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PeerJ 2022Bodily state is theorised to play a role in perceptual scaling of the environment, whereby low bodily capacity shifts visuospatial perception, with distances appearing... (Meta-Analysis)
Meta-Analysis
Does who I am and what I feel determine what I see (or say)? A meta-analytic systematic review exploring the influence of real and perceived bodily state on spatial perception of the external environment.
BACKGROUND
Bodily state is theorised to play a role in perceptual scaling of the environment, whereby low bodily capacity shifts visuospatial perception, with distances appearing farther and hills steeper, and the opposite seen for high bodily capacity. This may play a protective role, where perceptual scaling discourages engaging with the environment when capacity is low.
METHODOLOGY
Our protocol was pre-registered Open Science Framework (https://osf.io/6zya5/) with all amendments to the protocol tracked. We performed a systematic review and meta-analysis examining the role of bodily state/capacity on spatial perception measures of the environment. Databases (Medline, PsychINFO, Scopus, Embase, and Emcare) and grey literature were searched systematically, inclusive to 26/8/21. All studies were assessed using a customised Risk of Bias form. Standard mean differences and 95% CIs were calculated meta-analysis using a random-effects model.
RESULTS
A total of 8,034 studies were identified from the systematic search. Of these, 68 experiments (3,195 participants) met eligibility and were included in the review. These were grouped into the following categories: fatigue; pain; age; embodiment; body size/body paty size; glucose levels; fitness; and interoception, and interoceptive accuracy. We found low level evidence (limited studies, high risk of bias) for the effect of bodily state on spatial perception. There was consistent evidence that both glucose manipulations and age influence spatial perception of distances and hills in a hypothesised direction (lower capacity associated with increased distance and hill steepness). Mixed evidence exists for the influence of external loads, embodiment, body/body-part size manipulations, pain, and interoceptive accuracy. Evidence for fitness and/or fatigue influencing spatial perception was conflicting; notably, methodological flaws with fitness and fatigue paradigms and heterogenous spatial perception measures may underlie null/conflicting results.
CONCLUSION
We found limited evidence for bodily state influencing spatial perception of the environment. That all studies had high risk of bias makes conclusions about reported effects reflecting actual perceptual shifts ( merely reflecting experimental demands or error due to inadequate study design) pre-emptive. Rigorous evaluation is needed to determine whether reported effects reflect more than bias (., experimental demands, inadequate blinding). Future work using reliable measures of spatial perception, comprehensive evaluation of relevant confounders, and methodologically robust (and experimentally confirmed) bodily state experimental paradigms is warranted.
Topics: Humans; Space Perception; Emotions; Pain; Exercise; Fatigue
PubMed: 35646484
DOI: 10.7717/peerj.13383 -
Eye (London, England) Apr 2021We performed a systematic review and meta-analysis to assess the efficacy and safety of the mineralocorticoid receptor antagonist (MRA) treatment for central serous... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
We performed a systematic review and meta-analysis to assess the efficacy and safety of the mineralocorticoid receptor antagonist (MRA) treatment for central serous chorioretinopathy (CSC).
METHODS
We searched the PubMed, Embase, and the Cochrane Library to identify relevant clinical studies published prior to March 2020. The primary outcome was change in best-corrected visual acuity (BCVA), and the secondary outcomes included the subretinal fluid (SRF), subfoveal choroidal thickness (SFCT), and central macular thickness (CMT).
RESULTS
Five randomized controlled trials (RCT) and four cohort studies met the inclusion criteria with a total of 352 eyes. The MRA treatment was not superior to placebo in BCVA at 1 month (WMD = -0.06, 95% CI -0.15-0.02, P = 0.15, I = 86%), 3 months (WMD = -0.04, 95% CI -0.14-0.06, P = 0.44, I = 77%) and 6 months (WMD = -0, 95% CI -0.05-0.05, P = 0.92, I = 0%). The MRA treatment resulted in significant reduction than the placebo in the SRF (WMD = -60.64, 95% CI -97.91 to -23.37, P = 0.001, I = 49%), SFCT (WMD = -39.15, 95% CI -52.58 to -25.72, P < 0.001, I = 0%), and CMT (WMD = -60.75, 95% CI -97.85 to -23.65, P = 0.01, I = 53%).
