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Italian Journal of Pediatrics Oct 2023Retinopathy of prematurity (ROP) is typically treated with laser photocoagulation and/or intravitreal anti-vascular endothelial growth factor (anti-VEGF). To the best of... (Meta-Analysis)
Meta-Analysis
The efficacy and ocular safety following aflibercept, conbercept, ranibizumab, bevacizumab, and laser for retinopathy of prematurity: a systematic review and meta-analysis.
BACKGROUND
Retinopathy of prematurity (ROP) is typically treated with laser photocoagulation and/or intravitreal anti-vascular endothelial growth factor (anti-VEGF). To the best of our knowledge, most systematic reviews have focused on comparing anti-VEGF against laser treatment while comparisons between different anti-VEGF agents are lacking. Thus, we conducted this meta-analysis to compare the efficacy and safety of different anti-VEGF agents or laser after primary ROP therapy.
METHODS
We conducted a comprehensive search across multiple databases up to November 2022. We included studies that used anti-VEGF or laser for ROP with comparable cohorts.
RESULTS
Overall, 44 studies were included in this meta-analysis. When comparing anti-VGEF with laser, we found that the anti-VEGF group had a significantly higher retreatment rate (RR = 1.56, 95%CI = [1.06, 2.31], p = 0.03), a longer time from treatment to retreatment (WMD = 5.99 weeks, 95%CI = [4.03, 7.95], p < 0.001), a lower retinal detachment rate (RR = 0.55, 95%CI = [0.30, 0.91], p = 0.02), higher spherical equivalent (WMD = 1.69D, 95%CI = [0.61, 2.77], p = 0.002), lower myopia rate (RR = 0.69, 95%CI = [0.50, 0.97], p = 0.03) and lower anisometropia rate (RR = 0.44, 95%CI = [0.29, 0.67], p = 0.0001). In comparisons between ranibizumab and bevacizumab, the intravitreal ranibizumab (IVR) group was associated with higher recurrence rate (RR = 2.02, 95%CI = [1.49, 2.73], p < 0.0001), higher retreatment rate (RR = 1.70, 95%CI = [1.17, 2.47], p = 0.0006), and lower high myopia rate (RR = 0.31, 95%CI = [0.12, 0.77], p = 0.01). Similarly, when compared to aflibercept and conbercept, the IVR cohort also demonstrated higher recurrence and retreatment rates. While no significant differences were observed in any of the variables included in the statistical analysis in the comparison between bevacizumab and aflibercept.
CONCLUSIONS
Anti-VEGF was associated with higher retreatment and lesser incidence of myopia as compared to laser. Laser therapy was linked to more complications like retinal detachment and myopia. Ranibizumab exhibited higher recurrence and retreatment rates compared to bevacizumab, aflibercept, and conbercept.
Topics: Humans; Infant, Newborn; Angiogenesis Inhibitors; Bevacizumab; Lasers; Myopia; Ranibizumab; Retinal Detachment; Retinopathy of Prematurity; Vascular Endothelial Growth Factor A; Recombinant Fusion Proteins
PubMed: 37814332
DOI: 10.1186/s13052-023-01543-3 -
SAGE Open Medicine 2023This study aimed to estimate the pooled prevalence of myopia among school-age children in Ethiopia. (Review)
Review
OBJECTIVE
This study aimed to estimate the pooled prevalence of myopia among school-age children in Ethiopia.
METHODS
Eligible articles were searched from PubMed, Embase, and Web of Science databases. In addition, Google Scholar and reference lists of the retrieved articles were searched from 30 July 2022 to 02 January 2023. The preferred reporting of items for systematic reviews and meta-analysis was used to report the search results. Microsoft Excel was used to keep the data. The qualities of eligible studies were checked using the Joanna Briggs Institute critical appraisal checklist for prevalence studies. Analysis was held using STATA Version 11. The degree of heterogeneity was checked using ² statistics. The possible sources of heterogeneity were examined using meta-regression and subgroup analyses. The funnel plot and Egger's test were used to assess the potential publication bias. A correction was made for publication bias using Duval and Twee Die's trim-and-fill analysis. The systematic review registration number is PROSPERO (#CRD42022330541).
