摘要
目的 研究视网膜内层结构对增生性糖尿病视网膜病变(PDR)患者玻璃体切割术(PPV)后视力预后的影响.方法 回顾性选取2021年1月至2023年1月在秦皇岛市第一医院确诊PDR并行玻璃体切割术治疗的118例(135 眼)患者作为研究对象.术后随访6个月,根据视力变化情况,分为预后良好组(n=98,109眼)和预后不良组(n=20,26眼).比较术后1个月不同预后患者的视网膜内层厚度、视网膜内层不连续(DRIL)长度和中央黄斑厚度(CMT);采用Spearman相关性分析探究视网膜内层厚度、DRIL长度和CMT与PDR患者PPV后预后不良之间的关系;采用受试者操作特征(ROC)曲线评估视网膜内层厚度、DRIL长度和CMT对PDR患者PPV后预后不良的预测价值.结果 术后1个月,预后良好组患者视网膜内层厚度、DRIL长度和CMT厚度分别为(185.93±19.68)、(565.42±53.12)、(327.31±23.51)μm,均显著小于预后不良组[(132.25±11.59)、(235.17±40.18)、(225.52±18.33)μm],差异均有统计学意义(P＜0.05).Spearman相关性分析显示,视网膜结构中的视网膜内层厚度、DRIL长度和CMT厚度与PDR患者PPV后视力预后不良均呈正相关(r=0.679、0.683、0.624,P＜0.05).ROC曲线分析显示,曲线下面积(AUC)值分别为0.837、0.791及0.760;视网膜内层厚度、DRIL长度和CMT厚度对PDR患者PPV后视力预后具有一定预测价值(P＜0.05).结论 术后1个月,视网膜内层厚度、DRIL长度和CMT厚度增加与PDR患者玻璃体切割术后视力预后不良有关,并对其有一定的预测价值.
Abstract
Objective To investigate the effect of inner retinal structure on visual prognosis after vitrectomy(PPV)in patients with prolif-erative diabetic retinopathy(PDR).Methods A retrospective study was conducted on 118 patients(135 eyes)diagnosed with PDR and treated with vitrectomy at the First Hospital of Qinhuangdao from January 2021 to January 2023.After 6 months of postoperative follow-up,the patients were divided into the good prognosis group(n=98,109 eyes)and the poor prognosis group(n=20,26 eyes)based on changes in vision.The retinal inner layer thickness,retinal inner layer discontinuity(DRIL)length,and central macular thickness(CMT)of patients with different prognoses one month after surgery were compared between the good prognosis group and the poor prognosis group,and the relationship between reti-nal inner layer thickness,DRIL length,CMT of inner retinal structure and poor prognosis after PPV in PDR patients was investigated using Spearman correlation analysis;the predictive value of retinal inner layer thickness,DRIL length and CMT of inner retinal structure for poor progno-sis after PPV in PDR patients was evaluated using receiver operating characteristic(ROC)curves.Results One month after surgery,the retinal inner layer thickness,DRIL length,CMT in the good prognosis group were(185.93±19.68),(565.4±53.12),and(327.31±23.51)μm,respectively,which were significantly smaller than those in the poor prognosis group[(132.25±11.59),(235.17±40.18),and(225.52±18.33)μm],and the differences were statistically significant(P＜0.05).Spearman correlation analysis showed that the retinal inner layer thickness,DRIL length,CMT were positively correlated with poor visual prognosis in PDR patients after PPV(r=0.679,0.683,and 0.624;P＜0.05).The ROC curve analysis showed that the area under the receiver operating characteristic curve(AUC)values were 0.837,0.791,and 0.760,respectively;Retinal inner layer thickness the length of DRIL and the thickness of CMT had certain predictive value for the visual prognosis of PDR patients after PPV(P＜0.05).Conclusion One month after surgery,the increase in the thickness of the inner layer of the retina,DRIL length and CMT thickness is associated with poor visual prognosis after vitrectomy in PDR patients,and has certain predictive value.
基金项目
2022年度河北省医学科学课题研究计划(20221613)
秦皇岛市科学技术研究与发展计划(202301A192)
NETL
NSTL
万方数据