A systematic review of neuroprotective therapies for visual acuity preservation in retinitis pigmentosa
Abstract
Objectives: This systematic review aims to evaluate the efficacy of neuroprotective therapies in improving best-corrected visual acuity (BCVA) in retinitis pigmentosa (RP). Secondary outcomes investigated included electroretinogram measures (ERGs), adverse events and other relevant ophthalmological outcomes.
Methods and analysis: A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered on PROSPERO. MEDLINE, EMBASE, ClinicalTrials.gov and the Cochrane Library were searched without date restrictions. Randomised controlled trials comparing neuroprotective interventions with any relevant comparator in typical RP and reporting BCVA outcomes were included. Risk of bias was assessed using ROB2 and certainty of evidence graded using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Due to heterogeneity in interventions and outcome reporting, narrative synthesis was undertaken.
Results: 10 trials involving 1364 participants were included. Interventions included antioxidants, gamma-aminobutyric acid (GABA) modulators, mechanical neurostimulation and omega-3 fatty acids. Across studies, no neuroprotective therapy demonstrated a clinically or statistically significant improvement in BCVA compared with control, with the exception of Lycium barbarum, which was associated with modest BCVA improvement in a single phase II trial with a very low GRADE certainty of…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,364 participants or records.
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