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Graefe's Archive For Clinical and... Jun 2024Corneal collagen crosslinking (CXL) is the primary treatment for progressive keratoconus which has a significant impact on vision and quality of life. Our study aimed to... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Corneal collagen crosslinking (CXL) is the primary treatment for progressive keratoconus which has a significant impact on vision and quality of life. Our study aimed to compare the efficacy and safety of epithelium-on versus epithelium-off CXL to treat keratoconus.
METHODS
We searched PubMed, Medline, Embase, Web of Science, and Scopus databases. We included studies that compared standard epithelium-off with epithelium-on CXL. The primary outcome measures were changes in corrected distance visual acuity (CDVA) and maximum keratometry (Kmax), and the secondary outcomes were uncorrected distance visual acuity (UDVA), central corneal thickness (CCT), and adverse events. A meta-analysis was performed on the primary and secondary outcomes based on the weighted mean differences between baseline to 12-month follow-up.
RESULTS
The search retrieved 887 publications with 27 included in the systematic review. A total of 1622 eyes (1399 patients; age 25.51 ± 4.02 years) were included in comparisons of epithelium-off to epithelium-on CXL in keratoconus. Epithelium-off CXL treated 800 eyes and epithelium-on CXL for 822 eyes. At 12-month follow-up, CDVA and Kmax showed no significant difference between the epithelium-off and epithelium-on CXL. The secondary outcomes showed that UDVA was better in epithelium-off CXL (- 0.11D, 95% CI - 0.12, - 0.1; p < 0.001) and there was more thinning in CCT in epithelium-off CXL (- 3.23 μm, 95% CI - 4.64, - 1.81; p <0.001).
CONCLUSION
Epithelium-off and epithelium-on CXL were both effective to treat progressive keratoconus. Further research is needed to compare the long-term outcomes and safety of both CXL protocols for adaptation into clinical practice.
Topics: Keratoconus; Humans; Cross-Linking Reagents; Collagen; Photosensitizing Agents; Epithelium, Corneal; Photochemotherapy; Visual Acuity; Riboflavin; Ultraviolet Rays; Corneal Topography; Corneal Stroma
PubMed: 37938377
DOI: 10.1007/s00417-023-06287-8 -
BMC Women's Health Jul 2023Obesity is a pressing public health risk issue worldwide. Women, in particular, face a higher risk of obesity. Recent research has highlighted the association between... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Obesity is a pressing public health risk issue worldwide. Women, in particular, face a higher risk of obesity. Recent research has highlighted the association between obesity and female sexual dysfunction. Therefore, the objective of this study is to investigate the global prevalence of sexual dysfunction in obese and overweight women through a systematic review and meta-analysis.
METHODS
In this study, a systematic search was conducted across electronic databases, including PubMed, Scopus, Web of Science, Embase, ScienceDirect, and Google Scholar. The search aimed to identify studies published between December 2000 and August 2022 that reported metabolic syndrome's impact on female sexual dysfunction.
RESULTS
The review included nine studies with a sample size of 1508 obese women. The I heterogeneity index indicated high heterogeneity (I: 97.5). As a result, the random effects method was used to analyze the data. Based on this meta-analysis, the prevalence of sexual dysfunction in women with obesity was reported as 49.7% (95%CI: 35.8-63.5). Furthermore, the review comprised five studies involving 1411 overweight women. The I heterogeneity test demonstrated high heterogeneity (I: 96.6). Consequently, the random effects model was used to analyze the results. According to the meta-analysis, the prevalence of sexual dysfunction in overweight women was 26.9% (95% CI: 13.5-46.5).
CONCLUSION
Based on the results of this study, it has been reported that being overweight and particularly obese is an important factor affecting women's sexual dysfunction. Therefore, health policymakers must acknowledge the significance of this issue in order to raise awareness in society about its detrimental effect on the female population.
Topics: Female; Humans; Overweight; Prevalence; Sexual Dysfunction, Physiological; Obesity; Sexual Dysfunctions, Psychological
PubMed: 37454073
DOI: 10.1186/s12905-023-02544-4 -
BMC Public Health Aug 2023Despite being easily corrected with eyeglasses, over two-thirds of the world's child population presents with vision impairment (VI) due to uncorrected refractive...
BACKGROUND
Despite being easily corrected with eyeglasses, over two-thirds of the world's child population presents with vision impairment (VI) due to uncorrected refractive errors. While systematic reviews have shown that VI can significantly impact children's depression and anxiety, none have reviewed the existing literature on the association between spectacle correction and well-being. This review aims to address this knowledge gap.
MAIN OUTCOME MEASURES
The main outcome measures were i) cognitive and education well-being which included mathematics and english literacy, reading fluency, school function, academic performance and grades; ii) psychological and mental health well-being which included physical anxiety, learning anxiety and mental health test scores and iii) quality of life.
