<b><i>Background:</i></b> In children, myopia has become a widespread and serious global public health problem. Soft multifocal contact lenses (SMCLs) have been widely studied to control myopia progression in children. However, their efficacy in myopia control in children and its adverse effects and which added power SMCLs are more effective and safer remains to be explored. <b><i>Objectives:</i></b> Evaluate the efficacy and safety of various add power SMCLs to slow myopia progression in children. <b><i>Method:</i></b> Eligible randomized controlled trials were retrieved from PubMed, MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials databases. The present meta-analysis analyzed the mean differences (MD) in myopic progression, axial length, and odds ratios for adverse effects and dropout rates between SMCLs with different added powers and control groups. Changes in visual performance were also systematically evaluated. <b><i>Results:</i></b> Seven independent studies involving 805 children were included in the present meta-analysis. At 1-year, the weighted MD (WMD) in myopia progression between SMCL and control groups was −0.22 diopters (D) (95% confidence interval [CI]: −0.56 to 0.12 D) for low add power SMCLs, 0.09 D (95% CI: 0–0.19 D) for medium add power SMCLs, and 0.2 D (95% CI: 0.13, 0.27 D) for high add power SMCLs. At 2-years, the WMD for medium add power was 0.12 D (95% CI: −0.03 to 0.27 D), and for high add power was 0.25 D (95% CI: 0.14–0.35 D). No differences were detected for adverse effects (<i>p</i> = 0.2) and acceptability (<i>p</i> = 0.74) between different added powers. Additionally, differences in visual performance changes, produced by different added powers, were not detected. <b><i>Conclusions:</i></b> The present meta-analysis showed that high add power SMCLs are more effective and stable to control myopia progression. Besides, the adverse effects and acceptability were not related to the added power.
Background: Myopia is a common visual disorder which has become a public health problem worldwide. Myopia and high myopia are substantial risk factors for severe visual impairment and other serious eye diseases. Acupuncture used to prevent and control myopia is a common practice in China, but it is controversial in other countries. This study aims to evaluate the efficacy and safety of acupuncture in delaying the progression of myopia in children and adolescents through systematic evaluation. Methods and analysis: The following electronic databases will be searched from inception to November 2019 regardless of publication status and language: Medline, EMBASE, Web of Science, the Cochrane Library, PubMed, China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), Chinese Scientific Journal Database (VIP), Wanfang Database, Chinese Biomedical Literature Database (CBLD), Chinese Science and Technology Periodical Database (CSTPD). RCT registration websites, including http://www.ClinicalTrials.gov and http://www.chictr.org.cn, will also be searched. Review Manager V.5.3 will be used to analysis the statistic. Two reviewers (ZY and XW) will independently select studies, extract and code the data, assess risk of bias of the included studies, evaluate the quality of evidence for outcomes. Results: This study will provide a rational synthesis of current evidences for acupuncture to delay the progression for myopia in children and adolescents. Conclusion: The conclusion of this study will provide evidence for evaluating the efficacy and safety of acupuncture to delay the progression for myopia in children and adolescents.
Background. Dry eye disease (DED) is a multifactorial disease of the ocular surface, which affects the quality of life and work efficiency of affected patients. The traditional Chinese medicine formula Qiju Dihuang Pill (QJDHP) has a good therapeutic effect on DED. However, the pharmacological mechanism is not clear. Objective. To explore the mechanism of QJDHP in the treatment of DED based on network pharmacology. Method. The active components in QJDHP were screened in Traditional Chinese Medicine Systems Pharmacology (TCMSP), and putative molecular targets of QJDHP were identified using the SwissTargetPrediction database. DED-related targets were screened by GeneCards and OMIM. We established protein-protein interaction (PPI) and core targets and corresponding active compound network by Cytoscape to identify the core targets and main compounds of QJDHP against DED. DAVID database was utilized for Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses. Molecular docking was used to evaluate the binding activity between key active compounds and core targets. Results. The results of network pharmacology showed that 253 targets of QJDHP were related to DED. PPI network analysis showed the 18 core targets. The binding affinity of docking results ranged from -5.7 to -9.3 kcal/mol, indicating a good docking effect. The results of GO enrichment analysis showed that the mechanism of QJDHP in the treatment of DED mainly involved biological processes such as apoptosis, oxidative stress, response to estrogen, angiogenesis, and the regulation of transcription factors. KEGG analysis showed that QJDHP may be regulated by the TNF signaling pathway, Toll-like receptor signaling pathway, MAPK signaling pathway, and estrogen signaling pathway in the treatment of DED. Conclusion. In this study, we demonstrated the multicomponent, multitarget, and multichannel action mechanism of QJDHP in the treatment of DED and provided a foundation for further drug development research.
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