PDF(Pubmed)
Abstract：
Nonarteritic anterior ischemic optic neuropathy (NAION) is the second most common form of optic neuropathy. Most patients show no improvement over time. Until now, there is still no definitive therapy for NAION. The available literatures on the possible treatment of NAION are quite diverse and controversial. Neuroprotection strategies have been suggested as one of the potential treatments for NAION. This review aims to critically evaluate the literature on neuroprotective strategy for NAION.
This report was written in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We performed a systematic literature search in Pubmed, Science Direct, Proquest, and Cochrane databases. Only neuroprotective agents that directly work in protecting neurons were included. The outcome of interest in this review is retinal ganglion cell density and apoptosis for animal studies and retinal nerve fiber layer thickness for human studies.
The systematic search identified 591 studies of which 24 met the eligibility criteria, including 21 animal studies and three human studies. Only a few of the studies evaluated the same treatments, showing how diverse neuroprotector treatments are currently being evaluated as NAION treatment. From 21 animal studies, 14 studies showed significantly higher retinal ganglion cell density (1.49- to 2.81-fold) with neuroprotective treatment compared to control group. Two of three human studies in this review had also found a beneficial effect of preserving retinal nerve fiber layer thickness in NAION patients.
This review suggests the potential of neuroprotection as a viable option in the quest for an effective treatment strategy for NAION. Further studies, particularly clinical studies, are necessary to establish its efficacy in NAION patients.
This report was written in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We performed a systematic literature search in Pubmed, Science Direct, Proquest, and Cochrane databases. Only neuroprotective agents that directly work in protecting neurons were included. The outcome of interest in this review is retinal ganglion cell density and apoptosis for animal studies and retinal nerve fiber layer thickness for human studies.
The systematic search identified 591 studies of which 24 met the eligibility criteria, including 21 animal studies and three human studies. Only a few of the studies evaluated the same treatments, showing how diverse neuroprotector treatments are currently being evaluated as NAION treatment. From 21 animal studies, 14 studies showed significantly higher retinal ganglion cell density (1.49- to 2.81-fold) with neuroprotective treatment compared to control group. Two of three human studies in this review had also found a beneficial effect of preserving retinal nerve fiber layer thickness in NAION patients.
This review suggests the potential of neuroprotection as a viable option in the quest for an effective treatment strategy for NAION. Further studies, particularly clinical studies, are necessary to establish its efficacy in NAION patients.
摘要：
目的：非动脉炎性前部缺血性视神经病变（NAION）是第二常见的视神经病变。大多数患者随着时间的推移没有改善。直到现在,仍然没有明确的NAION治疗方法。关于NAION的可能治疗的现有文献是相当多样和有争议的。神经保护策略已被建议作为NAION的潜在治疗方法之一。这篇综述旨在批判性地评估有关NAION神经保护策略的文献。
方法：本报告按照PRISMA（系统评价和荟萃分析的首选报告项目）指南编写。我们在Pubmed，科学直接，Proquest,和Cochrane数据库。仅包括直接在保护神经元中起作用的神经保护剂。本综述感兴趣的结果是用于动物研究的视网膜神经节细胞密度和凋亡以及用于人类研究的视网膜神经纤维层厚度。
结果：系统搜索确定了591项研究，其中24项符合资格标准，包括21项动物研究和三项人体研究。只有少数研究评估了相同的治疗方法，显示了目前作为NAION治疗评估的多种神经保护剂治疗方法。从21项动物研究中，14项研究显示，与对照组相比，神经保护治疗组的视网膜神经节细胞密度明显更高（1.49至2.81倍）。这篇综述中的三项人体研究中的两项也发现了在NAION患者中保留视网膜神经纤维层厚度的有益效果。
结论：这篇综述表明神经保护作为寻求NAION有效治疗策略的可行选择的潜力。进一步研究,特别是临床研究，有必要确定其在NAION患者中的疗效。
方法：本报告按照PRISMA（系统评价和荟萃分析的首选报告项目）指南编写。我们在Pubmed，科学直接，Proquest,和Cochrane数据库。仅包括直接在保护神经元中起作用的神经保护剂。本综述感兴趣的结果是用于动物研究的视网膜神经节细胞密度和凋亡以及用于人类研究的视网膜神经纤维层厚度。
结果：系统搜索确定了591项研究，其中24项符合资格标准，包括21项动物研究和三项人体研究。只有少数研究评估了相同的治疗方法，显示了目前作为NAION治疗评估的多种神经保护剂治疗方法。从21项动物研究中，14项研究显示，与对照组相比，神经保护治疗组的视网膜神经节细胞密度明显更高（1.49至2.81倍）。这篇综述中的三项人体研究中的两项也发现了在NAION患者中保留视网膜神经纤维层厚度的有益效果。
结论：这篇综述表明神经保护作为寻求NAION有效治疗策略的可行选择的潜力。进一步研究,特别是临床研究，有必要确定其在NAION患者中的疗效。
