玻璃体黄斑粘连与渗出型老年性黄斑变性相关性的meta分析

The correlation between the vitreomacular adhesion and exudative age-related macular degeneration：a meta-analysis

目的探讨玻璃体黄斑粘连（VMA）与渗出型老年性黄斑变性（AMD）的相关性。方法通过计算机检索循证医学图书馆Cochrane Library、美国国立医学图书馆医学数据库PubMed、美国医学索引Medline、荷兰医学文摘数据库Embase、中国知网及万方科技期刊全文数据库中发表于2000年1月至2016年12月的文献，收集关于VMA、玻璃体后脱离（PVD）与渗出型AMD相关性的病例对照研究进行meta分析。按照纳入与排除标准筛选文献、提取资料，并采用纽卡斯尔-渥太华量表（NOS）对纳入文献进行方法学质量评价。纳入分析的7篇文献中，NOS评分为9分1篇，8分4篇，7分2篇。共纳入渗出型AMD患眼947只，萎缩型AMD患眼638只，正常对照眼618只。采用Revman 5.3软件对VMA状态与渗出型AMD的相关性进行统计学分析。结果渗出型AMD组患眼的VMA发生率明显高于正常对照组[比值比（OR）=2.14，95%可信区间（CI）为1.19～3.84，P=0.010]、萎缩型AMD组（OR=2.24，95%CI为1.24～4.03，P=0.007），差异有统计学意义。渗出型AMD组患眼PVD发生率与正常对照组（OR=0.70，95%CI为0.41～1.18，P=0.180）、萎缩型AMD组（OR=0.44，95%CI为0.16～1.20，P=0.110）比较，差异无统计学意义。结论VMA与渗出型AMD存在相关性。

ObjectiveTo investigate the correlation between the vitreomacular adhesion （VMA） and exudative age-related macular degeneration （AMD）.MethodsA literature research was performed in PubMed, EMbase, Cochrane Library, CNKI and Wanfang database from January 2000 to December 2016. Case-control studies on the relationship between VMA or posterior vitreous detachment and exudative AMD were included in this analysis. Literature screening and data extraction were performed according to inclusion and exclusion criteria. The qualities of the literatures were evaluated according to the Newcastle-Ottawa Scale （NOS）. Seven literatures were selected into meta-analysis. The NOS score was 9 points in 1 article, 8 scores in 4 articles, 7 points in 2 articles. A total of 947 eyes with exudative AMD, 638 eyes with dry AMD, and 618 eyes with controls were included. The correlation between exudative AMD and VMA were analyzed using the software Review manager 5.3.ResultsThe prevalence of VMA in exudative AMD eyes was higher than that in controls [odds ratio （OR）=2.14, 95% confidence interval （CI）=1.19 - 3.84, P=0.010] and dry AMD eyes （OR=2.24, 95%CI=1.24 - 4.03, P=0.007）. There was no difference in PVD prevalence among exudative AMD eyes, dry AMD eyes （OR=0.44, 95%CI=0.16 - 1.20, P=0.110） and controls （OR=0.70, 95%CI=0.41 - 1.18, P=0.180）.ConclusionThere is correlation between VMA and exudative AMD.