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PloS One 2023Glaucoma is a leading cause of irreversible blindness worldwide. Retinal ganglion cells (RGC), the neurons that connect the eyes to the brain, specifically die in...
PURPOSE
Glaucoma is a leading cause of irreversible blindness worldwide. Retinal ganglion cells (RGC), the neurons that connect the eyes to the brain, specifically die in glaucoma, leading to blindness. Elevated intraocular pressure (IOP) is the only modifiable risk factor, however, many patients progress despite excellent IOP control. Thus, alternative treatment strategies to prevent glaucoma progression are an unmet need. Citicoline has demonstrated neuroprotective properties in central neurodegenerative diseases. However, conclusive evidence of the effect of citicoline on glaucoma progression is missing. This systematic review investigates first-time the therapeutic potential of citicoline in glaucoma patients.
METHODS
The present study was conducted according to the PRISMA 2020 statement. PubMed, Web of Science, Google Scholar, and Embase were accessed in July 2023 to identify all clinical studies investigating the efficacy of citicoline on IOP, the mean deviation of the 24-2 visual field testing (MD 24-2), retinal nerve fibre layer (RNFL), and the pattern electroretinogram (PERG) P50-N95 amplitude in glaucoma patients. The risk of bias was assessed using the Review Manager 5.3 software (The Nordic Cochrane Collaboration, Copenhagen) and the Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I) tool.
RESULTS
Ten studies were eligible for this systematic review, including 424 patients. The mean length of the follow-up was 12.1 ± 11.6 months. The overall risk of bias was low to moderate. The mean age of the patients was 56.7 years. There were no significant differences in the IOP, MD 24-2, RNFL, or PERG P50-N95 amplitude between patients receiving citicoline and the control group. There was no improvement from baseline to the last follow-up in IOP, MD 24-2, RNFL, or PERG P50-N95 amplitude.
CONCLUSION
There is a lack of sufficient evidence to support that citicoline slows the progression of glaucoma.
Topics: Humans; Middle Aged; Cytidine Diphosphate Choline; Glaucoma, Open-Angle; Intraocular Pressure; Glaucoma; Retinal Ganglion Cells; Blindness
PubMed: 37768938
DOI: 10.1371/journal.pone.0291836 -
Biomedicine & Pharmacotherapy =... Nov 2023Humans rely on vision as their most important sense. This is accomplished by photoreceptors (PRs) in the retina that detect light but cannot function without the support... (Review)
Review
Humans rely on vision as their most important sense. This is accomplished by photoreceptors (PRs) in the retina that detect light but cannot function without the support and maintenance of the retinal pigment epithelium (RPE). In subretinal hemorrhage (SRH), blood accumulates between the neurosensory retina and the RPE or between the RPE and the choroid. Blood breakdown products subsequently damage PRs and the RPE and lead to poor vision and blindness. Hence, there is a high need for options to preserve the retina and visual functions. We conducted a systematic review of the literature in accordance with the PRISMA guidelines to identify the cell death mechanisms in RPE and PRs after SRH to deepen our understanding of the pathways involved. After screening 736 publications published until November 8, 2022, we identified 19 records that assessed cell death in PRs and/or RPE in experimental models of SRH. Among the different cell death mechanisms, apoptosis was the most widely investigated mechanism (11 records), followed by ferroptosis (4), whereas necroptosis, pyroptosis, and lysosome-dependent cell death were only assessed in one study each. We discuss different therapeutic options that were assessed in these studies, including the removal of the hematoma/iron chelation, cytoprotection, anti-inflammatory agents, and antioxidants. Further systematic investigations will be necessary to determine the exact cell death mechanisms after SRH with respect to different blood breakdown components, cell types, and time courses. This will form the basis for the development of novel treatment options for SRH.
