Objectives To assess the clinical effectiveness of non-penetrating trabecular surgery versus trabeculectomy for open angle glaucoma. Methods We searched the Cochrane Central Register of Controlled Trials (issue 2, 2007), MEDLINE (1966 to May 2008), EMbase (1980 to May 2008), and CMB-disk (1979 to May 2008). We also hand searched relevant journals and conference proceedings. Data were extracted by two reviewers independently using an extraction form. The Cochrane Collaboration’s RevMan 5.0 software was used for statistical analysis. Results Three RCTs involving 127 participants (144 eyes) with previously untreated open angle glaucoma were included. Meta-analysis showed that compared with non-penetrating trabecular surgery, trabeculectomy increased the proportion of patients with reduced postoperative intraocular pressure (WMD2.78, 95%CI 1.41 to 4.15), improved the operation success rate (RR 0.53, 95%CI 0.37 to 0.77), and reduced the use of postoperative antiglaucoma medication (WMD 0.96, 95%CI 0.84 to 1.08). Non-penetrating trabecular surgery reduced the incidence of postoperative complications (RR 17.00, 95%CI 8.36 to 26.00). Conclusion Since the sample sizes of the included trials are relatively small, and the two procedures are also related to progressive visual field loss and optic disk damage, more well-designed large-scale RCTs are required.
Objective To evaluate the efficacy and safety of latanoprost versus travoprost for primary open-angle glaucoma (OAG) and ocular hypertension (OH). Methods All the randomized controlled trials (RCTs) about treating primary open-angle glaucoma and ocular hypertension with latanoprost and travoprost were collected by searching MEDLINE, EMbase, OVID and CNKI. The assessment of methodological quality and data extraction of the included studies were performed independently by two reviewers, and the meta-analysis was conducted with RevMan 5.0 software. Results A total of 13 RCTs involving 1 433 patients were included. The results of meta-analyses showed that, a) At the second week, travoprost showed greater intraocular pressure (IOP) lowering efficacy compared with latanoprost (WMD= –1.47, 95%CI –2.62 to –0.33). At the first month (WMD= –0.50, 95%CI –1.52 to 0.52) and the sixth month (WMD= –0.12, 95%CI –0.85 to 0.61), the difference of IOP reduction between latanoprost and travoprost group was not significant; and b) The latanoprost-treated group showed fewer reported conjunctival congestion than the travoprost-treated group (OR=0.47, 95%CI 0.35 to 0.63). The difference in adverse events of eye pain (OR=0.55, 95%CI 0.27 to 1.12) and iris or skin depigmentation (OR=1.25, 95%CI 0.53 to 2.92) between latanoprost and travoprost group was not significant. Conclusion Latanoprost and travoprost are comparable in lowering IOP for OAG and OH patients. Latanoprost shows greater ocular tolerability with lower incidence of side effects as conjunctival congestion. This conclusion is not powerful enough in proof due to the medium methodology quality of the included studies, so a large number of high-quality RCTs with large sample are needed for objectively, entirely and precisely evaluating the efficacy.
Objective Methods of evidence-based medicine were used to make an individualized treatment plan concerning newly diagnosed open-angle glaucoma patient. Methods After clinical problems were put forward, evidence was collected from Cochrane Library (Issue 4, 2009), PubMed (1990 -2009), MEDLINE (1990-2009), EMbase (1990-2009), CBM (1990-2009), and CNKI (1990-2009) according to the search strategy. Subject words were open-angle glaucoma, timolol, latanoprost, trabeculectomy, intraocular pressure, randomized controlled trials, human, meta-analysis, systematic review. Results A total of 221 randomized controlled trials, and 19 systematic reviews were identified. A rational treatment plan was made upon a serious evaluation of the data. After one year follow-up, the plan was proved optimal. Conclusion The treatment efficacy in newly diagnosed open-angle glaucoma has been improved by determining an individualized treatment plan according to evidence-based methods.
Objective To assess the efficacy and safety of a dorzolamide/timolol combination versus latanoprost in the treatment of open-angle glaucoma. Method We searched for randomized control trials concerning a dorzolamide/timolol combination versus latanoprost in the treatment of open-angle glaucoma,in electronic databases , and handsearched some related journals. The quality was evaluated and meta-analysis was conducted using the software RevMan 5.0. Results Six randomized control trials involving 361 patients and 361 eyes were identified. The Meta-analysis showed that at the end of study, there was a statistically significant difference between the two study groups with WMD – 0.49, and 95%CI – 1.06 to 0.07 ( P=0.09) in lowering intraocular pressure; there was no statistically significant difference between the two groups with WMD 1.43 and 95%CI 0.49 to 4.21 (P=0.53); and there was no statistically significant differences between the two groupswith WMD 0.40 and 95%CI 0.13 to 1.26 (P=0.12) in incidence of headache. Conclusion Compared with latanoprost, dorzolamide-timolol combination have increased efficacu in lowering intraocular pressure (IOP).If we want a more reliable result ,we need a large number of multi-centre,double-blinded randomized control trials.
