慢性阻塞性肺疾病患者视网膜神经纤维层厚度的变化：一项系统评价与荟萃分析
Changes in Retinal Nerve Fiber Layer Thickness in Patients With Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis.
作者信息
Xu Yunpeng, Shi Peidong, Liu Xiaoying, Jiang Ziyi, Chen Yanru, Liu Jian, Lei Xunwen, Bai Xue, Wu Fanqi
机构信息
The First Clinical Medical College of Lanzhou University, Lanzhou, China.
The Second Clinical Medical School of Lanzhou University, Lanzhou, China.
出版信息
Clin Respir J. 2025 Mar;19(3):e70065. doi: 10.1111/crj.70065.
PURPOSE
The purpose of this study is to evaluate the relationship between retinal nerve fiber layer (RNFL) thickness and the onset as well as progression of chronic obstructive pulmonary disease (COPD).
METHODS
Database searches were conducted in PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang Data, VIP Database, and CBM, covering the period from each database's inception to March 2024.
RESULTS
This meta-analysis included 15 studies from 2016 to 2023, comprising a total of 1455 participants (801 in the COPD group and 654 in the health group). The results showed a significant reduction in RNFL thickness across all quadrants (average, inferior, nasal, superior, and temporal) in the COPD group compared to the health group (MD: -4.46; 95%CI: -7.77 to -1.14; p = 0.008; MD: -8.17; 95%CI: -11.36 to -4.99; p < 0.00001; MD: -4.69; 95%CI: -7.22 to -2.16; p = 0.0003; MD: -4.83; 95%CI: -8.45 to -1.21; p = 0.009; MD: -2.89; 95%CI: -5.35 to -0.43; p = 0.02). In the mild/moderate COPD group, only the inferior RNFL (MD: -2.32; 95%CI: -4.40 to -0.24; p = 0.03) showed a significant reduction. However, in the severe COPD group, all quadrants were significantly reduced (MD: -5.89; 95%CI: -7.40 to -4.38; p < 0.0001; MD: -6.74; 95%CI: -10.71 to -2.77; p = 0.0009; MD: -4.29; 95%CI: -5.95 to -2.64; p < 0.0001; MD: -2.34; 95%CI: -4.30 to -0.37; p = 0.02; MD: -4.84; 95%CI: -8.82 to -0.86; p = 0.02).
CONCLUSION
Based on current evidence, the average RNFL thickness and the thicknesses of various RNFL regions in COPD patients are significantly lower than those in healthy subjects, and these reductions are closely associated with disease severity. The inferior RNFL may be the first to show changes with the onset and progression of COPD.
目的
本研究旨在评估视网膜神经纤维层（RNFL）厚度与慢性阻塞性肺疾病（COPD）的发病及进展之间的关系。
方法
在PubMed、Embase、Cochrane图书馆、科学网、中国知网、万方数据、维普数据库和中国生物医学文献数据库中进行数据库检索，涵盖从各数据库创建至2024年3月的时间段。
结果
该荟萃分析纳入了2016年至2023年的15项研究，共1455名参与者（COPD组801名，健康组654名）。结果显示，与健康组相比，COPD组所有象限（平均、下方、鼻侧、上方和颞侧）的RNFL厚度均显著降低（MD：-4.46；95%CI：-7.77至-1.14；p = 0.008；MD：-8.17；95%CI：-11.36至-4.99；p < 0.00001；MD：-4.69；95%CI：-7.22至-2.16；p = 0.0003；MD：-4.83；95%CI：-8.45至-1.21；p = 0.009；MD：-2.89；95%CI：-5.35至-0.43；p = 0.02）。在轻度/中度COPD组中，仅下方RNFL（MD：-2.32；95%CI：-4.40至-0.24；p = 0.03）显示出显著降低。然而，在重度COPD组中，所有象限均显著降低（MD：-5.89；95%CI：-7.40至-4.38；p < 0.0001；MD：-6.74；95%CI：-10.71至-2.77；p = 0.0009；MD：-4.29；95%CI：-5.95至-2.64；p < 0.0001；MD：-2.34；95%CI：-4.30至-0.37；p = 0.02；MD：-4.84；95%CI：-8.82至-0.86；p = 0.02）。
结论
基于现有证据，COPD患者的平均RNFL厚度及各个RNFL区域的厚度均显著低于健康受试者，且这些降低与疾病严重程度密切相关。下方RNFL可能是COPD发病和进展时最先出现变化的部位。
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