Topics: Humans; Retinal Pigment Epithelium; Retina; Cell Death; Photoreceptor Cells; Hemorrhage
PubMed: 37742603
DOI: 10.1016/j.biopha.2023.115572 -
The Journal of Dermatological Treatment Dec 2023Isotretinoin is frequently used for treatment of severe nodulocystic and papulopustular acne, however use is limited by mucocutaneous, ocular, and systemic side... (Meta-Analysis)
Meta-Analysis
Isotretinoin is frequently used for treatment of severe nodulocystic and papulopustular acne, however use is limited by mucocutaneous, ocular, and systemic side effects. (1) provide a systematic meta-analysis of ocular side effects during isotretinoin use and their corresponding incidences; (2) provide a narrative summary of ocular side effects during isotretinoin use reported in case reports. A systematic database search using predefined search terms was performed in PubMed, EMBASE, and Scopus from inception to 5 March, 2021. Predetermined inclusion and exclusion criteria were used to select included studies. In total, 53 original studies qualified for meta-analysis, and 41 case reports/series qualified for narrative results. The studies included in the meta-analysis reported incidences of various ocular side effects including dry eye, eye sensitivity, vision changes, and ocular inflammatory conditions. Incidences across studies did vary, leading to considerable heterogeneity. The narrative results summarize more uncommon, but equally important, ocular side effects. Dry eye is the most commonly reported ocular side effect. Other less common, but more serious, ocular side effects including vision changes can occur. We recommend that isotretinoin prescribers monitor for dry eye. Limitations include the heterogeneity of reported incidences of ocular side effects between studies.
Topics: Humans; Acne Vulgaris; Dermatologic Agents; Drug-Related Side Effects and Adverse Reactions; Dry Eye Syndromes; Eye; Face; Isotretinoin
PubMed: 37248700
DOI: 10.1080/09546634.2023.2213364 -
International Health Nov 2023Trachomatous trichiasis is the potential stage of trachoma in which the eyelashes scratch the surface of the globe, ultimately causing corneal opacity, visual impairment... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Trachomatous trichiasis is the potential stage of trachoma in which the eyelashes scratch the surface of the globe, ultimately causing corneal opacity, visual impairment and blindness. The aim of this systematic review and meta-analysis is to obtain the pooled prevalence and associated factors of postoperative trachomatous trichiasis (PTT) in World Health Organization (WHO) trachoma-endemic regions.
METHODS
An inclusive literature search was undertaken using PubMed, Cochrane Library, Science Direct and Google Scholar databases from 30 May 2022 to 28 June 2022. I2 statistics and funnel plots were used to determine heterogeneity and publication bias among included studies. A random effects model was used to estimate pooled prevalence, incidence and odds ratios (ORs) with the respective 95% confidence intervals (CIs) using RevMan 5.4 software.
RESULTS
Eighteen articles were included in this meta-analysis and systematic review. The pooled prevalence of PTT was 19% (range 18-21). PTT was lower among young adults compared with old adults (OR 0.63 [95% CI 0.44 to 0.92]), single-dose oral azithromycin as compared with tetracycline eye ointment users (OR 0.82 [95% CI 0.69 to 0.99]) and minor trichiasis before surgery as compared with major trichiasis (OR 0.63 [95% CI 0.47 to 0.85]).
CONCLUSIONS
The incidence of PTT was higher than the WHO's recommendation. Prescribing single-dose oral azithromycin after surgery, periodic training for trichiasis surgeons, close follow-up and health education after surgery are crucial to minimize the recurrence.Study protocol registration on PROSPERO: CRD42022336003.
Topics: Young Adult; Humans; Trichiasis; Trachoma; Azithromycin; Eyelashes; Anti-Bacterial Agents
PubMed: 36852770
DOI: 10.1093/inthealth/ihad014 -
Molecular Psychiatry Feb 2024Abnormal findings on optical coherence tomography (OCT) and electroretinography (ERG) have been reported in participants with schizophrenia spectrum disorders (SSDs).... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Abnormal findings on optical coherence tomography (OCT) and electroretinography (ERG) have been reported in participants with schizophrenia spectrum disorders (SSDs). This study aims to reveal the pooled standard mean difference (SMD) in retinal parameters on OCT and ERG among participants with SSDs and healthy controls and their association with demographic characteristics, clinical symptoms, smoking, diabetes mellitus, and hypertension.
METHODS
Using PubMed, Scopus, Web of Science, and PSYNDEX, we searched the literature from inception to March 31, 2023, using specific search terms. This study was registered with PROSPERO (CRD4202235795) and conducted according to PRISMA 2020.