RESULTS
We identified 21 eligible articles including 20,757 subjects. Of those participants, 10,601 (51.1%) and 10,156 (48.9%) were males and females, respectively. A total of 15,152 (73%) participants were urban residents. The estimated prevalence of myopia among school-age children in Ethiopia was found to be 5.26% (95% confidence interval: 4.09-6.42).
CONCLUSIONS
The prevalence of myopia among school-age children in Ethiopia is considerable, affecting one in 20 school-age children. Therefore, the authors recommend the stakeholders take extra steps to speed up the implementation of the school vision screening program and its integration plan into the existing school nutrition program.
PubMed: 37808514
DOI: 10.1177/20503121231200105 -
Acta Ophthalmologica May 2024During the COVID-19 pandemic, home-based and remote learning-particularly using electronic devices-was rapidly pushed out. Increased near-work, screen time exposure and...
PURPOSE
During the COVID-19 pandemic, home-based and remote learning-particularly using electronic devices-was rapidly pushed out. Increased near-work, screen time exposure and lack of outdoor time are risk factors that contribute to childhood myopia, but it is difficult to adopt recommendations from prior publications as a consistent limitation in the literature is the heterogeneity of research methodology. This review seeks to systematically evaluate how observational studies published during the pandemic have quantified and measured risk factors and myopia in school-going children and adolescents.
METHODS
Three scientific databases (PubMed, CINAHL, Scopus) were systematically searched from March 2020 to April 2022. Findings from relevant studies were descriptively summarised in relation to the PICOS-based objective of the review.
RESULTS
The final sample of 13 studies included research from six countries and comprised 1 411 908 children and adolescents. The majority of studies (N = 10; 76.9%) used spherical equivalent refraction (SER) of -0.5 dioptres or lower as a common definition of myopia. Most studies (77.8%) measuring screen time exposure found it higher during COVID-19 compared to pre-COVID, but only one study used objective measurement of screen time. The average critical appraisal score of the sample was only 66.1%, with a considerable number of studies failing to identify and adjust for potential confounders.
CONCLUSION
Future studies should consider emergent objective and validated measures of risk factors, account for potential a priori confounders and covariates and ensure more representativeness in the sociodemographic makeup of their samples.
Topics: Adolescent; Humans; Child; Pandemics; COVID-19; Myopia; Risk Factors; Refraction, Ocular
PubMed: 37786939
DOI: 10.1111/aos.15773 -
Frontiers in Pharmacology 2023To comprehensively reassess the efficacy and safety of different concentrations of atropine for retarding myopia progression and seek the most appropriate therapeutic...
To comprehensively reassess the efficacy and safety of different concentrations of atropine for retarding myopia progression and seek the most appropriate therapeutic concentration for clinical practice. We searched PubMed, Cochrane Library, Embase, Chinese Science and Technology Periodicals (VIP) and China National Knowledege Infrastructure (CNKI) from their inception to 23 March 2023, to obtain eligible randomized controlled trials (RCTs) and cohort studies that had atropine in at least one treatment arm and placebo/no intervention in another arm. We evaluated the risk of bias of the RCTs according to the recommendations of the Cochrane Collaboration for RCTs and quality of cohort studies by the Newcastle‒Ottawa Scale. Weighted mean difference (WMD), 95% confidence interval were calculated for meta-analysis. All data analyses were performed using Review Manager 5.3, STATA 12.0 and SPSS 26.0 software. A total of 44 studies were included in the meta-analysis. Weighted mean difference (WMD) were 0.73 diopters (D), 0.65 D, 0.35 D per year in refraction progression ( = 14.63, = 86.3%; < 0.001) and -0.26 mm, -0.37 mm, -0.11 mm per year in axial length progression ( = 5.80, = 65.5%; = 0.06) for high (0.5%-1%), moderate (0.1%-0.25%), and low (0.005%-0.05%) dose atropine groups, respectively. Logarithmic dose‒response correlations were found between atropine and their effect on change of refraction, axial length, accommodation and photopic pupil diameter. Through these curves, we found that atropine with concentrations ≤0.05% atropine resulted in a residual value of accommodation of more than 5 D and an increase in pupil diameter no more than 3 mm. Higher doses of atropine resulted in a higher incidence of adverse effects, of which the incidence of photophobia was dose-dependent ( = 0.477, = 0.029). Both the efficacy and risk of adverse events for atropine treatment of myopia were mostly dose dependent. Comprehensively considered the myopia control effect and safety of each dose, 0.05% may be the best concentration of atropine to control myopia progression at present, at which myopia is better controlled and the side effects are tolerable. https://www.crd.york.ac.uk/PROSPERO/#recordDetails, CRD42022377705.
