Effect of Intravenous Mannitol on Intraocular Pressure Changes in Vitrectomized and Non-Vitrectomized Eyes: A Systematic Review and Meta-Analysis

<h3>Purpose</h3><p dir="ltr">Intraocular pressure (IOP) control is paramount during ophthalmic surgeries to ensure successful outcomes and prevent complications. Intravenous mannitol has been explored for its ability to manage IOP fluctuations in both vitrectomized and no...

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Main Author: HASHEM ABU SERHAN (19737499) (author)
Other Authors: PARUL CHAWLA GUPTA (19737502) (author), MAHALAQUA NAZLI KHATIB (19737505) (author), BIJAYA K. PADHI (19737508) (author), SHILPA GAIDHANE (19737511) (author), QUAZI SYED ZAHIRUDDIN (19737514) (author), ABHAY M. GAIDHANE (19737517) (author), NEELIMA KUKRETI (19737520) (author), SARVESH RUSTAGI (19737523) (author), PRAKASINI SATAPATHY (19737526) (author)
Published: 2024
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_version_ 1864513556483932160
author HASHEM ABU SERHAN (19737499)
author2 PARUL CHAWLA GUPTA (19737502)
MAHALAQUA NAZLI KHATIB (19737505)
BIJAYA K. PADHI (19737508)
SHILPA GAIDHANE (19737511)
QUAZI SYED ZAHIRUDDIN (19737514)
ABHAY M. GAIDHANE (19737517)
NEELIMA KUKRETI (19737520)
SARVESH RUSTAGI (19737523)
PRAKASINI SATAPATHY (19737526)
author2_role author
author
author
author
author
author
author
author
author
author_facet HASHEM ABU SERHAN (19737499)
PARUL CHAWLA GUPTA (19737502)
MAHALAQUA NAZLI KHATIB (19737505)
BIJAYA K. PADHI (19737508)
SHILPA GAIDHANE (19737511)
QUAZI SYED ZAHIRUDDIN (19737514)
ABHAY M. GAIDHANE (19737517)
NEELIMA KUKRETI (19737520)
SARVESH RUSTAGI (19737523)
PRAKASINI SATAPATHY (19737526)
author_role author
dc.creator.none.fl_str_mv HASHEM ABU SERHAN (19737499)
PARUL CHAWLA GUPTA (19737502)
MAHALAQUA NAZLI KHATIB (19737505)
BIJAYA K. PADHI (19737508)
SHILPA GAIDHANE (19737511)
QUAZI SYED ZAHIRUDDIN (19737514)
ABHAY M. GAIDHANE (19737517)
NEELIMA KUKRETI (19737520)
SARVESH RUSTAGI (19737523)
PRAKASINI SATAPATHY (19737526)
dc.date.none.fl_str_mv 2024-08-13T18:00:00Z
dc.identifier.none.fl_str_mv 10.1016/j.ajo.2024.07.013
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Effect_of_Intravenous_Mannitol_on_Intraocular_Pressure_Changes_in_Vitrectomized_and_Non-Vitrectomized_Eyes_A_Systematic_Review_and_Meta-Analysis/27101080
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
Ophthalmology and optometry
Pharmacology and pharmaceutical sciences
Intraocular pressure (IOP)
Ophthalmic surgery
Intravenous mannitol
Vitrectomized eyes
Non-vitrectomized eyes
Meta-analysis
Systematic review
Pharmacology
dc.title.none.fl_str_mv Effect of Intravenous Mannitol on Intraocular Pressure Changes in Vitrectomized and Non-Vitrectomized Eyes: A Systematic Review and Meta-Analysis
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3>Purpose</h3><p dir="ltr">Intraocular pressure (IOP) control is paramount during ophthalmic surgeries to ensure successful outcomes and prevent complications. Intravenous mannitol has been explored for its ability to manage IOP fluctuations in both vitrectomized and non-vitrectomized eyes. This meta-analysis aimed to assess the efficacy of mannitol in controlling IOP across these patient groups.</p><h3>Design</h3><p dir="ltr">Systematic review and meta-analysis.</p><h3>Methods</h3><p dir="ltr">A literature search was conducted across PubMed, EMBASE, Scopus, and Web of Science from inception up to March 1, 2024, focusing on studies investigating mannitol's impact on IOP in vitrectomized and non-vitrectomized eyes. Randomized controlled trials, cohort studies, and case-control studies were included, while case reports and review articles were excluded. The primary outcome was the change in IOP following mannitol administration. Meta-analysis was performed using a random-effects model. R software (V 4.3) was used for statistical analysis.