这篇综述的目的是评估可用的Purtscher视网膜病变治疗的疗效。
为了收集单病例报告,在包括PubMed在内的几个数据库中进行了电子搜索,Embase,WebofScience,中国国家知识基础设施,SinoMed,VIP,和万方在电子论文和论文中心。在贵宾和万方,我们还追踪了收录文章的参考文献。使用适应于Cochrane偏差风险工具的工具评估偏差风险。统计分析采用SPSS19.0。使用GRADE系统对证据进行评估和分级。
总共,共纳入76项研究,涉及88例病例和139只眼。90%的纳入研究存在严重偏倚。目前Purtscher视网膜病变的治疗包括糖皮质激素治疗(63.29%),中医治疗(10.13%),糖皮质激素中西医结合治疗(7.60%),中西医结合治疗(6.33%)。患者视力(56.83%)或未治疗(43.17%)均在1-3个月内得到改善,4-6个月,超过6个月;然而,在4-6个月和超过6个月后,与治疗组相比,未治疗的情况变得更好。在等级系统中,所有结果都“非常低”。没有研究报告任何患者的不良反应。
治疗和不治疗都能改善Purtscher视网膜病变患者的视力,但未治疗与糖皮质激素治疗差异无统计学意义。这一结论的证据质量“非常低”,有很大的偏差。需要进一步研究以了解Purtscher视网膜病变治疗的安全性。
The aim of this review is to evaluate the efficacy of available Purtscher\'s Retinopathy treatments.
In order to collect single-case reports, electronic searches were conducted in several databases including PubMed, Embase, Web of Science, China National Knowledge Infrastructure, SinoMed, VIP, and WanFang in the Electronic Theses and Dissertations Center. In VIP and Wanfang, we also traced the references of included articles. Risk of bias was evaluated using a tool adapted from the Cochrane Risk of Bias Tool. Statistical analysis was done in SPSS19.0. Evidence was evaluated and graded with GRADE system.
In total, 76 studies were included involving 88 cases and 139 eyes. Serious bias existed in 90% of the included studies. Current treatments for Purtscher\'s retinopathy included glucocorticoid therapy (63.29%), traditional Chinese medicine therapy (10.13%), glucocorticoid integrative medicine therapy (7.60%), and integrative medicine therapy (6.33%). Patients\' eyesight with (56.83%) or without (43.17%) treatment both improved in the follow-up within 1-3 months, 4-6 months, and more than 6 months; however, conditions without treatment became better compared to the treatment groups in after 4-6 months and more than 6 months. All results were \"very low\" in the GRADE system. None of the studies reported adverse reactions in any patient.
Both treatment and no treatment improve vision in Purtscher\'s retinopathy patients, but the difference between no treatment and glucocorticoid therapy had no statistical significance. The evidence quality for this conclusion was \"very low\" and had large bias. Further research is required to understand the safety of Purtscher\'s retinopathy treatment.