Peking University Eye Center, Peking University Third Hospital, Ministry of Education's Key Laboratory of Vision Loss and Restoration, Beijing, People's Republic of China.
Retina. 2013 Sep;33(8):1512-8. doi: 10.1097/IAE.0b013e3182852469.
To investigate potential risk factors for development of proliferative vitreoretinopathy (PVR) post trauma and evaluate the effect of PVR on anatomical and visual outcomes in injured eyes.
Overall, 179 eyes with PVR and 221 eyes without PVR after injury were selected from the database of the Eye Injury Vitrectomy Study, a multicenter cohort study launched in 1997. Multivariate logistic regression was used to ascertain the independent risk factors for development of PVR and to evaluate the influence of PVR on anatomical and visual outcomes.
An interval of injury and vitrectomy of more than 28 days (odds ratio, 139.25; confidence interval, 50.09-387.10), severe vitreous hemorrhage (odds ratio, 2.72; confidence interval, 1.13-6.52), and total retinal detachment (odds ratio, 12.67; confidence interval, 3.96-40.52) were important independent risk factors for PVR. One hundred and fifteen eyes (52.0%) and 49 eyes (27.4%) without and with PVR, respectively, were anatomically restored with ambulant visual acuity (≥4/200). Proliferative vitreoretinopathy, poor initial visual acuity, relative afferent pupillary defect, total retinal detachment, and retinal tear or retinal defect were unfavorable prognostic indicators.
Proliferative vitreoretinopathy occurs frequently in injured eyes and is associated with poor outcomes. Its onset depends on interval of injury and vitrectomy, wound location, vitreous hemorrhage, and retinal detachment. Early vitrectomy (before 2 weeks) and aggressive therapy should be considered for specific high-risk cases.
探讨创伤后发生增生性玻璃体视网膜病变（PVR）的潜在危险因素，并评估 PVR 对受伤眼的解剖和视力结果的影响。
本研究从 1997 年启动的多中心队列研究——眼外伤玻璃体切除术研究的数据库中，选择了 179 只眼有 PVR 和 221 只眼无 PVR 的受伤眼。采用多变量逻辑回归确定发生 PVR 的独立危险因素，并评估 PVR 对解剖和视力结果的影响。
受伤和玻璃体切除术之间的间隔超过 28 天（优势比，139.25；置信区间，50.09-387.10）、严重玻璃体积血（优势比，2.72；置信区间，1.13-6.52）和全视网膜脱离（优势比，12.67；置信区间，3.96-40.52）是 PVR 的重要独立危险因素。无 PVR 的 115 只眼（52.0%）和有 PVR 的 49 只眼（27.4%）分别通过可走动视力（≥4/200）获得解剖复位。PVR、初始视力差、相对传入瞳孔缺陷、全视网膜脱离以及视网膜裂孔或视网膜缺损是不利的预后指标。
增生性玻璃体视网膜病变在受伤眼中常发生，并与不良结局相关。其发生取决于受伤和玻璃体切除术之间的时间间隔、伤口位置、玻璃体积血和视网膜脱离。对于特定的高危病例，应考虑早期玻璃体切除术（<2 周）和积极治疗。