METHODS
We searched eight databases for articles published between 1999 to 2021 that assessed the associations between spectacle correction and children's (0 to 18 years) well-being. There were no restrictions on language or geographic location. Two reviewers independently screened all publications using validated quality checklists. The findings of the review were analysed using narrative synthesis. [PROSPERO CRD42020196847].
RESULTS
Of 692 records found in the databases, six randomised control trials, one cohort, one cross-sectional and one qualitative study (N = 9, 1.3%) were eligible for analysis. Data were collected from 25 522 children, 20 parents and 25 teachers across the nine studies. Seven were rated as good quality (67 to 100% of quality criteria fulfilled), and two were satisfactory (33 to 66% of quality criteria fulfilled). Spectacle correction was found to improve children's educational well-being (n = 4 very strong evidence; n = 2 strong evidence), quality of life (n = 1, very strong evidence) and decrease anxiety and increase mental health scores (n = 1, strong evidence).
CONCLUSION
Evidence suggests that spectacle correction improves children's cognitive and educational well-being, psychological well-being, mental health, and quality of life. More research is needed, given the paucity of published literature and the focus on only three aspects of well-being.
Topics: Humans; Child; Quality of Life; Cross-Sectional Studies; Eyeglasses; Educational Status; Anxiety
PubMed: 37596579
DOI: 10.1186/s12889-023-16484-z -
European Journal of Translational... Jan 2024The primary aim of this study was to systematically review and meta-analyze the impact of sensorimotor and proprioceptive exercises on balance in older adults. We also...
The primary aim of this study was to systematically review and meta-analyze the impact of sensorimotor and proprioceptive exercises on balance in older adults. We also sought to define how researchers describe proprioceptive and sensory-motor training and their respective protocols. The review was conducted following the PRISMA guidelines, with searches performed in March 2023. Both authors carried out independent searches using the PubMed and PEDro databases. From a total of 320 identified records, 12 studies were deemed eligible for meta-analysis after screening and removal of duplicates. The average PEDro score was 5.11 ± 1.11 indicating overall fair quality of studies. Common outcome measures included the Berg balance scale, Timed up and go test, Tinetti balance scale, Functional reach test and various single-leg stance tests. All outcomes were significantly improved by the interventions (standard mean difference = 0.65 - 1.29), with little difference between proprioceptive and sensorimotor training. However, the quality of evidence ranged from "very low" to "low" based on GRADE guidelines, suggesting further high-quality studies are needed. This review underscores the potential benefits of sensorimotor and proprioceptive exercises for enhancing balance in older adults, while also highlighting the ambiguity and inconsistency regarding the usage of the terms proprioceptive and sensorimotor training.
PubMed: 38213185
DOI: 10.4081/ejtm.2024.12010 -
International Ophthalmology Apr 2024To review all studies reporting the onset of white dot syndromes following COVID-19 vaccines. (Review)
Review
PURPOSE
To review all studies reporting the onset of white dot syndromes following COVID-19 vaccines.
METHODS
Our protocol was registered prospectively on PROSPERO [registration number: CRD42023426012]. We searched five different databases including PubMed, Scopus, Web of Science, Google Scholar, and Science Direct up to May 2023. All the studies that reported the occurrence of white dot syndrome following COVID-19 vaccines were included. All statistical tests were conducted with a 95% confidence interval and a 5% error margin. A p value of less than 0.05 was considered statistically significant. The methodological quality of included studies was performed using the IHE Quality Appraisal Checklist for Case Series studies and JBI Critical Appraisal Checklist for Case Reports.
RESULTS
Fifty studies involving seventy-one subjects were included. Multiple evanescent white dot syndrome (MEWDS) was the most common disease (n = 25, 35.2% %), followed by acute macular neuroretinopathy (AMN) (n = 22, 31.0%) and acute posterior multifocal placoid pigment epitheliopathy (APMPPE) (n = 4, 5.6%). They were mostly unilateral (n = 50, 70.4%). The presenting symptoms were blurred vision (n = 26, 36.6%), paracentral scotoma (n = 19, 26.8%), visual field disturbance, and photopsia (n = 7, 9.9%). The mean duration for follow-up was 10.15 ± 14.04 weeks. Nineteen subjects (29.69%) received steroids with improvement reported in 68.4%. Eleven subjects (17.19%) were managed by observation only with reported full recovery and improvement.
CONCLUSION
White dot syndromes are very rare entities. Our findings highlight a possible association between COVID-19 vaccines and the occurrence of white dot syndromes. However, larger studies with good quality should be implemented to confirm these findings.
