RESUMO
Many studies have evaluated different treatments for ischemic central retinal vein occlusion (CRVO). Nevertheless, improvement and complication rates vary significantly. This systematic review aimed to evaluate the efficacy of laser therapy in treating ischemic CRVO compared with a control group using other treatments. The databases of PubMed, Google Scholar, and ClinicalTrials.gov were searched using a variety of keywords, including "ischemic central retinal vein occlusion," "CRVO," "laser," and "panretinal photocoagulation." After data extraction, each study's quality was assessed using the methodological index for nonrandomized studies (MINORS) or grading of recommendations, assessment, development, and evaluation or GRADE standards. A sum of 195 abstracts were reviewed, and seven clinical trials were eventually chosen. Of these, four were prospective studies, two were randomized controlled studies, and only one was a retrospective study. The assessment of potential biases in our included studies revealed that all these studies demonstrated moderate or high quality. Two studies were selected for meta-analysis, and the results showed no significant difference in visual acuity (VA) outcomes between the treated and the control groups (P = 0.17). In the remaining five studies, laser therapy was found to be more effective at neovascular complications, with a higher rate of neovascular glaucoma (NVG), iris neovascularization (NVI), neovascularisation at disc (NVD), and retinal neovascularization in the group without laser treatments. This review suggests that laser therapy is essential in preventing neovascular complications, such as NVG, NVI, NVD, and retinal neovascularization rather than improving VA. In addition, the combination of laser photocoagulation and intravitreal injection (IVI) improved VA, but further studies are required.
RESUMO
OBJECTIVE: To evaluate the safety and effectiveness of levetiracetam and phenytoin by evaluating the events of seizure termination and recurrence in children. METHODS: We used the internet databases PubMed, Embase, and Google Scholar to conduct a literature search for the appropriate studies. A meta-analysis was performed to calculate the odds ratio using fixed and random-effects models. RESULTS: We identified 15 studies that were eligible for the meta-analysis. The incidence of seizure termination within 24 h was 76.9% for levetiracetam and 70.5% for phenytoin. Levetiracetam had a higher number of seizure termination events than phenytoin (P = 0.005, I2 = 66%). The incidence of seizure recurrence within 24 h was 10% for levetiracetam and 15.6% for phenytoin. Phenytoin had a significantly higher number of seizure recurrence events than levetiracetam (P = 0.00007, I2 = 21%). CONCLUSION: The efficacy and safety of levetiracetam are superior to that of phenytoin in children with status epilepticus. Large Randomized Controlled Trial studies are needed to confirm the result in children.
