首页|单眼孔源性视网膜脱离患者对侧眼发生视网膜脱离的危险因素分析

单眼孔源性视网膜脱离患者对侧眼发生视网膜脱离的危险因素分析

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目的 分析单眼孔源性视网膜脱离(RRD)患者对侧眼发生RRD的危险因素。方法 采用单中心回顾性队列研究,分析2018-2020年该院331例行单眼RRD手术住院患者的性别、年龄、眼别、双眼最佳矫正视力(BCVA)、双眼屈光度、对侧眼是否植入人工晶体,以及对侧眼视网膜裂孔或变性区(格子样、囊样、蜗牛迹样变性)位置分布等信息,并随访1年,期间对侧眼如发生视网膜裂孔或变性时,进行激光光凝预防治疗。采用logistic回归分析对侧眼发生RRD的危险因素,并计算Kappa值对患侧眼及对侧眼视网膜裂孔或变性区的位置分布进行一致性分析。结果 对侧眼是否发生RRD的影响因素主要包括年龄、术前BCVA、术前屈光度(P<0。05)。logistic 回归分析揭示,年龄 40~<60 岁(OR=6。906,P<0。001)、术前 BCVA<0。05(OR=3。015,P<0。001)、术前屈光度-3。00~<-6。00 D(OR=5。511,P<0。001)是对侧眼发生视网膜裂孔或变性区的显著独立危险因素;年龄<40岁(OR=0。101,P<0。001)和术前屈光度+0。50~<0。50 D(OR=0。160,P=0。001)则为保护因素。对侧眼在视网膜四个象限发生裂孔或变性的例数分别为59、14、27和8,其中与患侧眼在同一象限的例数为43、6、10和3,Kappa值为0。296,P<0。001。所有对侧眼出现视网膜裂孔及格子样变性区的患者接受激光光凝预防治疗,在1年随访期内未出现更进一步的视网膜脱离。结论 针对单眼RRD患者,应详细检查对侧眼,尤其是中老年、BCVA<0。05及屈光度-3。00~<-6。00 D的患者,重点关注对侧眼与患侧眼裂孔相同的视网膜象限,通过定期全面的眼部检查以有效降低对侧眼RRD的发生率。
Analysis on risk factors for retinal detachment occurrence in fellow eye of patients with monocular rhegmatogenous retinal detachment
Objective To analyze the risk factors for the occurrence of rhegmatogenous retinal detach-ment(RRD)in the fellow eye of the patients with monocular RRD.Methods A single-center retrospective cohort study was conducted.The information such as the gender,age,laterality,bilateral best corrected visual acuity(BCVA),bilateral refractive error,whether the fellow eye implanting an intraocular lens,and location distribution of retinal tears or degenerative areas(such as lattice,cystic,and snail track degeneration)in the fellow eye of 331 patients with unilateral RRD surgery in this hospital from January 2018 to December 2020 was analyzed.The patients were followed up for one year,during this period,the prophylactic laser photocoag-ulation was performed if retinal tears or degenerative areas occurred in the fellow eye.The risk factors for RRD occurrence in the fellow eye were analyzed by the logistic regression.The Kappa value was calculated.The location distribution of retinal tears or degenerative areas in the affected eye and the fellow eye conducted the consistency analysis.Results The influencing factors for RRD occurrence of the fellow eye in the two groups mainly included the age,preoperative BCVA and preoperative refractive error(P<0.05).Logistic re-gression analysis revealed that the age 40 to<60 years old(OR=6.906,P<0.001),preoperative BCVA<0.05(OR=3.015,P<0.001)and refractive error-3.00 to<-6.00 D(OR=5.511,P<0.001)were sig-nificant independent risk factors for the occurrence of retinal tears or degenerative areas in the fellow eye.The age<40 years old(OR=0.101,P<0.001)and refractive error+0.50 D-<-0.50 D(OR=0.160,P=0.001)were the protective factors.The numbers of cases in the fellow eye with retinal tears or degenerative areas in the 4 quadrants were 59,14,27,and 8,respectively.In the affected eye,the numbers of cases with reti-nal tears or degenerative areas in the same quadrants were 43,6,10,and 3,respectively.The Kappa value was 0.296,P<0.001.All patients with RRD or lattice degeneration in the fellow eye received prophylactic laser photocoagulation,and no further retinal detachment occurred during the one-year follow-up period.Conclusion Ai-ming at the patients with unilateral RRD,the contralateral eye should be examined in detail,especially in mid-dle-aged and elderly patients with BCVA<0.50 and diopter-3.00-<-6.00 D,focusing on the retinal quadrant of the contralateral eye that is the same as the affected eye hole,and the incidence of contralateral RRD should be effectively reduced through regular and comprehensive eye examination.

rhegmatogenous retinal detachmentretinal teardegenerative areafellow eyerisk factors

姚佳佳、冉黎、刘娜、吴楠

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陆军军医大学第一附属医院眼科,重庆 400037

孔源性视网膜脱离 视网膜裂孔 变性区 对侧眼 危险因素

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(24)