CONCLUSIONS
Our meta-analysis shows that the MRA treatment can improve anatomical structure in CSC patients, but it is not effective for achieving BCVA gain. The applicant of the MRA is safe and have no severe effect.
Topics: Central Serous Chorioretinopathy; Humans; Mineralocorticoid Receptor Antagonists; Subretinal Fluid; Tomography, Optical Coherence; Treatment Outcome; Visual Acuity
PubMed: 33414535
DOI: 10.1038/s41433-020-01338-4 -
BMC Oral Health Mar 2022Supportive periodontal therapy (SPT) is the key for a stable periodontal health following active treatment. Likewise, implant maintenance is crucial following implant... (Meta-Analysis)
Meta-Analysis
Efficacy of air polishing in comparison with hand instruments and/or power-driven instruments in supportive periodontal therapy and implant maintenance: a systematic review and meta-analysis.
BACKGROUND
Supportive periodontal therapy (SPT) is the key for a stable periodontal health following active treatment. Likewise, implant maintenance is crucial following implant placement. This systematic review aimed to assess clinical outcomes, patients' perception, and cost-effectiveness of repeated periodontal therapy with air polishing devices (APDs) in comparison with hand instruments and/or power-driven instruments (conventional interventions) in SPT and implant maintenance.
METHODS
Electronic search for randomised controlled clinical trials with minimum 6 months follow-up for SPT and implant maintenance programme was conducted for data published from 01 January 2000 to 30 April 2020 using multiple databases and hand searching. Risk of bias was assessed using the Revised Cochrane Risk-of-Bias tool (RoB 2).
RESULTS
A total of 823 articles were screened. 4 SPT and 2 implant maintenance studies were eligible for inclusion. For SPT, repeated APDs interventions revealed no statistically significant difference when compared to the conventional interventions (weighted mean difference [WMD] 0.11 mm, p = 0.08). Likewise, no statistical difference was noted in terms of percentage of bleeding on probing (BOP) and clinical attachment level (CAL) gain. APDs were associated with lower pain score (based on Visual Analogue Scale) and higher patient acceptance in SPT studies. For implant maintenance, APDs resulted in reduction in PPD and percentage of BOP. However, CAL gain was comparable between the two groups. In terms of patient reported outcomes, no implant maintenance studies recorded any forms of patient reported outcomes. In addition, no studies reported on economic evaluation of APDs in both SPT and implant maintenance.
CONCLUSION
Within the limitations of this systematic review and meta-analysis, repeated subgingival debridement using APDs in SPT resulted in similar clinical outcomes but better patients' comfort when compared to the conventional interventions. For implant maintenance, there is limited evidence to show that repeated application of APDs leads to improved clinical outcomes when compared to conventional treatments.
Topics: Dental Implants; Dental Polishing; Dental Scaling; Humans
PubMed: 35321688
DOI: 10.1186/s12903-022-02120-6 -
Survey of Ophthalmology 2022The COVID-19 pandemic disrupted the regular injections of anti-vascular endothelial growth factor (anti-VEGF) in patients with various retinal diseases globally. It is... (Meta-Analysis)
Meta-Analysis Review
Delayed anti-VEGF injections during the COVID-19 pandemic and changes in visual acuity in patients with three common retinal diseases: A systematic review and meta-analysis.
The COVID-19 pandemic disrupted the regular injections of anti-vascular endothelial growth factor (anti-VEGF) in patients with various retinal diseases globally. It is unclear to what extent delayed anti-VEGF injections have worsened patients' visual acuity. We performed a meta-analysis to assess the impact of delayed anti-VEGF injections on the best-corrected visual acuity (BCVA) in patients with neovascular age-related macular degeneration (nAMD), retinal vein occlusion (RVO), and diabetic macular edema (DME). We searched four computer databases (EMBASE, MEDLINE, Web of Science, Scopus) from inception to January 5, 2022. Data were pooled using the random-effects model. Results were reported by less than 4 months and 4 months or longer for the time period between the first injection during the pandemic and the last pre-pandemic injection. All BCVA measures were converted to the logarithm of the minimum angle of resolution (logMAR) for analyses. Among patients who received injections 4 months or longer apart, the mean difference in BCVA was 0.10 logMAR (or 5 ETDRS letters) (95% confidence interval [CI] 0.06∼0.14) for nAMD patients, 0.01 logMAR (or∼ 1 ETDRS letter) (95% CI -0.25∼0.27) for RVO patients, and 0.03 logMAR (or ∼1 ETDRS letters) (95% CI -0.06∼0.11) for DME patients. These results suggest that patients with nAMD needing scheduled anti-VEGF injections may require priority treatment over those with RVO and DME in the event of disturbed anti-VEGF injections from COVID-19 lockdowns or similar scenarios.