Topics: Humans; COVID-19; COVID-19 Vaccines; SARS-CoV-2; Tomography, Optical Coherence; White Dot Syndromes
PubMed: 38652153
DOI: 10.1007/s10792-024-03119-4 -
Neuroprotective Strategies for Nonarteritic Anterior Ischemic Optic Neuropathy: A Systematic Review.Korean Journal of Ophthalmology : KJO Aug 2023Nonarteritic anterior ischemic optic neuropathy (NAION) is the second most common form of optic neuropathy. Most patients show no improvement over time. Until now, there...
PURPOSE
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.
METHODS
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.
RESULTS
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.
CONCLUSIONS
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.
Topics: Animals; Humans; Optic Neuropathy, Ischemic; Optic Disk; Neuroprotection; Visual Acuity; Tomography, Optical Coherence
PubMed: 37563973
DOI: 10.3341/kjo.2022.0166 -
Eye (London, England) Oct 2023Endothelial keratoplasty (EK) is a commonly performed transplant procedure used in the treatment of corneal endothelial dysfunction. The aim of this systematic review... (Meta-Analysis)
Meta-Analysis
BACKGROUND/OBJECTIVES
Endothelial keratoplasty (EK) is a commonly performed transplant procedure used in the treatment of corneal endothelial dysfunction. The aim of this systematic review and meta-analysis is to evaluate the differences in visual acuity outcomes, endothelial cell density (ECD) and complications between two forms of EK, ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) and Descemet membrane endothelial keratoplasty (DMEK).
METHODS
A literature search of MEDLINE, Embase and Cochrane Library was conducted to identify studies reporting comparative results of UT-DSAEK versus DMEK. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was used for search strategy. Of 141 titles, 7 studies met the inclusion criteria; best corrected visual acuity (BCVA) (LogMAR), ECD (cells/mm), and complications were compared, with all statistical analysis performed using Review Manager.
RESULTS
A total of 362 eyes were included for analysis. DMEK resulted in significantly better BCVA at 3 months (0.14 vs 0.22, p = 0.003), 6 months (0.08 vs 0.18, p = 0.005) and 1 year post-op (0.07 vs 0.14, p = 0.0005). UT-DSAEK resulted in significantly lower total complications (25.2% vs 57.3%, p = 0.0001) and rates of re-bubbling (11.0% vs 33.7%, p = 0.004). No differences were found in ECD between the two procedures (1541 vs 1605, p = 0.77).
CONCLUSIONS
DMEK results in superior visual acuity rates with quicker recovery. However, UT-DSAEK has a more favourable complication profile, particularly regarding lower rates of re-bubbling. Both are valuable options in the treatment of corneal endothelial disease and choice of procedure may depend on surgical expertise.
Topics: Humans; Descemet Membrane; Descemet Stripping Endothelial Keratoplasty; Corneal Diseases; Visual Acuity; Research Design; Retrospective Studies; Fuchs' Endothelial Dystrophy; Endothelium, Corneal
PubMed: 36934158
DOI: 10.1038/s41433-023-02467-2 -
BMC Ophthalmology Apr 2024To assess the efficacy and safety of various intraocular lenses (IOLs), including standard monofocal, bifocal, trifocal, extended depth of focus (EDOF), and enhanced... (Meta-Analysis)
Meta-Analysis
PURPOSE
To assess the efficacy and safety of various intraocular lenses (IOLs), including standard monofocal, bifocal, trifocal, extended depth of focus (EDOF), and enhanced monofocal IOLs, post-cataract surgery through a network meta-analysis.
METHODS
A systematic search of PubMed, Cochrane Library, and Web of Science was conducted to identify relevant studies from the past 5 years. Parameters such as binocular visual acuities, spectacle independence, contrast sensitivity (CS), and optical quality were used to evaluate efficacy and safety. Data from the selected studies were analyzed using Review Manager 5.4 and STATA 17.0 software.
RESULTS
Twenty-eight Randomized Controlled Trials (RCTs) comprising 2465 subjects were included. Trifocal IOLs exhibited superior uncorrected near visual acuity (UNVA) compared to monofocal IOLs (MD: -0.35; 95% CI: -0.48, -0.22). Both trifocal (AcrySof IQ PanOptix IOLs group MD: -0.13; 95% CI: -0.21, -0.06) and EDOF IOLs (MD: -0.13; 95% CI: -0.17, -0.09) showed better uncorrected intermediate visual acuity (UIVA) than monofocal IOLs. Trifocal IOLs ranked highest in spectacle independence at various distances (AT LISAtri 839MP group: SUCRA 97.5% for distance, 80.7% for intermediate; AcrySof IQ PanOptix group: SUCRA 83.0% for near).
CONCLUSIONS
For cataract patients who want to treat presbyopia, trifocal IOLs demonstrated better visual acuity and spectacle independence at near distances. Different types of trifocal IOL characteristics differ. EDOF and enhanced monofocal IOLs have improved visual quality at intermediate distances.Therefore, It is very important to select the appropriate IOLs based on the lens characteristics and patient needs.