PubMed: 37767401
DOI: 10.3389/fphar.2023.1227787 -
European Review For Medical and... Sep 2023Myopia is becoming more common, a significant public health issue everywhere, including in China. There needs to be a comprehensive analysis of the evidence about the... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Myopia is becoming more common, a significant public health issue everywhere, including in China. There needs to be a comprehensive analysis of the evidence about the extent of myopia in Chinese schoolchildren, despite earlier studies showing a growing frequency in China. Therefore, the frequency of myopia in Chinese schoolchildren is examined in this study with supporting data and a meta-analysis.
MATERIALS AND METHODS
The 2022 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were used for this research. From January 1, 2015, to December 31, 2022, five computerized bibliographic databases, including PUBMED, Scopus, Web of Science, ProQuest, and China Index Medicus, were reviewed and aimed at investigating myopia's prevalence in China. The studies' methodological quality was evaluated. Myopia is defined as a refractive error. Data were collected according to gender, age, and refraction method. The prevalence was calculated through a meta-analysis.
RESULTS
Data from 11 quality-assessed studies, with a total of 1,013,206 adolescents, were included. Hanting District children had an overall myopia prevalence of 45.47%, but Changyi children had a myopia prevalence of 82.37%. In general, 48.56, 47.30, and 31.62% of elementary, middle, and higher school pupils had mild myopia, compared to 1.12, 8.89, and 20.12% who had high myopia. Children aged 7-9 years old experienced the largest overall increase in the prevalence of myopia. For girls and boys, the prevalence of higher myopia was 7.59% and 6.43% (p<0.001). Yet, the spherical equivalent (SE) dropped as students' ages and grades rose. Myopia prevalence rises as students age and grade.
CONCLUSIONS
The recent findings revealed that myopia predominated among schoolchildren in Weifang. It steadily grew through age, in addition to it being more common in Changyi neighborhoods. Females had a greater frequency of myopia than males.
Topics: Male; Child; Female; Adolescent; Humans; Prevalence; Myopia; Refraction, Ocular; China; Schools
PubMed: 37750628
DOI: 10.26355/eurrev_202309_33559 -
Eye (London, England) Feb 2024To evaluate the efficacy of eye exercises in preventing and controlling myopia. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To evaluate the efficacy of eye exercises in preventing and controlling myopia.
METHODS
We searched studies on eye exercises from nine Chinese and English databases from their inception to December 15, 2022. Using random-effect models and sensitivity/subgroup analyses, we estimated the effects of eye exercises compared to control on changes in three measures: visual acuity, refractive error (both quantified using standardized mean differences, SMDs), and protective/mitigating effects (assessed through risk ratios, RRs).
RESULTS
Eleven studies were included in the meta-analysis, with 921 participants. Nine studies had some concerns of bias in at least two domains, and two studies had a high risk of bias in two domains. Seven studies used visual acuity to measure myopia; visual acuity declined after eye-exercise interventions (SMD = -0.67, 95% CI -1.28 to -0.07, Z = 2.17, P = 0.03) and the effect was not better than control (SMD = -0.50, 95% CI -1.16 to 0.16, Z = 1.49, P = 0.14). Two studies used refractive error to measure myopia; the effect of eye-exercise interventions did not differ from control (SMD = -1.74, 95% CI -6.27 to 2.79, Z = 0.75, P = 0.45). Seven studies reported on protective/mitigating effects; eye exercises exhibited a greater protective/mitigating effect than control (RR = 0.40, 95% CI 0.23-0.71, Z = 3.13, P < 0.01).
CONCLUSIONS
Overall, the results suggest that eye exercises have limited to no efficacy in preventing or controlling myopia progression. Until robust evidence supports their efficacy, available evidence suggests retiring the eye-exercise policy.
