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Meta-Analysis
. 2024 Dec 6:22:eRW0832.
doi: 10.31744/einstein_journal/2024RW0832. eCollection 2024.

Autologous platelet concentrate for the treatment of macular hole: a systematic review and meta-analysis

Dillan Cunha Amaral  1 , Mário Luiz Ribeiro Monteiro  2 , Milton Ruiz Alves  2 , Ivar Vargas Belizario  3 , Lucas de Sousa Tebicherane  1 , Raíza Jacometti  2 , José Eduardo Ferreira Manso  1 , Agma Juci Machado Traina  4 , Ricardo Noguera Louzada  1   2   4
Affiliations
Meta-Analysis

Autologous platelet concentrate for the treatment of macular hole: a systematic review and meta-analysis

Dillan Cunha Amaral et al. Einstein (Sao Paulo). .

Abstract

Autologous platelet concentrates are rich in growth factors and have shown potential for high anatomical success rates in macular hole treatment. However, no systematic review has yet assessed its impact. Therefore, this study aimed to conduct a comprehensive review and meta-analysis on the comparative efficacy and safety of autologous platelet concentrates in treating macular hole. A systematic review of the literature on autologous platelet concentrate therapy for macular hole was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines on September 9, 2023. Databases, including PubMed, the Cochrane Library, Web of Science, and Embase, were queried. A meta-analysis of random effects was performed. Efficacy was evaluated through anatomical closure, reopening of the macular hole at 6 months, average improvement of 2 lines, and visual field loss. Safety was evaluated by monitoring complications. A systematic search of multiple databases identified six studies (three randomized controlled trials and three non-randomized cohort studies) involving 616 patients (626 eyes). Autologous platelets concentrate therapy significantly improved macular hole closure compared to that in the controls (OR=4.35; 95%CI=2.08-9.10; p<0.0001; I²=9%). No significant differences were observed in hole reopening at 6 months, post-operative visual acuity improvement by 2 lines or more, or visual field loss between autologous platelets concentrate and control groups. The overall complication rates were similar between groups. Thus, autologous platelet concentrate therapy shows promise for promoting macular hole closure, particularly in smaller holes. Further research with standardized protocols, prolonged follow-ups, and larger sample sizes is needed to fully understand its benefits and limitations in macular hole closure. (https://www.crd.york.ac.uk/prospero/) under ID CRD42023455815.

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Figures

Figure 1
Figure 1. Study screening and selection process
Figure 2
Figure 2. Forest plots of (A) anatomical closure and (B) reopening of the MH in 6 months
Figure 3
Figure 3. Forest plot of average improvement of 2 lines or more
Figure 4
Figure 4. Forest plots of (A) Complications and (B) Endophthalmitis
See this image and copyright information in PMC

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