Átfogó fejlesztések a Pécsi Tudományegyetemen az intelligens szakosodás megvalósítása
érdekében(EFOP-3.6.1-16-2016-00004) Támogató: EFOP
Szakterületek:
Metaanalízis
Background: Nonarteritic Anterior Ischemic Optic Neuropathy (NAION) is the second
most common cause of optic nerve-related permanent visual loss in adults. Aim: We
aimed to analyze the efficacy of the noninvasive and minimally invasive therapeutic
options of NAION. Methods: We performed a systematic literature search in MEDLINE,
EMBASE, and CENTRAL from inception to 10 June 2019 to identify the studies that report
on the effect of different therapies on visual acuity (VA) and visual field (VF).
Weighted mean difference (WMD) with 95% confidence interval (CI) was calculated for
these outcomes. The efficacy of steroids was investigated in quantitative, oxygen,
steroid plus erythropoietin (EPO), levodopa/carbidopa, memantine, and heparin-induced
extracorporeal LDL/fibrinogen precipitation (HELP) therapies and other therapeutic
modalities in qualitative synthesis. Results: Thirty-two studies were found to be
eligible. We found that steroid therapy compared to control did not improve VA (p
= 0.182, WMD = 0.14, 95% CI: −0.07, 0.35) or VF (p = 0.853, WMD = 0.16, 95% CI: −1.54,
1.86). Qualitative analysis could be performed for oxygen, steroid plus EPO, and HELP
as well, however, none of them showed VA and VF benefit. Two individual studies found
memantine and levodopa beneficial regarding VA. Conclusion: Our systematic review
did not reveal any effective treatment. Further investigations are needed to find
therapy for NAION.