Topics: Humans; Lens Implantation, Intraocular; Presbyopia; Refraction, Ocular; Patient Satisfaction; Lenses, Intraocular; Cataract; Prosthesis Design; Phacoemulsification; Randomized Controlled Trials as Topic
PubMed: 38627651
DOI: 10.1186/s12886-024-03446-1 -
Graefe's Archive For Clinical and... Aug 2023Retinal toxicity with long-term hydroxychloroquine (HCQ) treatment is a major concern. This systematic review aims to assess the application of optical coherence... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Retinal toxicity with long-term hydroxychloroquine (HCQ) treatment is a major concern. This systematic review aims to assess the application of optical coherence tomography angiography (OCTA) to detect microvascular alterations in patients under HCQ.
METHODS
PubMed, Scopus, Web of Science, and Cochrane Library databases were systematically searched until January 14, 2023. Studies using OCTA as a primary diagnostic method to evaluate the macular microvasculature of HCQ users were included. Primary outcomes were macular vessel density (VD) and foveal avascular zone (FAZ) at the superficial (SCP) and deep (DCP) capillary plexus. Meta-analysis was performed using a random-effects model.
RESULTS
Of 211 screened abstracts, 13 were found eligible, enrolling 989 eyes from 778 patients. High-risk patients due to longer duration of treatment presented lower VD in the retinal microvasculature than those with low-risk in SCP (P = 0.02 in fovea; P = 0.004 in parafovea) and in DCP (P = 0.007 in fovea; P = 0.01 in parafovea). When compared with healthy controls, HCQ users had lower VD in both plexus-no quantitative synthesis was presented.
CONCLUSIONS
Microvascular changes were found in autoimmune patients under HCQ treatment without any documented retinopathy. However, the evidence produced so far does not allow to draw conclusion concerning the effect of drug as studies were not controlled for disease duration.
Topics: Humans; Hydroxychloroquine; Fluorescein Angiography; Retinal Vessels; Tomography, Optical Coherence; Visual Acuity; Macula Lutea
PubMed: 36884062
DOI: 10.1007/s00417-023-06023-2 -
BMC Pediatrics Jan 2024Extracorporeal membrane oxygenation (ECMO) has been widely used in severe neonatal diseases for approximately 50 years, while few studies have concentrated on the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Extracorporeal membrane oxygenation (ECMO) has been widely used in severe neonatal diseases for approximately 50 years, while few studies have concentrated on the long-term follow-up of its neuropsychological development.
OBJECTIVE
To assess the long-term neuropsychological complications in children who underwent ECMO in infancy.
METHODS
The PubMed, Web of Science, Cochrane, and EMBASE databases were searched for retrieving studies published in the recent 10 years (until June 10, 2022). All studies were eligible that concentrated on the long-term follow-up of neuropsychological complications in neonates undergoing ECMO. Excluding animal studies, neonates with congenital craniocerebral dysplasia and studies with data from the same center performed at different times. Statistical analysis was performed using RevMan 5.3 and Stata/SE 12.0 software. A random-effects model was used to report results. The sensitivity analysis was utilized to identify sources of heterogeneity.
RESULTS
The meta-analysis of 10 studies that enrolled 1199 patients was conducted, showing the pooled morbidity of intelligence (pooled morbidity: 20.3%, 95% CI: 0.16-0.25, I: 9.5%, P=0.33), motor activity (pooled morbidity: 10.3%, 95%CI: 0.07-0.14, I: 43.5%, P=0.15), learning (pooled morbidity: 9.0%, 95%CI: -0.03-0.21, I: 63.2%, P=0.10), hearing (pooled morbidity: 15.7%, 95%CI: 0.02-0.29, I: 94.2%, P=0.00), vision (pooled morbidity: 18.5%, 95%CI: 0.12-0.25, I: 0%, P=0.46), cognition (pooled morbidity: 26.3%, 95%CI: 0.19-0.34, I: 0%, P=0.32), attention (pooled morbidity: 7.4%, 95%CI: 0.02-0.13, I: 38.9%, P=0.20), speed in attention (pooled morbidity: 69.9%, 95%CI: 0.62-0.78), and accuracy in attention (pooled morbidity: 39.0%, 95%CI: 0.30-0.48) in neonates undergoing ECMO. The results of the Begg's test and sensitivity analysis indicated that the heterogeneity was originated from factors other than sample size.
CONCLUSION
This systematic review and meta-analysis showed that neonates undergoing ECMO were associated with various neuropsychological complications. Additional randomized controlled trials (RCTs) with a larger sample size and a higher quality are needed.
Topics: Child; Humans; Infant, Newborn; Cognition; Extracorporeal Membrane Oxygenation; Follow-Up Studies; Hearing
PubMed: 38267850
DOI: 10.1186/s12887-024-04564-x