Topics: Humans; Exercise; Myopia; Randomized Controlled Trials as Topic
PubMed: 37740051
DOI: 10.1038/s41433-023-02739-x -
Ophthalmology and Therapy Dec 2023This study aims to assess the existing literature on fundus tessellation (FT), focusing on its prevalence, associated factors, distribution, and progression.
INTRODUCTION
This study aims to assess the existing literature on fundus tessellation (FT), focusing on its prevalence, associated factors, distribution, and progression.
METHODS
Systemic methods were employed to search and gather published literature on FT from databases such as the National Library of Medicine (PubMed), Web of Science (WOS), and Elsevier on July 1, 2023. The quality of the studies was evaluated using the Newcastle-Ottawa Scale (NOS) and the Healthcare Research and Quality (AHRQ) criteria. A meta-analysis was conducted to compare tessellated and normal fundus with respect to age, gender, axial length, and spherical equivalent.
RESULTS
The systematic review included 23 articles, encompassing a total of 3053 eyes in the meta-analysis. The prevalence of FT varied from 43.00 to 94.35%. The severity of FT was significantly associated with older age, male sex, lower body weight index, longer axial length, larger peripapillary atrophy, thinner choroid, thinner sclera, and larger corneal radius of curvature, suggesting a potential progression pattern. Notably, FT was observed predominantly in the macular and peripapillary regions. The meta-analysis revealed that tessellated fundus tended to be associated with older age (mean difference [MD] 4.76, 95% confidence interval [CI] 1.71-7.80, P < 0.01), longer axial length (MD 0.86, 95% CI 0.70-1.02, P < 0.01), and a lower spherical equivalent (MD - 1.16, 95% CI - 1.68 to 0.65, P < 0.01) compared to normal fundus. However, there was no significant difference in the proportion of males between individuals with tessellated and normal fundus (odds ratio [OR] 1.12, 95% CI 0.89-1.42, P = 0.32).
CONCLUSIONS
Overall, this systematic review and meta-analysis shed light on the prevalence, characteristics, and factors associated with FT, offering valuable insights for clinicians and researchers in the field of ophthalmology.
STUDY REGISTRATION
The study protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42023442486).
PubMed: 37733224
DOI: 10.1007/s40123-023-00802-0 -
PloS One 2023This work aimed to comprehensively assess the risk factors affecting myopia in children to develop more effective prevention and treatment strategies. To this end, data... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
This work aimed to comprehensively assess the risk factors affecting myopia in children to develop more effective prevention and treatment strategies. To this end, data from database were employed to assess the relationship between the incidence of myopia and its risk factors.
METHODS
We searched eight databases online in June 2022. Cohort studies were included that measured the connection between risk factors and myopia. Eligibility was not restricted by language. The Newcastle-Ottawa Scale (NOS) was used to measure the risk of bias and conducted GRADE evaluation to determine the certainty of evidence. Potential risk factors with positive or negative results were seen. Inplasy Registration: https://inplasy.com/inplasy-2022-4-0109/.
RESULTS
Evidence that risk factors for myopia are mixed, comprising both positive (20) and null (17) findings. In 19 cohort studies on 3578 children, girls were more likely to develop myopia (RR: 1.28 [1.22-1.35]). Myopia can occur at any age, from early childhood to late adulthood. Children whose parents had myopia were more likely to develop myopia. Longer outdoor activities time (RR: 0.97 [0.95-0.98]) and less near-work time (RR: 1.05 [1.02-1.07]) appeared to be significantly decrease the incidence of myopia. Children with lower SE, longer AL, a lower magnitude of positive relative accommodation, worse presenting visual acuity, deeper anterior chamber, and thinner crystalline lens may be related to myopia onset. The burden of myopia in underprivileged countries is higher than in developed countries (RR: 5.28 [2.06-13.48]). The quality of evidence for the evaluated factors was moderate to low or very low.
CONCLUSIONS
Genetic factors, environmental factors (such as excessive use of electronic products, and poor study habits) and lifestyle factors (such as lack of outdoor activities, poor nutrition, etc.) are the main risk factors for myopia in children. Myopia prevention strategies should be designed based on environmental factors, gender, parental myopia and eye indicators in order to explore a lifestyle that is more conducive to the eye health of children.
