2022年3月份RIO论文推荐

SILICONE OIL–FILLED FOLDABLE CAPSULAR VITREOUS BODY VERSUS SILICONE OIL ENDOTAMPONADE FOR TREATMENT OF NO LIGHT PERCEPTION AFTER SEVERE OCULAR TRAUMA

(Retina: March 2022 – Volume 42 – Issue 3 – p 553-560）

硅油填充的折叠式人工玻璃体球囊和硅油填充治疗严重眼外伤后的无光感眼

Purpose

To compare the anatomical and functional outcomes of silicone oil (SO)–fifilled foldable capsular vitreous body (FCVB) and SO endotamponade in vitrectomy for patients with no light perception after ocular trauma.

比较硅油填充的折叠式人工玻璃体球囊（FCVB）和硅油（SO）填充在严重眼外伤无光感眼患者玻璃体切割术术后的解剖和功能结果。

Methods

A total of 64 patients (64 eyes) with no light perception caused by severe ocular trauma were divided into FCVB and SO groups based on the surgical treatment. The main outcome measurements were retinal reattachment rate, intraocular pressure, bestcorrected visual acuity, and number of operations.

将64例(64只眼)严重眼外伤致无光感患者根据手术治疗情况分为FCVB组和SO组。主要观察指标为视网膜再附着率、眼压、最佳矫正视力和手术次数。

Results

Both the FCVB group (29 eyes) and the SO group (35 eyes) showed signifificant improvement in postoperative best-corrected visual acuity and intraocular pressure. The two groups showed no signifificant differences in fifinal intraocular pressure and the retinal reattachment rate. The postoperative vision ($LP) in the FCVB group was signifificantly worse than in the SO group (FCVB [4/29] vs. SO [18/35], P = 0.003). However, the number of surgeries in the FCVB group was signifificantly lower than in the SO group (FCVB [1.10] vs. SO [2.23], P , 0.001).

FCVB组(29眼)和SO组(35眼)术后最佳矫正视力和眼压均有明显改善。两组末次随访眼压及视网膜再附着率无显著差异。FCVB组术后视力($LP)明显低于SO组(FCVB [4/29] vs. SO [18/35]， P = 0.003)。但FCVB组的手术次数明显低于SO组(FCVB [1.10] vs. SO [2.23]， P, 0.001)。

Conclusion

 Vitrectomy combined with SO endotamponade shows better short-term improvement in the treatment of no light perception caused by severe ocular trauma. However, SO-fifilled FCVB can effectively prevent many complications caused by direct SO endotamponade, such as secondary surgeries or SO dependence.

玻璃体切割术联合SO内填充治疗重度眼外伤无光感短期疗效较好。然而，硅油填充的FCVB能有效预防SO直接填充引起的许多并发症，如二次手术或硅油依赖眼等。

推荐理由

本文研究了硅油填充的FCVB与硅油填充治疗严重眼外伤后无光感对比分析了两种手术的优点和缺点，FCVB有助于减少术后并发症的发生，但玻璃体切除术联合SO内填充治疗重度眼外伤无光感短期疗效较好。

本文创新之处在于通过科学的对比，分析了无光感眼接受两种手术方式后患者的术后并发症和视力比较，得出FCVB手术可以有效预防患者术后并发症，预后好；在视力方面，SO直接填充只能起到短期的一个维持效果，从长远角度来看，预后并发症多，二次手术可能性大。

文章不足之处在于未对SO二次手术效果与第一次做FCVB手术效果进行进一步分析，SO直接填充的二次手术是否优于第一次，效果是否优于首次FCVB手术。

No.2

Investigative Ophthalmology & Visual Science · 推荐

Study of the Correlation Between Severity of Endophthalmitis and Posterior Vitreous Detachment Using a Rabbit Endophthalmitis Model

( Investigative Ophthalmology & Visual Science February 2022, Vol.63, 6. ）

用兔眼内炎模型研究眼内炎严重程度与玻璃体后脱离的相关性

Purpose

We have reported that the absence of posterior vitreous detachment (PVD) is related to the onset and severity of infectious endophthalmitis, based on clinical experience. To demonstrate clinical findings in animal models, we created endophthalmitis models for the presence or absence of PVD and examined differences in severity.