Topics: Angiogenesis Inhibitors; Bevacizumab; COVID-19; Communicable Disease Control; Diabetic Retinopathy; Endothelial Growth Factors; Humans; Intravitreal Injections; Macular Edema; Pandemics; Ranibizumab; Retinal Diseases; Retinal Vein Occlusion; Vascular Endothelial Growth Factor A; Visual Acuity
PubMed: 35970234
DOI: 10.1016/j.survophthal.2022.08.002 -
Frontiers in Endocrinology 2022Changes in fundus signs and loss of visual acuity are an important basis for screening and treating diabetic patients with retinopathy, and conventional Western medicine... (Meta-Analysis)
Meta-Analysis
Effect of Chinese herbal compounds on ocular fundus signs and vision in conventional treated-persons with non-proliferative diabetic retinopathy: A systematic review and meta-analysis.
BACKGROUND
Changes in fundus signs and loss of visual acuity are an important basis for screening and treating diabetic patients with retinopathy, and conventional Western medicine is moderately effective in treating diabetic retinopathy(DR),To systematically evaluate the effectiveness and safety of Chinese herbal compounds(CHCs) in the combined treatment of diabetic retinopathy.
METHOD
Six electronic databases, including PubMed, were searched to screen eligible literature. Randomized controlled trials of non-proliferative diabetic retinopathy(NPDR) were included, in which the control group was treated with conventional Western-based drugs or retinal laser photocoagulation, and the intervention group was treated with CHCs in combination based on the control group.The Cochrane Risk of Bias Assessment Tool was used to evaluate the quality of the literature, and the RevMan 5.4 software was used for statistical analysis.
RESULTS
Compared with Conventional group alone,CHCs group was superior at improving clinical efficacy [RR=1.29, 95%CI=(1.23, 1.36),P<0.01] and best corrected visual acuity(BCVA) [MD=0.10,95%CI=(0.09,0.12),P<0.01],it was also superior at reducing the number of microangiomas [MD=-2.37, 95%CI=(-3.26, -1.49),P<0.01], microangioma volume [MD=-4.72, 95%CI=(-5.14, -4.29), P<0.01], hemorrhagic spots [MD=-2.05, 95%CI=(-2.51,-1.59), P<0.01], hemorrhagic area [MD=-0.76, 95%CI=(-1.06, -0.47), P<0.01], hard exudates [MD= -1.86, 95%CI=(-2.43, -1.28), P<0.01], cotton lint spots [MD= -0.93, 95%CI= (-1.31, -0.55), P<0.01], central macular thickness(CMT) [SMD=-1.52, 95%CI=(-1.85, -1.19),P<0.01], Chinese medicine evidence score [SMD=-1.33,95%CI=(-1.58, -1.08),P<0.01], fasting blood glucose (FBG) [SMD=-0.47, 95%CI=(-0.61,-0.33),P<0.01], 2h postprandial blood glucose(2hPBG) [SMD=-0.87, 95% CI=(-1.06, -0.67), P<0.01], glycosylated hemoglobin (HbAlc) [SMD=-0.76, 95%CI=(-1.16, -0.3),P<0.01], total cholesterol(TC) [SMD=-0.33,95%CI=(-0.51,-0.16),P<0.01],and CHCs group with less adverse events occurred [RR=0.46, 95%CI=(0.29, 0.74),P<0.01].
CONCLUSION
CHCs combined with conventional medicine for NPDR has better clinical efficacy and higher safety, but the above findings need further validation in more large sample, multicenter, and low-bias RCTs due to the limitation of the quality and quantity of included literature.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/, identifier CRD42022342137.
