Treatment of ocular hypertension and open angle glaucoma: meta-analysis of randomised controlled trials
Treatment of ocular hypertension and open angle glaucoma: meta-analysis of randomised controlled trials
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DOI：
10.1136/bmj.38506.594977.e0
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发表时间：
2005-07-16
影响因子：
105.7
通讯作者：
Falck-Ytter, YT
中科院分区：
文献类型：
--
作者：
Maier, PC;Funk, J;Falck-Ytter, YT
目的开角型青光眼是工业化国家最常见的致盲性疾病之一。降低眼压的治疗方法被广泛应用于青光眼的预防和治疗，尽管有相互矛盾的证据。设计我们进行了荟萃分析，以重新评估降压治疗对延迟高眼压症青光眼发展的有效性，以及明显的开角型青光眼的进展。数据来源Medline，Embase，和科克伦图书馆。研究的选择合格的研究是随机对照试验，同时未经治疗的对照组和信息的时间，以青光眼的变化，以视野和视盘。试验报告由两名研究者独立审查在一个unblinded standardised mathematic.Results荟萃分析的高眼压症的试验表明，降低眼压对青光眼的进展有显着的预防作用（危害比0.56，95%）的置信区间0.39至0.81，P = 0.01，需要治疗的人数12）。显性青光眼研究的汇总数据显示视野恶化显著延迟（0.65，0.49至0.87，P = 0.003; NNT = 7），亚组分析显示，对眼压升高患者的影响较大，对正常眼压性青光眼的影响较小（亚组比较：不显著）结论对高眼压或明显青光眼患者降低眼压有利于降低视野损害的风险。长期的损失。
Objective Open angle glaucoma is one of the most common causes of blindness in industrialised nations. Treatments to lower ocular pressure are widely used in glaucoma prevention and treatment, despite conflicting evidence.Design We performed meta-analyses to reassess the effectiveness of pressure lowering treatment to delay the development of glaucoma in ocular hypertension, as well as progression of manifest open angle glaucoma.Data sources Medline, Embase, and the Cochrane Library.Selection of studies Eligible studies were randomised controlled trials with a concurrent untreated control group and information on time to glaucomatous changes to visual field and optic disc. Trial reports were reviewed independently by two investigators in an unblinded standardised manner.Results Meta-analysis of trials in ocular hypertension showed a significant preventive effect of reducing intraocular pressure on progression to glaucoma (hazard ratio 0.56, 95%) confidence interval 0.39 to 0.81, P = 0.01; number needed to treat 12). Pooled data of studies in manifest glaucoma showed a significant delay of visual field deterioration (0.65, 0.49 to 0.87, P = 0.003; NNT = 7), with subgroup analysis showing a larger effect in patients with raised pressure and a reduced effect in normal tension glaucoma (subgroup comparison: not significant).Conclusions Lowering intraocular pressure in patients with ocular hypertension or manifest glaucoma is beneficial in reducing the risk of visual field loss in the long term.