偏头痛与青光眼风险：一项系统综述与荟萃分析。
完整摘要 · 中文译文
背景：偏头痛和青光眼是全球范围内普遍且负担沉重的疾病，然而将两者联系起来的证据仍不一致。本系统综述和荟萃分析旨在综合关于两者关联的现有证据，并探讨异质性的来源。 方法：我们全面检索了PubMed、Embase和Cochrane图书馆自建库至2026年4月8日的文献，纳入考察偏头痛-青光眼关联的队列研究、病例对照研究和横断面研究。采用随机效应模型计算合并比值比（OR）及其95%置信区间（CI）。通过亚组分析、敏感性分析和meta回归分析探讨异质性。采用纽卡斯尔-渥太华量表和医疗保健研究与质量局清单评估研究质量。通过漏斗图、Egger检验和剪补法分析评估发表偏倚。 结果：共纳入19项研究，涉及3,625,071名参与者。合并分析显示偏头痛与青光眼风险之间存在显著正相关（OR = 1.28，95% CI：1.20-1.37），异质性中等（I2 = 46.2%）。亚组分析表明，来自美洲的研究、基于临床环境的研究、使用自我报告偏头痛诊断的研究以及女性参与者比例较高（≥60%）的研究中关联更强。Egger检验提示可能存在发表偏倚。经剪补法校正后（填入8项可能缺失的研究），合并估计值仍然显著但略有减弱（OR = 1.23，95% CI：1.13-1.34）。 结论：本meta- 分析提示偏头痛与青光眼风险显著增加相关。在针对潜在发表偏倚进行调整后，该关联在方向上仍然持续存在，但其幅度因数据来源、诊断方法和人群特征而异。需要采用标准化标准的进一步高质量前瞻性研究来阐明因果关系和潜在机制。 系统综述注册：https://www.crd.york.ac.uk/PROSPERO/view/CRD420261367870，CRD420261367870。
完整摘要 · 英文原文
BACKGROUND: Migraine and glaucoma are prevalent and burdensome conditions worldwide, yet the evidence linking them remains inconsistent. This systematic review and meta-analysis aimed to synthesize available evidence on their association and investigate sources of heterogeneity. METHODS: We comprehensively searched PubMed, Embase, and the Cochrane Library from inception to April 8, 2026, for cohort, case-control, and cross-sectional studies examining the migraine-glaucoma link. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models. Heterogeneity was explored via subgroup, sensitivity, and meta-regression analyses. Study quality was assessed using the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality checklist. Publication bias was evaluated via funnel plots, Egger's test, and trim-and-fill analysis. RESULTS: Nineteen studies involving 3,625,071 participants were incorporated. The pooled analysis demonstrated a significant positive association between migraine and glaucoma risk (OR = 1.28, 95% CI: 1.20-1.37), with moderate heterogeneity (I2 = 46.2%). Subgroup analyses indicated stronger associations in studies from America, clinic-based settings, those using self-reported migraine diagnosis and those with higher female participant proportions (≥60%). Egger's test suggested potential publication bias. Following trim-and-fill adjustment (imputing eight potentially missing studies), the pooled estimate remained significant though slightly attenuated (OR = 1.23, 95% CI: 1.13-1.34). CONCLUSION: This meta-analysis suggests migraine is associated with a significantly increased risk of glaucoma. While the association persisted directionally after adjusting for potential publication bias, its magnitude varied by data source, diagnostic method, and population characteristics. Further high-quality prospective studies employing standardized criteria are needed to elucidate causality and underlying mechanisms. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261367870, CRD420261367870.