辐辏障碍视力治疗后的神经变化:系统回顾

IF 1.8 4区 医学 Q3 OPHTHALMOLOGY Journal of Ophthalmology Pub Date : 2024-07-30 eCollection Date: 2024-01-01 DOI:10.1155/2024/5586202
Laura Barberán-Bernardos, Natalia Jiménez, David P Piñero
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引用次数: 0

摘要

目的研究视觉疗法(VT)对辐辏功能不全(CI)患者的神经系统是否有显著影响,以及这种影响与该治疗方案所产生的临床变化之间的相关性:方法: 在 PubMed 和 Scopus 数据库中对科学文献进行了系统回顾,分析了所有有关 VT 对 CI 神经影响的科学文献。最初共找到 17 篇文章,并进行了详细分析。全文阅读后,只有四项研究符合规定的纳入标准。我们从中提取了以下数据:CI 病例和对照组、评估的临床和神经参数、观察到的 VT 神经反应、研究类型和进行的 VT。研究质量采用 GRADE 工具进行评估:使用功能磁共振成像(fMRI)对 CI 患者进行 VT 后的一些神经变化进行了报道。具体而言,一些脑区(尤其是前场、眼动蚓部和小脑)的功能活动发生了改变。然而,在功能活动的变化(增加或减少)方面却发现了相互矛盾的结果,这可能与 fMRI 方案的不同有关。在 GRADE 分析中,发现在偏倚风险、不一致性、间接性和不精确性方面存在严重问题,因此每项结果的证据确定性都很低:迄今为止所进行的研究还不能证实 CI 患者在接受视力治疗后神经系统是否发生了变化,因为这方面的研究质量很低,存在一些方法学方面的问题。
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Neural Changes after Vision Therapy in Convergence Insufficiency: A Systematic Review.

Objective: To investigate if the use of vision therapy (VT) in convergence insufficiency (CI) has a significant neural impact and how it correlates with the clinical changes occurring with this option of treatment.

Methods: A systematic review of the scientific literature was carried out in the PubMed and Scopus databases, where all the scientific literature on the neural impact of VT in CI was analyzed. A total of 17 articles were initially found and a detailed analysis was carried out. After full-text reading, only four studies met the defined inclusion criteria. The following data from them were extracted: CI cases and controls, clinical and neural parameters evaluated, the neural response to VT observed, type of study, and VT performed. The quality of the studies was assessed using the GRADE tool.

Results: Some neural changes have been reported after VT in CI with the use of functional magnetic resonance imaging (fMRI). Specifically, a modification of the functional activity of some brain areas (especially front fields, oculomotor vermis, and cerebellum) was found. However, contradictory findings in terms of the change in functional activity (increase or decrease) were found that might be associated to differences in fMRI protocols. In the GRADE analysis, serious concerns were found in the categories of risk of bias, inconsistency, indirectness, and imprecision, so the certainty of evidence for each outcome was very low.

Conclusion: The research performed to this date does not allow confirming if there are neural changes occurring after vision therapy in patients with CI because the quality of the research performed on this issue is very low, with several methodological concerns.

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来源期刊
Journal of Ophthalmology
Journal of Ophthalmology MEDICINE, RESEARCH & EXPERIMENTAL-OPHTHALMOLOGY
CiteScore
4.30
自引率
5.30%
发文量
194
审稿时长
6-12 weeks
期刊介绍: Journal of Ophthalmology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies related to the anatomy, physiology and diseases of the eye. Submissions should focus on new diagnostic and surgical techniques, instrument and therapy updates, as well as clinical trials and research findings.
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