NVD）和视网膜新生血管形成的发生率更高。本综述表明，激光治疗对于预防NVG、NVI、NVD和视网膜新生血管形成等新生血管并发症至关重要，而非改善视力。此外，激光光凝和玻璃体内注射（IVI）联合使用可改善视力，但仍需进一步研究。