我们根据临床经验报道，后玻璃体脱离(PVD)的缺失与感染性眼内炎的发病和严重程度有关。为了证明动物模型的临床结果，我们创建了有或没有眼内病变的眼内炎模型，并检查了严重程度的差异。

Methods

We estimated a rabbit infectious eye model with and without PVD using Pseudomonas aeruginosa (PVD(+) and PVD(−) groups). After injection of bacteria inoculation for 3, 6, 12, and 24 hours, we evaluated the clinical score of the anterior chamber (n = 14). Removing the vitreous and retina from the enucleated eyeballs, the number of bacteria was counted using each specimen (n = 12). In addition, the number of inflammatory cells approximately 3 mm2 around the optic disc and histopathologic grading of intraocular inflammation was compared from histopathologic images (n = 7). Elec-troretinogram (ERG) was performed in experimentally infected rabbit eyes in both groups at three times after injection of the bacterial suspension.

我们用铜绿假单胞菌(PVD(+)组和PVD(-)组)对兔传染性眼模型进行评估。在接种细菌3、6、12和24小时后，我们对14例患者的前房进行临床评分。摘除眼球的玻璃体和视网膜后，每个标本计数细菌数(n = 12)。此外,炎症细胞的数量约3平方毫米在视神经盘和组织病理分级的眼内炎症比较病理图像(n = 7)。Elec-troretinogram (ERG)进行实验感染兔的眼睛在两组细菌悬液注射后的三倍。

Results

There was no difference between the two groups in the clinical score of the anterior chamber of each time phase, but the bacterial cultures showed significantly fewer bacteria in the PVD(−) group 24 hours after bacterial inoculation (P < 0.05). Furthermore, the number of inflammatory cells was significantly less in the PVD group (P < 0.05). As a result of ERG, the decreases of a- and b-waves in amplitude were significantly greater in the PVD(−) group than in the PVD(+) group.

两组前房各时间阶段的临床评分差异无统计学意义，但PVD(-)组在细菌接种24小时后细菌培养量明显减少(P <0.05)。此外，PVD组炎症细胞数量显著减少(P <0.05)。ERG结果显示，PVD(-)组a波和b波振幅的下降明显大于PVD(+)组。

Conclusion

The present study confirms using animal models that the absence of PVD contributed to the severity of bacterial endophthalmitis.

本研究通过动物模型证实，PVD的缺失与细菌性眼内炎的严重程度有关。

推荐理由

本文通过动物实验研究了眼内炎严重程度与玻璃体后脱离的相关性，得出PVD的缺失与细菌性眼内炎的严重程度有关。

文章创新之处在利用动物做实验，观察更加直接，结果准确，将兔眼内严重程度做了对比分析，直接清晰可靠，数据清楚明了，有利于分析。

本文的不足之处在于未将兔眼内炎和人眼内炎做一个比较分析，有利于结果的准确性未考虑到潜在变化，未来可进一步继续优化设计方案的科学性。

No.3

Ophthalmology · 推荐

Effificacy and Safety of 8 Atropine Concentrations for Myopia Control in Children

(Volume 129, Issue 3, March 2022, Pages 322- 333）

8种阿托品浓度控制儿童近视的疗效和安全性

Topic

Comparative effificacy and safety of different concentrations of atropine for myopia control.

不同浓度阿托品控制近视的疗效和安全性比较。

Clinical Relevance

Atropine is known to be an effective intervention to delay myopia progression. Nonetheless, no well-supported evidence exists yet to rank the clinical outcomes of various concentrations of atropine.

阿托品被认为是延缓近视进展的有效干预手段。尽管如此，目前还没有得到充分支持的证据对不同浓度阿托品的临床结果进行排序。

Methods

We searched PubMed, EMBASE, Cochrane Central Register of Controlled Trials, the World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov on April 14, 2021. We selected studies involving atropine treatment of at least 1 year’s duration for myopia control in children. We performed a network meta-analysis (NMA) of randomized controlled trials (RCTs) and compared 8 atropine concentrations (1% to 0.01%). We ranked the atropine concentrations for the corresponding outcomes by P score (estimate of probability of being best treatment). Our primary outcomes were mean annual changes in refraction (diopters/ year) and axial length (AXL; millimeters/year). We extracted data on the proportion of eyes showing myopia progression and safety outcomes (photopic and mesopic pupil diameter, accommodation amplitude, and distance and near best-corrected visual acuity [BCVA]).