Topics: Child, Preschool; Female; Humans; Child; Adult; Risk Factors; Accommodation, Ocular; Databases, Factual; Factor Analysis, Statistical; Myopia
PubMed: 37729320
DOI: 10.1371/journal.pone.0291470 -
Ophthalmology Feb 2024This review summarizes existing evidence of the impact of vision impairment and ocular morbidity and their treatment on children's quality of life (QoL). (Meta-Analysis)
Meta-Analysis Review
TOPIC
This review summarizes existing evidence of the impact of vision impairment and ocular morbidity and their treatment on children's quality of life (QoL).
CLINICAL RELEVANCE
Myopia and strabismus are associated with reduced QoL among children. Surgical treatment of strabismus significantly improves affected children's QoL.
METHODS
We conducted a systematic review and meta-analysis by screening articles in any language in 9 databases published from inception through August 22, 2022, addressing the impact of vision impairment, ocular morbidity, and their treatment on QoL in children. We reported pooled standardized mean differences (SMDs) using random-effects meta-analysis models. Quality appraisal was performed using Joanna Briggs Institute and National Institutes of Health tools. This study was registered with the International Prospective Register of Systematic Reviews (identifier, CRD42021233323).
RESULTS
Our search identified 29 118 articles, 44 studies (0.15%) of which were included for analysis that included 32 318 participants from 14 countries between 2005 and 2022. Seventeen observational and 4 interventional studies concerned vision impairment, whereas 10 observational and 13 interventional studies described strabismus and other ocular morbidities. Twenty-one studies were included in the meta-analysis. The QoL scores did not differ between children with and without vision impairment (SMD, -1.04; 95% confidence interval [CI], -2.11 to 0.03; P = 0.06; 9 studies). Myopic children demonstrated significantly lower QoL scores than those with normal vision (SMD, -0.60; 95% CI, -1.09 to -0.11; P = 0.02; 7 studies). Children with strabismus showed a significantly lower QoL score compared with those without (SMD, -1.19; 95% CI, -1.66 to -0.73; P < 0.001; 7 studies). Strabismus surgery significantly improved QoL in children (SMD, 1.36; 95% CI, 0.48-2.23; P < 0.001; 7 studies). No randomized controlled trials (RCTs) concerning refractive error and QoL were identified. Among all included studies, 35 (79.5%) were scored as low to moderate quality; the remaining met all quality appraisal tools criteria.
DISCUSSION
Reduced QoL was identified in children with myopia and strabismus. Surgical correction of strabismus improves the QoL of affected children, which supports insurance coverage of strabismus surgery. Further studies, especially RCTs, investigating the impact of correction of myopia on QoL are needed.
FINANCIAL DISCLOSURE(S)
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Topics: Child; Humans; Myopia; Quality of Life; Refractive Errors; Strabismus; Systematic Reviews as Topic; United States; Clinical Trials as Topic; Observational Studies as Topic
PubMed: 37696451
DOI: 10.1016/j.ophtha.2023.09.005 -
[Zhonghua Yan Ke Za Zhi] Chinese... Sep 2023Myopia and glaucoma are two common ocular diseases that pose significant health and economic burdens to patients, their families, and society. In recent years, the...
Myopia and glaucoma are two common ocular diseases that pose significant health and economic burdens to patients, their families, and society. In recent years, the relationship between these two conditions has become a prominent research focus. This article provides a systematic review of the current research progress on the association between myopia and glaucoma, with a primary emphasis on discussing the two major viewpoints: myopia as a risk factor for glaucoma development and the multifaceted impact of myopia on glaucoma progression. Possible mechanisms and potential clinical biomarkers are outlined, and the academic community's complementary insights and doubts regarding these viewpoints are summarized. Additionally, unresolved issues in existing studies are identified to pave the way for future scientific explorations, aiming to further elucidate the relationship between myopia and glaucoma and optimize the clinical diagnosis and management of glaucoma.
Topics: Humans; Myopia; Glaucoma; Eye; Face; Risk Factors
PubMed: 37670661
DOI: 10.3760/cma.j.cn112142-20221129-00607