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术前眼科检查依从性与增生性糖尿病视网膜病变玻璃体切除术后视力结果的关系。

Relationship between compliance with ophthalmic examinations preoperatively and visual outcome after vitrectomy for proliferative diabetic retinopathy.

机构信息

Kyorin Eye Center, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan.

出版信息

Jpn J Ophthalmol. 2012 Sep;56(5):481-7. doi: 10.1007/s10384-012-0161-4. Epub 2012 Jul 6.

Abstract

PURPOSE

To evaluate the relationship between compliance with ophthalmic examinations before vitrectomy for proliferative diabetic retinopathy (PDR) and postoperative vision.

METHODS

The clinical findings and visual acuity in 128 eyes of 94 patients who had undergone vitrectomy for PDR were reviewed. The patients were divided into the never-examined group with no previous ophthalmic examination until the first visit when vitrectomy was prescribed, the noncompliant group with a history of missing ophthalmic examinations over a 1-year period, and the compliant group with ophthalmic examinations at least once a year before the vitrectomy.

RESULTS

Compliance with general medical examinations in the never-examined group (19 %) and in the noncompliant group (26 %) was significantly lower than that in the compliant group (100 %; P < 0.001 and P < 0.001, respectively). The mean glycosylated hemoglobin in the never-examined group (8.9 %) was significantly higher than that in the compliant group (7.6 %; P = 0.047). The postoperative visual acuities at 6 months and at the final visit were significantly better in the compliant group than in the never-examined group (P = 0.017).

CONCLUSIONS

Compliance with preoperative examinations significantly affects vision after vitrectomy for PDR. Low compliance with ophthalmic examinations was significantly associated with low compliance with general medical examinations and high blood glucose levels.

摘要

目的

评估增殖型糖尿病性视网膜病变(PDR)患者行玻璃体切割术前眼部检查依从性与术后视力的关系。

方法

回顾性分析了 94 例(128 只眼)行玻璃体切割术治疗 PDR 患者的临床资料和视力。患者分为从未检查组(在接受玻璃体切割术治疗前,一直未进行眼科检查,直至首次就诊时才开始)、不依从组(在过去 1 年内错过眼科检查的次数超过 1 次)和依从组(在玻璃体切割术前每年至少进行 1 次眼科检查)。

结果

从未检查组(19%)和不依从组(26%)患者的一般医疗检查依从性显著低于依从组(100%;P<0.001 和 P<0.001)。从未检查组患者的平均糖化血红蛋白(8.9%)显著高于依从组(7.6%;P=0.047)。依从组患者术后 6 个月和最终随访时的视力显著优于从未检查组(P=0.017)。

结论

术前检查的依从性显著影响 PDR 患者玻璃体切割术后的视力。眼部检查依从性低与一般医疗检查依从性低和血糖水平高显著相关。

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