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Efficacy of Treatments in Nonarteritic Ischemic Optic Neuropathy: A Systematic Review and Meta-Analysis

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...

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Autores principales: Lantos, Krisztina, Dömötör, Zsuzsa Réka, Farkas, Nelli, Kiss, Szabolcs, Szakács, Zsolt, Garami, András, Varga, Gábor, Lujber, László, Kanaan, Reem, Hegyi, Péter, Fehér, Gergely, Gaál, Valéria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8910678/
https://www.ncbi.nlm.nih.gov/pubmed/35270411
http://dx.doi.org/10.3390/ijerph19052718
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author Lantos, Krisztina
Dömötör, Zsuzsa Réka
Farkas, Nelli
Kiss, Szabolcs
Szakács, Zsolt
Garami, András
Varga, Gábor
Lujber, László
Kanaan, Reem
Hegyi, Péter
Fehér, Gergely
Gaál, Valéria
author_facet Lantos, Krisztina
Dömötör, Zsuzsa Réka
Farkas, Nelli
Kiss, Szabolcs
Szakács, Zsolt
Garami, András
Varga, Gábor
Lujber, László
Kanaan, Reem
Hegyi, Péter
Fehér, Gergely
Gaál, Valéria
author_sort Lantos, Krisztina
collection PubMed
description 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.
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spelling pubmed-89106782022-03-11 Efficacy of Treatments in Nonarteritic Ischemic Optic Neuropathy: A Systematic Review and Meta-Analysis Lantos, Krisztina Dömötör, Zsuzsa Réka Farkas, Nelli Kiss, Szabolcs Szakács, Zsolt Garami, András Varga, Gábor Lujber, László Kanaan, Reem Hegyi, Péter Fehér, Gergely Gaál, Valéria Int J Environ Res Public Health Systematic Review 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. MDPI 2022-02-26 /pmc/articles/PMC8910678/ /pubmed/35270411 http://dx.doi.org/10.3390/ijerph19052718 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Systematic Review
Lantos, Krisztina
Dömötör, Zsuzsa Réka
Farkas, Nelli
Kiss, Szabolcs
Szakács, Zsolt
Garami, András
Varga, Gábor
Lujber, László
Kanaan, Reem
Hegyi, Péter
Fehér, Gergely
Gaál, Valéria
Efficacy of Treatments in Nonarteritic Ischemic Optic Neuropathy: A Systematic Review and Meta-Analysis
title Efficacy of Treatments in Nonarteritic Ischemic Optic Neuropathy: A Systematic Review and Meta-Analysis
title_full Efficacy of Treatments in Nonarteritic Ischemic Optic Neuropathy: A Systematic Review and Meta-Analysis
title_fullStr Efficacy of Treatments in Nonarteritic Ischemic Optic Neuropathy: A Systematic Review and Meta-Analysis
title_full_unstemmed Efficacy of Treatments in Nonarteritic Ischemic Optic Neuropathy: A Systematic Review and Meta-Analysis
title_short Efficacy of Treatments in Nonarteritic Ischemic Optic Neuropathy: A Systematic Review and Meta-Analysis
title_sort efficacy of treatments in nonarteritic ischemic optic neuropathy: a systematic review and meta-analysis
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8910678/
https://www.ncbi.nlm.nih.gov/pubmed/35270411
http://dx.doi.org/10.3390/ijerph19052718
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