Topics: Blood Glucose; China; Diabetes Mellitus; Diabetic Retinopathy; Humans; Laser Coagulation; Multicenter Studies as Topic; Visual Acuity
PubMed: 36034416
DOI: 10.3389/fendo.2022.977971 -
Brain Sciences Nov 2022The present review aims to explore the use of Immersive Virtual Reality (IVR) in the treatment of visual perception in Unilateral Spatial Neglect (USN) after a stroke.... (Review)
Review
The present review aims to explore the use of Immersive Virtual Reality (IVR) in the treatment of visual perception in Unilateral Spatial Neglect (USN) after a stroke. PubMed, Scopus, Embase and Pedro databases were searched, from inception to 1 February 2022. All studies that investigated the effect of IVR on USN, such as outcome in the stroke population, have been included. The current comprehensive systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations and was registered in the PROSPERO database [CRD42022311284]. Methodological quality was assessed through JBI critical appraisal tool. A total of 436 articles were identified through the database searches. A total of 10 articles, with a heterogeneous study design, which involved 77 patients with USN with low-to-moderate methodological quality, have been selected. Five out the included studies tested usability of IVR for assessed or treated visual perception deficits in USN, comparing the results with 134 healthy subjects. In the rest of studies that tested IVR such as treatment, three showed statistical positive results (p < 0.05) in visual perception outcome. To date, the literature has suggested the potential benefits in the use of IVR for the treatment of visual perception disorders in USN. Interestingly, IVR motivates patients during the rehabilitation process improving compliance and interest. The heterogeneity in the studies’ design and in IVR treatments indicate the need of future investigations in the consideration of potentiality and low-cost of this technology.
PubMed: 36421913
DOI: 10.3390/brainsci12111589 -
The Cochrane Database of Systematic... Jun 2020Infectious keratitis is an infection of the cornea that can be caused by bacteria, viruses, fungi, protozoa, or parasites. It may be associated with ocular surgery,... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Infectious keratitis is an infection of the cornea that can be caused by bacteria, viruses, fungi, protozoa, or parasites. It may be associated with ocular surgery, trauma, contact lens wear, or conditions that cause deficiency or loss of corneal sensation, or suppression of the immune system, such as diabetes, chronic use of topical steroids, or immunomodulatory therapies. Photoactivated chromophore for collagen cross-linking (PACK-CXL) of the cornea is a therapy that has been successful in treating eye conditions such as keratoconus and corneal ectasia. More recently, PACK-CXL has been explored as a treatment option for infectious keratitis.
OBJECTIVES
To determine the comparative effectiveness and safety of PACK-CXL with standard therapy versus standard therapy alone for the treatment of bacterial keratitis.
SEARCH METHODS
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2019, Issue 7); Ovid MEDLINE; Embase.com; PubMed; Latin American and Caribbean Health Science Information database (LILACS); ClinicalTrials.gov; and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). We did not use any date or language restrictions in the electronic search for trials. We last searched the electronic databases on 8 July 2019.
SELECTION CRITERIA
We included randomized controlled trials (RCTs), quasi-RCTs, and controlled clinical trials (CCTs) of PACK-CXL for bacterial keratitis. We included quasi-RCTs and CCTs as we anticipated that there would not be many RCTs eligible for inclusion.
DATA COLLECTION AND ANALYSIS
Two review authors working independently selected studies for inclusion in the review, assessed trials for risk of bias, and extracted data. The primary outcome was proportion of participants with complete healing at four to eight weeks. Secondary outcomes included visual acuity, morphology, adverse events, and treatment failure at four to eight weeks.
