Non-surgical therapy for intermittent exotropia: a systematic review and network analysis
Abstract Objective This study aimed to conduct a network meta-analysis to evaluate the efficacy of various non-surgical treatments for intermittent exotropia(IXT). Methods A comprehensive search of the PubMed, EMbase, and Cochrane Library databases was performed to identify relevant randomized contr...
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BMC
2024-12-01
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| Series: | BMC Ophthalmology |
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| Online Access: | https://doi.org/10.1186/s12886-024-03804-z |
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| author | Desheng Song Yanqiu Ma Hua Ji Qing Zhou Haixia Cheng |
| author_facet | Desheng Song Yanqiu Ma Hua Ji Qing Zhou Haixia Cheng |
| author_sort | Desheng Song |
| collection | DOAJ |
| description | Abstract Objective This study aimed to conduct a network meta-analysis to evaluate the efficacy of various non-surgical treatments for intermittent exotropia(IXT). Methods A comprehensive search of the PubMed, EMbase, and Cochrane Library databases was performed to identify relevant randomized controlled trials (RCTs) up to June 2024. Following independent screening, data extraction, and bias assessment by two researchers, network meta-analysis was conducted using R 4.2.2 software. Results A total of 11 RCTs involving 1411 patients were included. Treatment options included overminus lenses (OML), conventional prisms(base-in prism) (CP), part time occlusion (PTO), and binocular vision training (BVT). OML demonstrated superior efficacy in improving distance and near control(1.1, 95% confidence interval (CI), 0.22 ∼ 1.8); 0.67, 95% CI :0.027 ∼ 1.2), as well as reducing near exodeviation compared to observation(4.5, 95% CI, 1.9 ∼ 6.9), but failed to reduce distance angle of deviation(3.2, 95%CI, -1.1 ∼ 6.4). No significant effect in improving control and reducing exodeviation angle at both distance and near was observed in PTO, BVT, and CP. Probability ranking indicated that the top-ranking three non-surgical interventions were OML, BVT and PTO for improving distance control and reducing near exodeviation; the top three non-surgical interventions for reducing distance exodevition were OML, PTO and BVT; the best non-surgical intervention for improving near control was OML, BVT、 PTO and CP have similar effects. The four non-surgical treatments had no significant impact on near stereoacuity. Conclusion Overall, OML ranks first among the four conservative treatment methods. These four commonly used non-surgical interventions did not significantly impact near stereoacuity. Clinicians should tailor personalized treatment strategies for patients with intermittent exotropia based on disease severity, characteristics, efficacy, and cost considerations. |
| format | Article |
| id | doaj-art-212d973cc9914c08b93e6f78a81a03bd |
| institution | Kabale University |
| issn | 1471-2415 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Ophthalmology |
| spelling | doaj-art-212d973cc9914c08b93e6f78a81a03bd2024-12-22T12:22:03ZengBMCBMC Ophthalmology1471-24152024-12-0124111210.1186/s12886-024-03804-zNon-surgical therapy for intermittent exotropia: a systematic review and network analysisDesheng Song0Yanqiu Ma1Hua Ji2Qing Zhou3Haixia Cheng4Department of Ophthalmology, Children’s Hospital of Nanjing Medical UniversityDepartment of nursing, Children’s Hospital of Nanjing Medical UniversityDepartment of nursing, Children’s Hospital of Nanjing Medical UniversityDepartment of Ophthalmology, Children’s Hospital of Nanjing Medical UniversityDepartment of Ophthalmology, Children’s Hospital of Nanjing Medical UniversityAbstract Objective This study aimed to conduct a network meta-analysis to evaluate the efficacy of various non-surgical treatments for intermittent exotropia(IXT). Methods A comprehensive search of the PubMed, EMbase, and Cochrane Library databases was performed to identify relevant randomized controlled trials (RCTs) up to June 2024. Following independent screening, data extraction, and bias assessment by two researchers, network meta-analysis was conducted using R 4.2.2 software. Results A total of 11 RCTs involving 1411 patients were included. Treatment options included overminus lenses (OML), conventional prisms(base-in prism) (CP), part time occlusion (PTO), and binocular vision training (BVT). OML demonstrated superior efficacy in improving distance and near control(1.1, 95% confidence interval (CI), 0.22 ∼ 1.8); 0.67, 95% CI :0.027 ∼ 1.2), as well as reducing near exodeviation compared to observation(4.5, 95% CI, 1.9 ∼ 6.9), but failed to reduce distance angle of deviation(3.2, 95%CI, -1.1 ∼ 6.4). No significant effect in improving control and reducing exodeviation angle at both distance and near was observed in PTO, BVT, and CP. Probability ranking indicated that the top-ranking three non-surgical interventions were OML, BVT and PTO for improving distance control and reducing near exodeviation; the top three non-surgical interventions for reducing distance exodevition were OML, PTO and BVT; the best non-surgical intervention for improving near control was OML, BVT、 PTO and CP have similar effects. The four non-surgical treatments had no significant impact on near stereoacuity. Conclusion Overall, OML ranks first among the four conservative treatment methods. These four commonly used non-surgical interventions did not significantly impact near stereoacuity. Clinicians should tailor personalized treatment strategies for patients with intermittent exotropia based on disease severity, characteristics, efficacy, and cost considerations.https://doi.org/10.1186/s12886-024-03804-zIntermittent exotropiaNon-surgical therapyMeta-analysis |
| spellingShingle | Desheng Song Yanqiu Ma Hua Ji Qing Zhou Haixia Cheng Non-surgical therapy for intermittent exotropia: a systematic review and network analysis BMC Ophthalmology Intermittent exotropia Non-surgical therapy Meta-analysis |
| title | Non-surgical therapy for intermittent exotropia: a systematic review and network analysis |
| title_full | Non-surgical therapy for intermittent exotropia: a systematic review and network analysis |
| title_fullStr | Non-surgical therapy for intermittent exotropia: a systematic review and network analysis |
| title_full_unstemmed | Non-surgical therapy for intermittent exotropia: a systematic review and network analysis |
| title_short | Non-surgical therapy for intermittent exotropia: a systematic review and network analysis |
| title_sort | non surgical therapy for intermittent exotropia a systematic review and network analysis |
| topic | Intermittent exotropia Non-surgical therapy Meta-analysis |
| url | https://doi.org/10.1186/s12886-024-03804-z |
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