RESULTS
We included 65 studies in the systematic review and 44 in the meta-analysis. Participants with SSDs showed thinning of the peripapillary retinal nerve fiber layer (pRNFL), macular ganglion cell layer- inner plexiform cell layer, and retinal thickness in all other segments of the macula. A meta-analysis of studies that excluded SSD participants with diabetes and hypertension showed no change in results, except for pRNFL inferior and nasal thickness. Furthermore, a significant difference was found in the pooled SMD of pRNFL temporal thickness between the left and right eyes. Meta-regression analysis revealed an association between retinal thinning and duration of illness, positive and negative symptoms. In OCT angiography, no differences were found in the foveal avascular zone and superficial layer foveal vessel density between SSD participants and controls. In flash ERG, the meta-analysis showed reduced amplitude of both a- and b-waves under photopic and scotopic conditions in SSD participants. Furthermore, the latency of photopic a-wave was significantly shorter in SSD participants in comparison with HCs.
DISCUSSION
Considering the prior report of retinal thinning in unaffected first-degree relatives and the results of the meta-analysis, the findings suggest that retinal changes in SSDs have both trait and state aspects. Future longitudinal multimodal retinal imaging studies are needed to clarify the pathophysiological mechanisms of these changes and to clarify their utility in individual patient monitoring efforts.
Topics: Humans; Tomography, Optical Coherence; Electroretinography; Schizophrenia; Retina; Biomarkers; Male; Adult; Female; Nerve Fibers
PubMed: 38081943
DOI: 10.1038/s41380-023-02340-4 -
Indian Journal of Ophthalmology Oct 2023A systematic review and meta-analysis were conducted to evaluate the success and complications of endoscopic laser dacryocystorhinostomy (ELDCR) vs. external... (Meta-Analysis)
Meta-Analysis Review
A systematic review and meta-analysis were conducted to evaluate the success and complications of endoscopic laser dacryocystorhinostomy (ELDCR) vs. external dacryocystorhinostomy (ExDCR) in primarily acquired nasal duct obstruction. The search of PubMed, Embase, and Cochrane Central Register of Controlled Trials databases revealed 109 studies on ELDCR and ExDCR. Eleven studies were found to be suitable for review. The primary objective was to compare the success rate between ELDCR and ExDCR. The secondary objectives were to analyze the surgical time, overall complications, bleeding, infection, intranasal synechia, and granulation tissue. Pooled analysis of all studies revealed that ELDCR had a significantly lesser success rate compared to ExDCR (80.3% vs. 91.6%; odds ratio [OR] 0.41; 95% confidence interval [CI] [0.27, 0.62]; P < 00001; I = 13%). However, there were no difference in the overall complication rate (12.0% vs. 13.0%; OR 1.04; 95% CI [0.17, 6.33]; P = 0.97, I = 80%) and intranasal synechiae (9.5% vs. 4.3%; OR 2.22 [1.04, 4.72]; P = 0.04; I = 10%). The ExDCR group had significantly increased risks of bleeding (1.9% vs. 13.0%; OR 0.20; 95% CI [0.09, 0.47]; P = 0.0002; I = 0%) and infection (0.3% vs. 4.6%; OR 0.09; 95%CI [0.02, 0.51]; P = 0.006; I = 0%). Nevertheless, ELDCR needed a shorter surgical time compared to ExDCR (mean difference [MD] -28.35, 95% CI [-35.45, -21.26], P < 0.00001, I = 78%). Although ELDCR is associated with lesser bleeding, lesser infection, and shorter surgical duration, the success rate of ExDCR is higher.
Topics: Humans; Dacryocystorhinostomy; Lasers; Time Factors; Endoscopy; Treatment Outcome; Nasolacrimal Duct; Lacrimal Duct Obstruction
PubMed: 37787224
DOI: 10.4103/IJO.IJO_3334_22 -
BMC Ophthalmology Nov 2023To evaluate the efficacy of anti-vascular endothelial growth factor (VEGF) in treatment of age-related macular degeneration (AMD) with retinal pigment epithelial... (Meta-Analysis)
Meta-Analysis
Comparative efficacy of aflibercept and ranibizumab in the treatment of age-related macular degeneration with retinal pigment epithelial detachment: a systematic review and network meta-analysis.
