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Abstract：
OBJECTIVE: To assess the methodological quality of Clinical Practice Guidelines (CPG) for the diagnosis and management of Retinal Vein Occlusion (RVO).
METHODS: A systematic review of CPGs for the diagnosis and management of RVO was carried out with a search in databases, metasearch engines, CPG development institutions, ophthalmology associations and CPG repositories until April 2022. Search update was performed on April 2023, with no new record available. Five CPGs published in the last 10 years in English/Spanish were selected, and 5 authors evaluated them independently, using the Appraisal of Guidelines for Research and Evaluation (AGREE-II) instrument. An individual assessment of each CPG by domain (AGREE-II), an overall assessment of the guide, and its use with or without modifications were performed. Additionally, a meta-synthesis of the recommendations for the most relevant outcomes was carried out.
RESULTS: The lowest score (mean 18.8%) was for domain 5 \'applicability\', and the highest score (mean 62%) was for domain 4 \'clarity of presentation\'. The 2019 American guideline (PPP) presented the best score (40.4%) in domain 3 \'rigour of development\'. When evaluating the overall quality of the CPGs analysed, all CPGs could be recommended with modifications. In the meta-synthesis, anti-VEGF therapy is the first-choice therapy for macular oedema associated with RVO, but there is no clear recommendation about the type of anti-VEGF therapy to choose. Recommendations for diagnosis and follow-up are similar among the CPGs appraised.
CONCLUSIONS: Most CPGs for the diagnosis and management of RVO have a low methodological quality assessed according to the AGREE-II. PPP has the higher score in the domain \'rigour of development\'. Among the CPGs appraised, there is no clear recommendation on the type of anti-VEGF therapy to choose.
METHODS: A systematic review of CPGs for the diagnosis and management of RVO was carried out with a search in databases, metasearch engines, CPG development institutions, ophthalmology associations and CPG repositories until April 2022. Search update was performed on April 2023, with no new record available. Five CPGs published in the last 10 years in English/Spanish were selected, and 5 authors evaluated them independently, using the Appraisal of Guidelines for Research and Evaluation (AGREE-II) instrument. An individual assessment of each CPG by domain (AGREE-II), an overall assessment of the guide, and its use with or without modifications were performed. Additionally, a meta-synthesis of the recommendations for the most relevant outcomes was carried out.
RESULTS: The lowest score (mean 18.8%) was for domain 5 \'applicability\', and the highest score (mean 62%) was for domain 4 \'clarity of presentation\'. The 2019 American guideline (PPP) presented the best score (40.4%) in domain 3 \'rigour of development\'. When evaluating the overall quality of the CPGs analysed, all CPGs could be recommended with modifications. In the meta-synthesis, anti-VEGF therapy is the first-choice therapy for macular oedema associated with RVO, but there is no clear recommendation about the type of anti-VEGF therapy to choose. Recommendations for diagnosis and follow-up are similar among the CPGs appraised.
CONCLUSIONS: Most CPGs for the diagnosis and management of RVO have a low methodological quality assessed according to the AGREE-II. PPP has the higher score in the domain \'rigour of development\'. Among the CPGs appraised, there is no clear recommendation on the type of anti-VEGF therapy to choose.
摘要：
目的：评估视网膜静脉阻塞（RVO）诊断和治疗临床实践指南（CPG）的方法学质量。
方法：通过在数据库中搜索，对用于诊断和治疗RVO的CPGs进行了系统评价。元搜索引擎，CPG发展机构，眼科协会和CPG存储库，直到2022年4月。搜索更新于2023年4月进行，没有新记录可用。选择了过去10年以英语/西班牙语发布的五个CPG，5位作者独立评估了它们，使用评估研究和评估指南(AGREE-II)工具。按领域对每个CPG的单独评估(AGREE-II)，对指南的总体评估，并在有或没有修改的情况下使用。此外,对最相关结局的建议进行了荟萃分析.
结果：最低得分（平均18.8%）是领域5“适用性”，最高得分(平均62%)是第4域的“呈现清晰度”。2019年美国指南（PPP）在领域3“发展的严谨性”中得分最高（40.4%）。在评估所分析的CPG的整体质量时，所有CPG都可以推荐修改。在meta合成中，抗VEGF治疗是与RVO相关的黄斑水肿的首选治疗方法，但对于抗VEGF治疗的选择没有明确的建议.在评估的CPG中，诊断和随访建议相似。
结论：根据AGREE-II评估，大多数用于诊断和治疗RVO的CPG的方法学质量较低。PPP在“发展的严谨性”领域中得分较高。在评估的CPG中，对于可选择的抗VEGF治疗类型没有明确的建议.
方法：通过在数据库中搜索，对用于诊断和治疗RVO的CPGs进行了系统评价。元搜索引擎，CPG发展机构，眼科协会和CPG存储库，直到2022年4月。搜索更新于2023年4月进行，没有新记录可用。选择了过去10年以英语/西班牙语发布的五个CPG，5位作者独立评估了它们，使用评估研究和评估指南(AGREE-II)工具。按领域对每个CPG的单独评估(AGREE-II)，对指南的总体评估，并在有或没有修改的情况下使用。此外,对最相关结局的建议进行了荟萃分析.
结果：最低得分（平均18.8%）是领域5“适用性”，最高得分(平均62%)是第4域的“呈现清晰度”。2019年美国指南（PPP）在领域3“发展的严谨性”中得分最高（40.4%）。在评估所分析的CPG的整体质量时，所有CPG都可以推荐修改。在meta合成中，抗VEGF治疗是与RVO相关的黄斑水肿的首选治疗方法，但对于抗VEGF治疗的选择没有明确的建议.在评估的CPG中，诊断和随访建议相似。
结论：根据AGREE-II评估，大多数用于诊断和治疗RVO的CPG的方法学质量较低。PPP在“发展的严谨性”领域中得分较高。在评估的CPG中，对于可选择的抗VEGF治疗类型没有明确的建议.