【摘要】 目的 了解原发性开角型青光眼患者用2%盐酸卡替洛尔滴眼液后的眼压及眼脉动幅度变化特征。 方法 选取2009年1－12月确诊为原发性开角型青光眼患者19例32只眼。给予2%盐酸卡替洛尔滴眼液点眼1周，2次/d。用动态轮廓眼压计测量患者用药前后的眼压、眼脉动幅度，同时测量患者的血压及心率。比较用药前后眼压及眼脉动幅度的变化，并用SPSS 14.0统计学软件对用药前后的眼压及眼脉动幅度数据进行配对t检验及Pearson相关性分析。 结果 患者用药前后眼压分别为（22.76±4.29）、（17.79±2.93） mm Hg（1 mm Hg=0.133 kPa），眼脉动幅度分别为（3.47±1.00）、（2.63±0.86） mm Hg。患者的眼压及眼脉动幅度用药后较用药前明显降低，差异有统计学意义（Plt;0.01），用药前后的眼压与眼脉动幅度之间存在正相关关系（r=0.444， 0.364；P=0.011， P=0.040）。眼压及眼脉动幅度与患者的血压及心率均无相关性。 结论 原发性开角型青光眼患者用2%盐酸卡替洛尔滴眼液后眼压及眼脉动幅度均有显著降低，眼压与眼脉动幅度有正相关性。眼压及眼脉动幅度与血压及心率无相关关系。【Abstract】 Objective To investigate the variations of intraocular pressure (IOP) and ocular pulse amplitude (OPA) in patients with primary open-angle glaucoma after 2% carteolol hydrochloride was applied. Methods Thirty-two eyes of 19 patients with primary open-angle glaucoma diagnosed between January and December 2009 were chosen to be the study subjects. The patients received 2% cartelol hydrochloride eye drops twice a day for one week. IOP and OPA before and after using cartelol were measured by dynamic contour tonometry (DCT). Blood pressure and heart rate were detected at the same time. The variations of IOP and OPA were analyzed by SPSS 14.0. t test and Pearson correlation analysis were applied. Results The mean IOP and OPA before and after using cartelol were respectively (22.76±4.29) mm Hg (1 mm Hg=0.133 kPa) vs. (17.79±2.93) mm Hg, and (3.47±1.00) mm Hg vs. (2.63±0.86) mm Hg. Both of them decreased significantly after the use of cartelol (P＜0.01). OPA was obviously correlated with IOP both before and after using cartelol (r=0.444, 0.364; P=0.011, 0.040). OPA and IOP had no correlation with blood pressure and heart rate. Conclusions OPA and IOP decreases signifficantly after the use of 2% carteolol hydrochloride. OPA is signifficantly correlated with IOP. OPA and IOP have no correlation with blood pressure and heart rate.
ObjectiveTo systematically review the association between myopia and open-angle glaucoma (OAG). MethodsForeign and domestic articles published from January 2000 to May 2013 were searched in PubMed, EMbase, WanFang Data, VIP and CNKI for observational studies on the association between myopia and OAG. According to the inclusion and exclusion criteria, the studies were screened, the data were extracted, and the method quality of included studies was assessed. Then meta-analysis was performed using Stata 12.0 software. ResultsEleven cross-sectional studies including 45 996 participants were finally included. The results of meta-analysis showed that, myopia increased the risk of OAG. Besides, the results of subgroup analysis by the severity of myopia showed that, low-degree myopia (more than-3.00 D) increased 1.52 times the risk (OR=1.52, 95%CI 1.23 to 1.88) while middle/high-degree myopia (no more than-3.00 D) increased 2.41 times (OR=2.41, 95%CI 1.91 to 3.03). ConclusionIndividuals with myopia have increased risk of OAG.
Objective To explore the diagnostic value on 24 hour monitoring of intraocular pressure (IOP) for primary open angle glaucoma (POAG). Methods A prospective study was applied, and a total of 372 subjects through January 2012 to May 2015 for 24 hour IOP monitoring were collected successively, including 137 subjects (271 eyes) with glaucoma (glaucoma group) and 235 subjects (470 eyes) with non-glaucoma (Control group). Data was analyzed using SPSS 13.0 software, and the Kappa statistics was used to evaluate concordance between 24 hour monitoring of IOP and gold standard for POAG diagnosis. Results The mean value of IOP at all monitoring period in glaucoma group was significant higher than that in the control group (P < 0.001). The peak of IOP occurred at 6:00 am and 10:00 in the glaucoma group, and the fluctuation value of IOP in women patients at night (especially at 22:00 pm) was higher than that of men (t=2.064, P=0.04). The sensitivity and specificity of 24 hour IOP monitoring for POAG were 97% and 78.7%, respectively, and with a high consistency comparing to the result of gold standard for POAG diagnosis, with the Kappa values of 0.707 (P < 0.000 1). Conclusion 24 hour IOP monitoring is efficacy and convenient tool, which can be applied alone or combined with other tools to assist early diagnosis patients who are suspected with POAG, so as to improve the diagnostic accuracy.
ObjectivesTo systematically review the association between the SIX6 gene rs10483727 mutation and primary open angle glaucoma (POAG).MethodsPubMed, Web of Science, The Cochrane Library, CNKI, WanFang Data and VIP databases were searched to collect case-control studies on the SIX6 gene rs10483727 polymorphism and primary open angle glaucoma from inception to December 28th, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was performed by Stata 12.0 software.ResultsSeventeen case-control studies in 16 papers were included, involving 9 886 patients and 19 663 controls. The results of meta-analysis showed that rs10483727 polymorphism in SIX6 gene was associated with the risk of POAG in the Asians and Caucasians. However, no association was found in the Africans.ConclusionsThe current evidence shows that rs10483727 polymorphism in SIX6 gene is associated with the risk of POAG in the Asians and Caucasians.