我们于2021年4月14日搜索了PubMed、EMBASE、Cochrane对照试验中央注册、世界卫生组织国际临床试验注册平台和ClinicalTrials.gov。我们选择了阿托品治疗至少1年的儿童近视控制的研究。我们对随机对照试验(rct)进行了网络荟萃分析(NMA)，并比较了8个阿托品浓度(1%至0.01%)。我们根据P评分(对最佳治疗可能性的估计)对相应结果的阿托品浓度进行排序。我们的主要结果是每年的平均屈光度(屈光度/年)和轴长(AXL;毫米/年)。我们提取了显示近视进展和安全结果(光和介浅瞳孔直径、调节幅度、距离和近最佳矫正视力[BCVA])的眼睛比例的数据。

Results

Thirty pairwise comparisons from 16 RCTs (3272 participants) were obtained. Our NMA ranked the 1%, 0.5%, and 0.05% atropine concentrations as the 3 most benefificial for myopia control, as assessed for both primary outcomes: 1% atropine (mean differences compared with control: refraction, 0.81 [95% confifidence interval (CI), 0.58e1.04]; AXL, e0.35 [e0.46 to e0.25]); 0.5% atropine (mean differences compared with control: refraction, 0.70 [95% CI, 0.40e1.00]; AXL, e0.23 [e0.38 to e0.07]); 0.05% atropine (mean differences compared with control: refraction, 0.62 [95% CI, 0.17e1.07]; AXL, e0.25 [e0.44 to e0.06]). In terms of myopia control as assessed by relative risk (RR) for overall myopia progression, 0.05% was ranked as the most benefificial concentration (RR, 0.39 [95% CI, 0.27e0.57]). The risk for adverse effects tended to rise as the atropine concentration was increased, although this tendency was not evident for distance BCVA. No valid network was formed for near BCVA.

从16项随机对照试验(3272名参与者)中获得了30个两两比较。我们的NMA将1%、0.5%和0.05%的阿托品浓度列为3个最有利于近视控制的指标，评估了两种主要结果:1%的阿托品(与对照组相比的平均差异:屈光，0.81[95%置信区间(CI)， 0.58e1.04];AXL, e0.35 [e0.46到e0.25]);0.5%阿托品(与对照组相比的平均差异:屈光度，0.70 [95% CI, 0.40e1.00];AXL, e0.23 [e0.38到e0.07]);0.05%阿托品(与对照组相比，平均差异:屈光度，0.62 [95% CI, 0.17e1.07];AXL, e0.25 [e0.44 to e0.06])。在总体近视进展的相对风险(RR)评估的近视控制方面，0.05%被列为最有益的浓度(RR, 0.39 [95% CI, 0.27e0.57])。不良反应的风险随着阿托品浓度的增加而增加，尽管这种趋势在距离BCVA中不明显。BCVA附近未形成有效网络。

Discussion

The ranking probability for effificacy was not proportional to dose (i.e., 0.05% atropine was comparable with that of high-dose atropine [1% and 0.5%]), although those for pupil size and accommodation amplitude were dose related.

疗效排名的概率与剂量无关(即0.05%阿托品与高剂量阿托品具有可比性[1%和0.5%])，尽管瞳孔大小和调节幅度与剂量相关。

推荐理由

本研究探索了8种阿托品浓度控制儿童近视的疗效和安全性得出在总体近视进展的相对风险(RR)评估的近视控制方面，0.05%被列为最有益的浓度(RR, 0.39 [95% CI, 0.27e0.57]),0.05%阿托品与高剂量阿托品具有可比性[1%和0.5%]

文章创新点是关注不同阿托品浓度，从大数据中提取合适患者进行研究，数据准确度高，通过科学的方案设计分析出阿托品浓度控制对于视力的影响

文章的不足之处为没有做患儿之间的差异性比较，可能存在偏差。

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