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The prevalence and presentation patterns of microcystic macular oedema: a systematic review and meta-analysis of 2128 glaucomatous eyes

Eye volume 37, pages 3322–3333 (2023)Cite this article

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Abstract

We conducted this research to determine the prevalence rate and presentation patterns with microcystic macular oedema (MMO) in glaucoma patients. The protocol was pre-registered on PROSPERO (CRD42022316367). PubMed, Scopus, Web of Science, EMBASE, ProQuest, EBSCOHost, CENTRAL, clinicaltrials.gov, and Google Scholar were searched for articles reporting MMO in glaucoma patients. The primary outcome was the prevalence of MMO, while secondary outcomes included the comparison between MMO and non-MMO in terms of patients’ characteristics (age, gender), glaucoma stage, and ocular parameters (axial length (AL), intraocular pressure, mean deviation, spherical equivalent). Data are reported as mean difference (MD) or log odds ratio (logOR) along with their corresponding 95% confidence intervals (CI) for continuous and dichotomous outcomes, respectively. The quality of included studies was assessed using the NIH tool, and the certainty of evidence was assessed using GRADE framework. Ten studies (2128 eyes) were included, revealing an overall prevalence rate of MMO of 8% (95%CI: 5–12%). When compared to non-MMO group, MMO was associated with lower age (MD = −5.91; 95%CI: −6.02: −5.20), greater risk of advanced glaucoma stage (LogOR=1.41; 95%CI: 0.72: 2.09), and lower mean deviation of the visual field (MD = −5.00; 95%CI: −7.01: −2.99). No significant difference was noted between both groups in terms of gender, axial length, or spherical equivalent. Three studies had good quality while seven had poor quality. MMO is a prevalent observation in glaucoma patients and is associated with patients’ age and stage of the disease. However, the certainty of evidence remains very low.

摘要

该研究旨在确定青光眼患者中微小黄斑囊性水肿 (microcystic macular oedema, MMO) 的流行率和表现模式。该研究已在PROSPERO进行预注册 (CRD42022316367) 。检索了PubMed, Scopus, Web of Science, EMBASE, ProQuest, EBSCOHost, CENTRAL, clinicaltrials.gov和谷歌学术中报告了青光眼患者MMO的文献。主要结局为MMO的患病率, 次要结局包括MMO和非MMO患者的特征 (年龄, 性别), 青光眼分期和眼部参数 (轴长 (axial length, AL) 、眼压、平均偏差、等效球镜度数) 。对于连续和二分类变量, 数据以平均差 (mean difference, MD) 或对数比值比 (log odds ratio, logOR) 及其95%的置信区间 (confidence intervals, CI) 表示。使用NIH工具评估纳入研究的质量, 使用GRADE框架评估证据的确定性。共纳入了10项研究 (2128只眼), 显示MMO的总患病率为8% (95%CI: 5–12%) 。与非MMO组对比, MMO组与较低的年龄 (MD = −5.91; 95%CI: −6.02: −5.20), 青光眼晚期高风险 (LogOR=1.41; 95%CI: 0.72: 2.09) 以及更低的视野平均偏差 (MD = −5.00; 95%CI: −7.01: −2.99) 相关。两组在性别、轴向长度和等效球镜度数方面无显著差异。纳入的文献中, 有三篇文献的质量较好, 七篇文献质量较差。MMO在青光眼患者中较为常见, 且与患者年龄及青光眼疾病分期密切相关。然而, 目前证据的确定性仍然较低。

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Fig. 1: PRISMA flow diagram of the database search and screening processes.
Fig. 2: Forest plot showing the overall prevalence of MME based on type of glaucoma.
Fig. 3: Forest plot showing the difference in male gender between MME and non-MME glaucoma patients.
Fig. 4: Forest plot showing the difference in age between MME and non-MME glaucoma patients.
Fig. 5: Forest plot showing the difference in early glaucoma between MME and non-MME patients.
Fig. 6: Forest plot showing the difference in moderate glaucoma between MME and non-MME patients.
Fig. 7: Forest plot showing the difference in advanced glaucoma between MME and non-MME patients.

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Author information

Author notes

  1. These authors contributed equally: Abdelaziz Abdelaal, Mennatullah Mohamed Eltaras.

Authors and Affiliations

  1. Tanta Research Team, Tanta, El-Gharbia, Egypt

    Abdelaziz Abdelaal, Mennatullah Mohamed Eltaras, Basant E. Katamesh, Hashem Abu Serhan, Ramadan Abdelmoez Farahat, Helmy Badr & Basel Abdelazeem

  2. Harvard Medical School, Boston, MA, USA

    Abdelaziz Abdelaal

  3. Master of Medical Sciences in Clinical Investigation (MMSCI), Harvard Medical School, Boston, MA, USA

    Abdelaziz Abdelaal

  4. Tanta University Hospitals, Tanta, Gharbia Governorate, Egypt

    Abdelaziz Abdelaal, Basant E. Katamesh & Helmy Badr

  5. Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt

    Mennatullah Mohamed Eltaras

  6. Research Scholar, Mayo Clinic, Rochester, USA

    Basant E. Katamesh

  7. Department of Ophthalmology, Hamad Medical Corporations, Doha, Qatar

    Hashem Abu Serhan

  8. Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt

    Ramadan Abdelmoez Farahat

  9. McLaren Health Care, Flint, MI, 48532, USA

    Basel Abdelazeem

  10. Michigan State University, East Lansing, MI, 48824, USA

    Basel Abdelazeem

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Contributions

AA: conceptualisation of the research idea, protocol registration, idea validation, data checking, data analysis, manuscript writing, and revision and approval of the final version of the manuscript; MMO: conceptualisation of the research idea, protocol registration, idea validation, data checking, manuscript writing, and revision and approval of the final version of the manuscript; BA: conceptualisation of the research idea, formulating the search query for each database, carrying out the database search, substantial editing and revision of the manuscript, and approval of the final version of the manuscript; BEK, HB, and RAF: screening of retrieved records, extraction of data for analysis, quality assessment, and approval of the final manuscript; HAS: substantial contribution to the writing of the manuscript as well as editing for the improvement of the quality of the manuscript.

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Correspondence to Abdelaziz Abdelaal.

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Abdelaal, A., Eltaras, M.M., Katamesh, B.E. et al. The prevalence and presentation patterns of microcystic macular oedema: a systematic review and meta-analysis of 2128 glaucomatous eyes. Eye 37, 3322–3333 (2023). https://doi.org/10.1038/s41433-023-02524-w

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