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台湾非创伤性脉络膜上腔出血的临床特征与视力预后

Clinical characteristics and visual outcome of non-traumatic suprachoroidal haemorrhage in Taiwan.

作者信息

Wang Lu-Chun, Yang Chung-May, Yang Chang-Hao, Huang Jen-Sheng, Ho Tzyy-Chang, Lin Chang-Ping, Chen Muh-Shy

机构信息

Department of Ophthalmology, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan.

出版信息

Acta Ophthalmol. 2008 Dec;86(8):908-12. doi: 10.1111/j.1755-3768.2008.01266.x. Epub 2008 Jul 8.

Abstract

PURPOSE

This study aimed to evaluate the clinical features and visual outcomes of non-traumatic suprachoroidal haemorrhage (SH) in Taiwan.

METHODS

We report a retrospective, non-comparative, interventional case series study carried out in an institutional setting. Thirty-nine eyes with non-traumatic SH were studied using a new system for grading the severity of SH. The aetiologies of SH were analysed. The correlations between grades and prognoses of SH were studied. Multiple logistic regression was used to assess factors associated with final visual outcome.

RESULTS

Conditions causing SH in the eyes considered in this study included cataract surgery (43.59%), age-related macular degeneration (AMD) (17.95%), filtering operation and vitrectomy (both 10.26%), scleral buckling (5.13%) and others. Twelve eyes (12/39, 30.77%) had a final visual outcome of no light perception. Only 12 eyes (12/39, 30.77%) had final visual acuity (VA) > 4/200. Grade of SH correlated significantly with need for surgical drainage and with final visual outcome (Spearman rank correlations 0.313 and - 0.408, p = 0.010 and p = 0.00317, respectively). 'Good' and 'poor' final VA was significantly associated with VA at the time of SH (multiple logistic regression coefficients 2.132 and - 2.809, p = 0.015 and p = 0.008, respectively), as well as initial retinal detachment (multiple logistic regression coefficients - 2.267 and 2.223, p = 0.036 and p = 0.006, respectively). Higher grades of SH and increased age were associated with poor final visual outcome (multiple logistic regression coefficients - 1.332 and - 0.122, p = 0.013 and p = 0.022, respectively).

CONCLUSIONS

Suprachoroidal haemorrhage is a devastating ocular problem. Complications of intraoperative surgery and AMD are common causes. The new SH grading system provides a simple method for evaluating the need for drainage and for predicting visual prognosis. Visual acuity and retinal detachment at the time of SH are major factors associated with good and poor final VA, respectively.

摘要

目的

本研究旨在评估台湾地区非创伤性脉络膜上腔出血(SH)的临床特征及视力预后。

方法

我们报告了一项在机构环境中进行的回顾性、非对照、干预性病例系列研究。采用一种新的SH严重程度分级系统对39例非创伤性SH患者的眼部情况进行研究。分析SH的病因,研究SH分级与预后的相关性。采用多元逻辑回归分析评估与最终视力预后相关的因素。

结果

本研究中导致眼部SH的情况包括白内障手术(43.59%)、年龄相关性黄斑变性(AMD)(17.95%)、滤过手术和玻璃体切除术(均为10.26%)、巩膜扣带术(5.13%)及其他。12只眼(12/39,30.77%)最终视力为无光感。仅12只眼(12/39,30.77%)最终视力(VA)>4/200。SH分级与手术引流需求及最终视力预后显著相关(Spearman等级相关性分别为0.313和 - 0.408,p = 0.010和p = 0.00317)。最终视力“好”和“差”与SH发生时的视力显著相关(多元逻辑回归系数分别为2.132和 - 2.809,p = 0.015和p = 0.008),以及与初始视网膜脱离相关(多元逻辑回归系数分别为 - 2.267和2.223,p = 0.036和p = 0.006)。较高等级的SH和年龄增加与较差的最终视力预后相关(多元逻辑回归系数分别为 - 1.332和 - 0.122,p = 0.013和p = 0.022)。

结论

脉络膜上腔出血是一种严重的眼部问题。术中手术并发症和AMD是常见原因。新的SH分级系统为评估引流需求和预测视力预后提供了一种简单方法。SH发生时的视力和视网膜脱离分别是与最终视力良好和较差相关的主要因素。

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