MAIN RESULTS
We included three trials (two RCTs and one quasi-RCT) in this review for a total of 59 participants (59 eyes) with bacterial keratitis. Trials were all single-center and were conducted in Egypt, Iran, and Thailand between 2010 and 2014. It is very uncertain whether PACK-CXL with standard antibiotic therapy is more effective than standard antibiotic therapy alone for re-epithelialization and complete healing (risk ratio (RR) 1.53, 95% confidence interval (CI) 0.88 to 2.66; participants = 15). We judged the certainty of the evidence to be very low due to the small sample size and high risk of selection and performance bias. The high risk of selection bias reflects the overall review. Masking of participants was not possible for the surgical arm. No participant had a best-corrected visual acuity of 20/100 or better at eight weeks (very low certainty evidence). There is also no evidence that use of PACK-CXL with standard therapy results in fewer instances of treatment failure than standard therapy alone (RR 0.50, 95% CI 0.05 to 4.98; participants = 32). We judged the certainty of evidence to be low due to the small sample size and high risk of selection bias. There were no adverse events reported at 14 days (low certainty evidence). Data on other outcomes, such as visual acuity and morphological characteristics, could not be compared because of variable time points and specific metrics.
AUTHORS' CONCLUSIONS
The current evidence on the effectiveness of PACK-CXL for bacterial keratitis is of low certainty and clinically heterogenous in regard to outcomes. There are five ongoing RCTs enrolling 1136 participants that may provide better answers in the next update of this review. Any future research should include subgroup analyses based on etiology. A core outcomes set would benefit healthcare decision-makers in comparing and understanding study data.
Topics: Anti-Bacterial Agents; Collagen; Eye Infections, Bacterial; Humans; Keratitis; Photosensitizing Agents; Randomized Controlled Trials as Topic; Riboflavin; Ultraviolet Therapy; Visual Acuity
PubMed: 32557558
DOI: 10.1002/14651858.CD013001.pub2 -
Annals of Palliative Medicine Feb 2022Surgical treatment is the primary intervention for cataracts. Extracapsular cataract extraction (ECCE) is a routine surgery for cataracts, phacoemulsification (PE) is... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Surgical treatment is the primary intervention for cataracts. Extracapsular cataract extraction (ECCE) is a routine surgery for cataracts, phacoemulsification (PE) is another procedure with a small incision and injury area. This study investigated the comparison of the effects of these two procedures on the patient's visual acuity.
METHODS
Embase, PubMed, Cochrane Library, and SpringerLink databases were searched from January 2000 to August 2021 to obtain randomized controlled trial (RCT) studies of PE and ECCE procedures for cataract in English. After the initial screening, Revman 5.4 software was used for the meta-analysis.
RESULTS
This meta-analysis included a total of eight articles with 1,015 affected eyes. The results showed that the rate of good final visual acuity in the PE group was higher than that in the ECCE group [odds ratio (OR) =2.94, 95% confidence interval (CI): 2.17-3.99, P<0.00001], the incidence of vitreous Loss during PE surgery was lower than that in ECCE surgery (OR =0.16, 95% CI: 0.04-0.64, P=0.01), as was the incidence of capsular tear (OR =0.29, 95% CI: 0.10-0.85, P=0.02), the incidence of capsule opacification after surgery (OR =0.20, 95% CI: 0.08-0.53, P=0.001), and the incidence of cystoid macular edema after surgery (OR =0.16, 95% CI: 0.04-0.74, P=0.02).
DISCUSSION
Compared with ECCE, PE demonstrates an improvement in postoperative visual acuity and has fewer complications for cataract patients.
Topics: Cataract; Cataract Extraction; Humans; Phacoemulsification; Postoperative Complications; Visual Acuity
PubMed: 35249333
DOI: 10.21037/apm-21-3633 -
JAMA Ophthalmology Jun 2022The association between residual subretinal fluid (SRF) and intraretinal fluid (IRF) and visual acuity following anti-vascular endothelial growth factor (VEGF) treatment... (Meta-Analysis)
Meta-Analysis
Association Between Visual Acuity and Residual Retinal Fluid Following Intravitreal Anti-Vascular Endothelial Growth Factor Treatment for Neovascular Age-Related Macular Degeneration: A Systematic Review and Meta-analysis.
IMPORTANCE
The association between residual subretinal fluid (SRF) and intraretinal fluid (IRF) and visual acuity following anti-vascular endothelial growth factor (VEGF) treatment is not well understood.
OBJECTIVE
To examine the association of residual retinal fluid, SRF, and IRF with visual acuity following anti-VEGF treatment in patients with neovascular age-related macular degeneration (nAMD).
