对疑似结核性葡萄膜炎抗结核治疗效用的系统评价。
A systemic review of the utility of antituberculosis therapy for presumed tuberculous uveitis.
作者信息
Taylor Jemma W, Wright Ginevra E L, Lim Lyndell L, Denholm Justin T
机构信息
Department of Infectious Diseases at the Peter Doherty Institute for Infection and Immunity, University of Melbourne, 792 Elizabeth Street, Melbourne, 3000, Australia.
University of Melbourne, Parkville, Australia.
出版信息
BMC Infect Dis. 2025 Jan 24;25(1):112. doi: 10.1186/s12879-024-10288-1.
BACKGROUND
Uveitis presumed to be secondary to Mycobacterium tuberculosis is a rare but potentially blinding condition. Difficulty in making an accurate diagnosis and the low incidence of TB uveitis (TBU) contribute to the lack of evidence regarding the best management of this condition. This systematic review aims to analyse existing research to provide a summary of the literature regarding the utility of TB therapy for the management of TBU.
METHODS
This systematic review was prospectively registered on PROSPERO (PROSPERO 2021 CRD42021273379). We searched Medline, Embase and Central databases, and the search was done on 20th June 2023 with an updated literature search.
RESULTS
We included 55 studies and found that the heterogeneity in the methodology of these studies precluded metanalysis, and a narrative analysis was undertaken. Risk of bias analysis was undertaken using the Newcastle-Ottawa scale.
CONCLUSIONS
Key findings of this systematic review include multiple systemic biases in the available evidence, and general lack of control for confounding variables. This results in many unanswered questions regarding the utility of TB therapy for TBU and reinforces the need for more data in this area.
背景
推测继发于结核分枝杆菌的葡萄膜炎是一种罕见但可能致盲的疾病。准确诊断困难以及结核性葡萄膜炎（TBU）发病率低，导致缺乏关于该疾病最佳治疗方法的证据。本系统评价旨在分析现有研究，以总结关于结核病治疗对TBU管理效用的文献。
方法
本系统评价在PROSPERO（PROSPERO 2021 CRD42021273379）上进行了前瞻性注册。我们检索了Medline、Embase和Central数据库，并于2023年6月20日进行了检索及更新文献检索。
结果
我们纳入了55项研究，发现这些研究方法的异质性排除了荟萃分析，因此进行了叙述性分析。使用纽卡斯尔-渥太华量表进行偏倚风险分析。
结论
本系统评价的主要发现包括现有证据中存在多种系统性偏倚，且普遍缺乏对混杂变量的控制。这导致了许多关于结核病治疗对TBU效用的未解答问题，并强化了该领域需要更多数据的必要性。
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