Gupta Shikha, Gogia Varun, Jose Cijin, Chanana Bhuvan, Bypareddy Ravi, Kapoor Kulwant Singh, Gupta Viney
*Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India; and †Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
Retina. 2016 Jan;36(1):188-91. doi: 10.1097/IAE.0000000000000688.
To determine the prevalence of peripheral retinal degenerations (PRD) and rhegmatogenous retinal detachment in patients with primary congenital glaucoma (PCG).
Records of all patients with PCG operated from year 2000 onwards were evaluated to look for the prevalence of rhegmatogenous retinal detachment. Of these, those children who were old enough to cooperate and had sufficient medial clarity were screened with an indirect ophthalmoscopy in a cross-sectional evaluation from 2010 to 2014. Peripheral retina was examined, and prevalence of PRD was estimated in this subset. For statistical purposes, only one eye of each patient was considered in this cross-sectional analysis.
Of the 310 eyes (180 patients with PCG) operated from the year 2000 onwards, a rhegmatogenous retinal detachment was noted in 13 eyes (4%). Mean axial length of these eyes was 26.3 ± 3.2 mm (range, 19.8-34.7 mm). Among the eyes screened for PRD (n = 60), prevalence of pathologic PRD (lattices with/without atrophic holes and isolated holes/tears) was 15%. The average follow-up between glaucoma filtering surgery and the date of last examination was 8.55 ± 3.98 years (range, 5-20 years) in this subset. Mean axial length was significantly greater in eyes with pathologic PRD than in those without (28.1 ± 3.3 mm vs. 25.8 ± 2.6 mm; P = 0.01). For axial length ≥ 26 mm, the odds of having a pathologic PRD were 14.4 times more than those with axial length < 26 mm (P < 0.001; 95% confidence interval, 1.7-120.5).
Prevalence of PRD among eyes with PCG is high. Peripheral retinal screening should be performed in eyes with PCG, especially those with axial lengths ≥ 26 mm.
确定原发性先天性青光眼（PCG）患者周边视网膜变性（PRD）和孔源性视网膜脱离的患病率。
评估2000年起接受手术的所有PCG患者的记录，以查找孔源性视网膜脱离的患病率。其中，对年龄足够大且能配合、眼部清晰度足够的儿童，在2010年至2014年的横断面评估中用间接检眼镜进行筛查。检查周边视网膜，并在该亚组中估算PRD的患病率。出于统计目的，在该横断面分析中仅考虑每位患者的一只眼。
在2000年起接受手术的310只眼（180例PCG患者）中，13只眼（4%）发现孔源性视网膜脱离。这些眼的平均眼轴长度为26.3±3.2mm（范围19.8 - 34.7mm）。在接受PRD筛查的眼中（n = 60），病理性PRD（伴有/不伴有萎缩孔的格子样变性和孤立的孔/裂孔）的患病率为15%。该亚组中青光眼滤过手术至最后一次检查日期的平均随访时间为8.55±3.98年（范围5 - 20年）。病理性PRD的眼的平均眼轴长度显著长于无病理性PRD的眼（28.1±3.3mm对25.8±2.6mm；P = 0.01）。对于眼轴长度≥26mm者，发生病理性PRD的几率是眼轴长度<26mm者的14.4倍（P < 0.001；95%置信区间1.7 - 120.5）。
PCG患者眼中PRD的患病率较高。应对PCG患者的眼睛进行周边视网膜筛查，尤其是眼轴长度≥26mm的患者。