</p><h3>Results</h3><p dir="ltr">Our search included five studies of both vitrectomized (145 eyes) and non-vitrectomized eyes (91 eyes). The meta-analysis demonstrated significant IOP reductions following mannitol administration across multiple time points. Three studies were included at 30 min and 2 studies at all other time points in the analysis. In vitrectomized eyes, notable decreases were observed: at 30 min, the Ratio of Means (ROM) was 0.81 (95% CI: 0.53; 1.24), indicating a 19% reduction; at 60 min, the ROM of 0.833 (95% CI: 0.77; 0.89) showed a 16.7% reduction; at 90 min, the ROM of 0.757 (95% CI: 0.755; 0.758) corresponded to a 24.3% reduction; at 2 h, the ROM of 0.726 (95% CI: 0.642; 0.820) reflected a 27.4% reduction; at 3 h, the ROM of 0.692 (95% CI: 0.600; 0.797) resulted in a 30.8% reduction; and at 4 h, the ROM of 0.700 (95% CI: 0.363; 1.350) indicated a 30% reduction. No significant changes were observed on IOP with mannitol administration when comparing vitrectomized versus non- vitrectomized eyes.</p><h3>Conclusion</h3><p dir="ltr">Intravenous mannitol effectively reduces IOP in both vitrectomized and non-vitrectomized eyes, demonstrating its utility in the acute management of elevated IOP during and after ophthalmic surgeries. These findings support the integration of mannitol into perioperative care protocols. However, further research, particularly randomized controlled trials and studies with broader demographic representation, is needed to optimize mannitol's usage and fully understand its long-term safety and efficacy.</p><h2>Other Information</h2><p dir="ltr">Published in: American Journal of Ophthalmology<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.ajo.2024.07.013" target="_blank">https://dx.doi.org/10.1016/j.ajo.2024.07.013</a></p>
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identifier_str_mv 10.1016/j.ajo.2024.07.013
network_acronym_str Manara2
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oai_identifier_str oai:figshare.com:article/27101080
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spelling Effect of Intravenous Mannitol on Intraocular Pressure Changes in Vitrectomized and Non-Vitrectomized Eyes: A Systematic Review and Meta-AnalysisHASHEM ABU SERHAN (19737499)PARUL CHAWLA GUPTA (19737502)MAHALAQUA NAZLI KHATIB (19737505)BIJAYA K. PADHI (19737508)SHILPA GAIDHANE (19737511)QUAZI SYED ZAHIRUDDIN (19737514)ABHAY M. GAIDHANE (19737517)NEELIMA KUKRETI (19737520)SARVESH RUSTAGI (19737523)PRAKASINI SATAPATHY (19737526)Biomedical and clinical sciencesClinical sciencesOphthalmology and optometryPharmacology and pharmaceutical sciencesIntraocular pressure (IOP)Ophthalmic surgeryIntravenous mannitolVitrectomized eyesNon-vitrectomized eyesMeta-analysisSystematic reviewPharmacology<h3>Purpose</h3><p dir="ltr">Intraocular pressure (IOP) control is paramount during ophthalmic surgeries to ensure successful outcomes and prevent complications. Intravenous mannitol has been explored for its ability to manage IOP fluctuations in both vitrectomized and non-vitrectomized eyes. This meta-analysis aimed to assess the efficacy of mannitol in controlling IOP across these patient groups.</p><h3>Design</h3><p dir="ltr">Systematic review and meta-analysis.</p><h3>Methods</h3><p dir="ltr">A literature search was conducted across PubMed, EMBASE, Scopus, and Web of Science from inception up to March 1, 2024, focusing on studies investigating mannitol's impact on IOP in vitrectomized and non-vitrectomized eyes. Randomized controlled trials, cohort studies, and case-control studies were included, while case reports and review articles were excluded. The primary outcome was the change in IOP following mannitol administration. Meta-analysis was performed using a random-effects model. R software (V 4.3) was used for statistical analysis.