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眼弓形体病的玻璃体内治疗的临床结局:系统评价和荟萃分析。

Clinical outcomes of intravitreal treatment for ocular toxoplasmosis: systematic review and meta-analysis.

机构信息

Fundação Ezequiel Dias, Diretoria de Pesquisa e Desenvolvimento, Belo Horizonte, MG, Brasil.

Byers Eye Institute at Stanford University School of Medicine, Ophthalmology, Palo Alto, CA, United States.

出版信息

Rev Soc Bras Med Trop. 2023 May 22;56:e05522022. doi: 10.1590/0037-8682-0552-2022. eCollection 2023.

Abstract

BACKGROUND

Ocular toxoplasmosis is the leading cause of infectious posterior uveitis worldwide, accounting for 30-50% of all cases in immunocompetent patients. Conventional treatment is associated with adverse effects and does not prevent recurrence. Intravitreal drug administration can improve disease outcomes and reduce side effects. Herein, we conducted a systematic review and meta-analysis on the efficacy of intravitreal injections for treating ocular toxoplasmosis.

METHODS

The systematic search was conducted using PubMed, SciELO, and Google Scholar with the descriptors "ocular toxoplasmosis" AND "intravitreal". We analyzed studies that met the inclusion criteria, i.e., experimental cases in patients treated intravitreally for ocular toxoplasmosis. Considering the systematic review, we focused on the number of intravitreal injections, the therapeutic drug class, and the presence of preexisting conditions. To assess the efficacy of intravitreal injections, a meta-analysis was performed using visual acuity, side effects, disease recurrence, and inflammatory responses as variables.

RESULTS

Intravitreal injection-induced side effects were rarely observed (0.49% [0.00, 1.51%] ). The use of antiparasitic and anti-inflammatory drugs afforded improved visual acuity (99.81% [98.60, 100.00%]) and marked effectiveness in treating ocular toxoplasmosis.

CONCLUSIONS

Intravitreal injections may facilitate the successful treatment of ocular toxoplasmosis. However, clinicians should carefully evaluate the presence of preexisting conditions for ocular toxoplasmosis or previous diseases, as these can impact the decision to administer intravitreal injections.

摘要

背景

眼弓形体病是全球传染性后葡萄膜炎的主要原因,占免疫正常患者所有病例的 30-50%。常规治疗与不良反应相关,且无法预防复发。玻璃体内药物给药可改善疾病结局并减少副作用。在此,我们对玻璃体内注射治疗眼弓形体病的疗效进行了系统评价和荟萃分析。

方法

使用 PubMed、SciELO 和 Google Scholar 进行系统检索,使用的检索词为“眼弓形体病”和“玻璃体内”。我们分析了符合纳入标准的研究,即患有眼弓形体病并接受玻璃体内治疗的患者的实验性病例。考虑到系统评价,我们重点关注玻璃体内注射的次数、治疗药物类别以及是否存在潜在疾病。为了评估玻璃体内注射的疗效,我们使用视力、副作用、疾病复发和炎症反应等变量进行了荟萃分析。

结果

玻璃体内注射引起的副作用很少见(0.49%[0.00,1.51%])。使用抗寄生虫和抗炎药物可提高视力(99.81%[98.60,100.00%]),并显著有效治疗眼弓形体病。

结论

玻璃体内注射可能有助于成功治疗眼弓形体病。然而,临床医生应仔细评估眼弓形体病或既往疾病的潜在状况,因为这些情况可能会影响玻璃体内注射的决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bb2/10204153/385f954753e6/1678-9849-rsbmt-56-e0552-2022-gf1.jpg

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