OBJECTIVES
To evaluate the efficacy of anti-vascular endothelial growth factor (VEGF) in treatment of age-related macular degeneration (AMD) with retinal pigment epithelial detachment (PED).
METHODS
Systematic review identifying studies comparing intravitreal ranibizumab (IVR), intravitreal aflibercept (IVA) and intravitreal conbercept (IVC) published before Mar 2022.
RESULTS
One randomized controlled trial and 6 observational studies were selected for meta-analysis (1,069 patients). The change of best corrected visual acuity (BCVA) in IVA 2.0 mg group was better than IVR 0.5 mg (average difference 0.07) and IVR 2.0 mg (average difference 0.10), the differences were statistically significant. The change of the height of PED in IVA 2.0 group was better than IVR 0.5 group (average difference 45.30), the difference was statistically significant. The proportion of patients without PED at last visit in IVA 2.0 group were better than those in IVR 2.0 group (hazard ratio 1.91), the difference was statistically significant. There was no significant difference compared with IVR 0.5 group (hazard ratio 1.45). IVA required fewer injections than IVR, with a mean difference of -1.58.
CONCLUSIONS
IVA appears to be superior to IVR in improvement of BCVA, height decrease of PED and regression of PED with less injections in nAMD with PED.
Topics: Humans; Ranibizumab; Angiogenesis Inhibitors; Retinal Detachment; Network Meta-Analysis; Vascular Endothelial Growth Factor A; Retinal Pigment Epithelium; Retrospective Studies; Receptors, Vascular Endothelial Growth Factor; Recombinant Fusion Proteins; Intravitreal Injections; Macular Degeneration
PubMed: 37990182
DOI: 10.1186/s12886-023-03214-7 -
Translational Vision Science &... Sep 2023The aim of this study was to compare the safety and efficacy of trabeculectomy alone or combined with intravitreal injections of anti-vascular endothelial growth factor... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The aim of this study was to compare the safety and efficacy of trabeculectomy alone or combined with intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) agents for the treatment of neovascular glaucoma.
METHODS
We conducted a systematic review and meta-analysis to compare the effects of trabeculectomy alone or combined with intravitreal injections of anti-VEGF agents for the treatment of neovascular glaucoma. We searched four databases (PubMed, Cochrane Library, Embase, and Web of Science) up to January 2023 and extracted data on three surgical outcomes: postoperative intraocular pressure, success rate and complications. We used a random-effects model to calculate pooled relative risk (RR) or standardized mean difference (SMD) estimates and 95% confidence intervals (CIs). We assessed publication bias using Begg and Egger tests.
RESULTS
We included seven studies with 353 eyes. Compared to trabeculectomy alone, trabeculectomy with anti-VEGF had a lower risk of postoperative complications (RR, 0.60; 95% CI, 0.41-0.89) and higher success rate (RR, 1.19; 95% CI, 1.02-1.40). The intraocular pressure reduction was significantly greater in the trabeculectomy with anti-VEGF augmentation group than the trabeculectomy group from 1 week (SMD, -1.36; 95% CI, -2.76 to 0.04) to 6 months (SMD, -0.79; 95% CI, -1.50 to -0.07) after surgery.
CONCLUSIONS
According to current evidence, adding intravitreal injection of anti-VEGF agents to trabeculectomy may improve the short time outcomes of patients with neovascular glaucoma.
Topics: Humans; Trabeculectomy; Glaucoma, Neovascular; Eye; Tonometry, Ocular; Intraocular Pressure
PubMed: 37728893
DOI: 10.1167/tvst.12.9.12 -
Medicine Aug 2023Small incision lenticule extraction (SMILE) and femtosecond laser in situ keratomileusis (FS-LASIK) have been extensively studied as the main surgical methods for... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Small incision lenticule extraction (SMILE) and femtosecond laser in situ keratomileusis (FS-LASIK) have been extensively studied as the main surgical methods for corneal refractive surgery. However, there is no consensus on whether SMILE is superior to FS-LASIK in corneal biomechanics. Therefore, this systematic review and meta-analysis used the results of ocular response analyzer and corvis ST to explore whether SMILE is superior to FS-LASIK in corneal biomechanics.