</p><h3>Results</h3><p dir="ltr">Our search included five studies of both vitrectomized (145 eyes) and non-vitrectomized eyes (91 eyes). The meta-analysis demonstrated significant IOP reductions following mannitol administration across multiple time points. Three studies were included at 30 min and 2 studies at all other time points in the analysis. In vitrectomized eyes, notable decreases were observed: at 30 min, the Ratio of Means (ROM) was 0.81 (95% CI: 0.53; 1.24), indicating a 19% reduction; at 60 min, the ROM of 0.833 (95% CI: 0.77; 0.89) showed a 16.7% reduction; at 90 min, the ROM of 0.757 (95% CI: 0.755; 0.758) corresponded to a 24.3% reduction; at 2 h, the ROM of 0.726 (95% CI: 0.642; 0.820) reflected a 27.4% reduction; at 3 h, the ROM of 0.692 (95% CI: 0.600; 0.797) resulted in a 30.8% reduction; and at 4 h, the ROM of 0.700 (95% CI: 0.363; 1.350) indicated a 30% reduction. No significant changes were observed on IOP with mannitol administration when comparing vitrectomized versus non- vitrectomized eyes.</p><h3>Conclusion</h3><p dir="ltr">Intravenous mannitol effectively reduces IOP in both vitrectomized and non-vitrectomized eyes, demonstrating its utility in the acute management of elevated IOP during and after ophthalmic surgeries. These findings support the integration of mannitol into perioperative care protocols. However, further research, particularly randomized controlled trials and studies with broader demographic representation, is needed to optimize mannitol's usage and fully understand its long-term safety and efficacy.</p><h2>Other Information</h2><p dir="ltr">Published in: American Journal of Ophthalmology<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.ajo.2024.07.013" target="_blank">https://dx.doi.org/10.1016/j.ajo.2024.07.013</a></p>2024-08-13T18:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1016/j.ajo.2024.07.013https://figshare.com/articles/journal_contribution/Effect_of_Intravenous_Mannitol_on_Intraocular_Pressure_Changes_in_Vitrectomized_and_Non-Vitrectomized_Eyes_A_Systematic_Review_and_Meta-Analysis/27101080CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/271010802024-08-13T18:00:00Z
spellingShingle Effect of Intravenous Mannitol on Intraocular Pressure Changes in Vitrectomized and Non-Vitrectomized Eyes: A Systematic Review and Meta-Analysis
HASHEM ABU SERHAN (19737499)
Biomedical and clinical sciences
Clinical sciences
Ophthalmology and optometry
Pharmacology and pharmaceutical sciences
Intraocular pressure (IOP)
Ophthalmic surgery
Intravenous mannitol
Vitrectomized eyes
Non-vitrectomized eyes
Meta-analysis
Systematic review
Pharmacology
status_str publishedVersion
title Effect of Intravenous Mannitol on Intraocular Pressure Changes in Vitrectomized and Non-Vitrectomized Eyes: A Systematic Review and Meta-Analysis
title_full Effect of Intravenous Mannitol on Intraocular Pressure Changes in Vitrectomized and Non-Vitrectomized Eyes: A Systematic Review and Meta-Analysis
title_fullStr Effect of Intravenous Mannitol on Intraocular Pressure Changes in Vitrectomized and Non-Vitrectomized Eyes: A Systematic Review and Meta-Analysis
title_full_unstemmed Effect of Intravenous Mannitol on Intraocular Pressure Changes in Vitrectomized and Non-Vitrectomized Eyes: A Systematic Review and Meta-Analysis
title_short Effect of Intravenous Mannitol on Intraocular Pressure Changes in Vitrectomized and Non-Vitrectomized Eyes: A Systematic Review and Meta-Analysis
title_sort Effect of Intravenous Mannitol on Intraocular Pressure Changes in Vitrectomized and Non-Vitrectomized Eyes: A Systematic Review and Meta-Analysis
topic Biomedical and clinical sciences
Clinical sciences
Ophthalmology and optometry
Pharmacology and pharmaceutical sciences
Intraocular pressure (IOP)
Ophthalmic surgery
Intravenous mannitol
Vitrectomized eyes
Non-vitrectomized eyes
Meta-analysis
Systematic review
Pharmacology