DATA SOURCES
A systematic literature search was performed from January 2005 to August 2021 using Ovid MEDLINE, Embase, and the Cochrane Library.
STUDY SELECTION
Peer-reviewed articles reporting on visual acuity stratified by the presence or absence of any residual SRF, IRF, or any retinal fluid at last study observation after intravitreal bevacizumab, ranibizumab, aflibercept, or brolucizumab in patients with nAMD were included. Studies that were noncomparative, included fewer than 10 eyes, or reported on other anti-VEGF agents were excluded.
DATA EXTRACTION AND SYNTHESIS
Two independent reviewers conducted data extraction and synthesis. The Cochrane risk of bias tool 2 and ROBINS-I were used to assess risk of bias and GRADE evaluation was conducted to assess certainty of evidence.
MAIN OUTCOMES AND MEASURES
Primary outcomes were BCVA at last study observation, change in BCVA from baseline, and retinal thickness at last study observation.
RESULTS
In this systematic review and meta-analysis, 11 studies (6 randomized clinical trials [RCTs]) comprising 3092 eyes were included in our analysis. Across all included studies, the BCVA of eyes with residual SRF was better than eyes without SRF (weighted mean difference [WMD], 3.1 letter score; 95% CI, 0.05 to 6.18; P = .05; GRADE, low certainty of evidence; 6 studies; 1931 eyes) but similar in RCTs (WMD, 2.7 letter score; 95% CI, -2.40 to 7.84; P = .30; GRADE, low certainty of evidence; 3 studies; 1406 eyes). The BCVA of eyes with residual IRF was worse than that of eyes without IRF (WMD, -8.2 letter score; 95% CI, -11.79 to -4.50; P < .001; GRADE, low; 7 studies; 2114 eyes).
CONCLUSIONS AND RELEVANCE
The findings suggest that the presence of residual SRF was associated with slightly better BCVA at last study observation; however, baseline differences in BCVA existed and this conclusion was primarily driven by 1 study. The presence of residual IRF was associated with substantially worse BCVA at last study observation and less improvement of BCVA from baseline. The conclusions are limited by the inclusion of data from observational studies, heterogeneity, and a low certainty of evidence.
Topics: Angiogenesis Inhibitors; Humans; Intravitreal Injections; Macular Degeneration; Ranibizumab; Receptors, Vascular Endothelial Growth Factor; Retina; Tomography, Optical Coherence; Vascular Endothelial Growth Factor A; Visual Acuity; Wet Macular Degeneration
PubMed: 35551359
DOI: 10.1001/jamaophthalmol.2022.1357 -
Psychonomic Bulletin & Review Oct 2022Peripheral vision is fundamental for many real-world tasks, including walking, driving, and aviation. Nonetheless, there has been no effort to connect these applied... (Review)
Review
Peripheral vision is fundamental for many real-world tasks, including walking, driving, and aviation. Nonetheless, there has been no effort to connect these applied literatures to research in peripheral vision in basic vision science or sports science. To close this gap, we analyzed 60 relevant papers, chosen according to objective criteria. Applied research, with its real-world time constraints, complex stimuli, and performance measures, reveals new functions of peripheral vision. Peripheral vision is used to monitor the environment (e.g., road edges, traffic signs, or malfunctioning lights), in ways that differ from basic research. Applied research uncovers new actions that one can perform solely with peripheral vision (e.g., steering a car, climbing stairs). An important use of peripheral vision is that it helps compare the position of one's body/vehicle to objects in the world. In addition, many real-world tasks require multitasking, and the fact that peripheral vision provides degraded but useful information means that tradeoffs are common in deciding whether to use peripheral vision or move one's eyes. These tradeoffs are strongly influenced by factors like expertise, age, distraction, emotional state, task importance, and what the observer already knows. These tradeoffs make it hard to infer from eye movements alone what information is gathered from peripheral vision and what tasks we can do without it. Finally, we recommend three ways in which basic, sport, and applied science can benefit each other's methodology, furthering our understanding of peripheral vision more generally.
Topics: Automobile Driving; Eye Movements; Humans; Vision, Ocular; Visual Perception
PubMed: 35581490
DOI: 10.3758/s13423-022-02117-w