METHODS
The literature was searched in PubMed, EMBASE, and Controlled Trials Register databases. The Cochrane Collaboration's "risk of bias" tool was used to evaluate the quality of the included randomized clinical trials, and the Newcastle-Ottawa Scale was used to evaluate the included non-randomized controlled trials. The results were analyzed using Revman 5.3.
RESULTS
Sixteen studies (3 randomized clinical trials and 13 non-randomized controlled trials) were included in this meta-analysis. There was no statistical difference in corneal biomechanics between SMILE and FS-LASIK in corneal hysteresis [mean difference (MD), 0.20; 95% confidence interval (CI): -0.09, 0.49; P = .18] and corneal resistant factor (MD, 0.31; 95% CI: -0.09, 0.71; P = .13), A1 time (MD, -0.02; 95% CI: -0.11, 0.07; P = .66), A1 length (MD, 0.01; 95% CI: -0.01, 0.03; P = .42), A1 velocity (MD, 0.00; 95% CI: -0.01, 0.01; P = .85), A2 velocity (MD, -0.01; 95% CI: -0.11, 0.09; P = .86), HC time (MD, 0.12; 95% CI: -0.13, 0.38; P = .35), The stiffness parameter at first applanation (MD, -7.91; 95% CI: -17.96, 2.14; P = .12), The ratio between the deformation amplitude 2 mm away from apex and the apical deformation (MD, 0.01; 95% CI: -0.26, 0.27; P = .96).
CONCLUSION
A comprehensive assessment of the parameters of ocular response analyzer and corvis ST showed that SMILE is not superior to LASIK in corneal biomechanics 3 months post-surgery.
Topics: Humans; Keratomileusis, Laser In Situ; Biomechanical Phenomena; Myopia; Cornea; Prospective Studies; Surgical Wound; Corneal Stroma
PubMed: 37565903
DOI: 10.1097/MD.0000000000034580 -
BMC Ophthalmology Nov 2023Vitreoretinal lymphoma (VRL) is usually treated with a combination of intraocular methotrexate (ioMTX), high-dose intravenous methotrexate (HD-MTX), or local... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Vitreoretinal lymphoma (VRL) is usually treated with a combination of intraocular methotrexate (ioMTX), high-dose intravenous methotrexate (HD-MTX), or local radiotherapy (RT) as the first options. The effectiveness and safety of monotherapy like bruton's tyrosine kinase inhibitors (BTKi) for PVRL remain uncertain.
METHODS
A systematic review and meta-analysis of clinical trial data and conference abstracts in VRL patients treated with first-line combination therapy or monotherapy were conducted through a search of PubMed, Embase, and Scopus databases until December 2022. A total of 24 studies comprising 517 patients were included, and survival data were extracted from 279 patients due to inconsistent units across studies.
RESULTS
The combined treatment group used ioMTX + chemotherapy (in 4 studies), RT + chemotherapy (in 2 studies), ioMTX/HD-MTX based regimen (in 2 studies), ioMTX + RT + chemotherapy (in 2 studies), ioMTX + lenalidomide/BTKi (in 2 studies) and combination of multiple therapies (in 7 studies). The monotherapy group was mainly treated with oral monotherapies such as BTKi. The combination therapy had a higher overall response rate (ORR) and complete response rate (CRR) than monotherapy (ORR: 96% vs. 72%, CRR: 92% vs. 63%). Combination therapy also resulted in a longer median progression-free survival (28.8 months vs. 13 months, p = 0.012). However, the combination therapy group had more severe side effects (grade 3/4 toxicity) than the monotherapy group (45% vs. 8%).
CONCLUSION
The study showed combination therapy had better OR and CR rates, longer survival, and more toxicity than monotherapy. While BTK inhibitors were well-tolerated, long-term effectiveness needs confirmation from prospective studies. In addition, given the small number of studies of monotherapy for VRL, more studies are needed to validate its effects.
TRIAL REGISTRATION
CRD42023400305.
Topics: Humans; Methotrexate; Retinal Neoplasms; Prospective Studies; Vitreous Body; Central Nervous System Neoplasms; Lymphoma
PubMed: 37993841
DOI: 10.1186/s12886-023-03226-3