25G玻璃体切割术治疗增殖性糖尿病视网膜病变术后玻璃体出血病例的特征
Characteristics of cases with postoperative vitreous hemorrhage after 25-gauge vitrectomy for repair of proliferative diabetic retinopathy.
作者信息
Sato Tatsuhiko, Tsuboi Kotaro, Nakashima Hiroshi, Emi Kazuyuki
机构信息
Osaka Rosai Hospital Clinical Research Center for Occupational Sensory Organ Disability, Sakai, Japan.
Department of Ophthalmology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
出版信息
Graefes Arch Clin Exp Ophthalmol. 2017 Apr;255(4):665-671. doi: 10.1007/s00417-016-3522-8. Epub 2016 Oct 21.
PURPOSE
The purpose of this study was to compare ocular and systemic parameters between proliferative diabetic retinopathy (PDR) cases with postoperative vitreous hemorrhage (PVH) and those without PVH after 25-gauge vitrectomy, and to investigate the predictors of PVH.
METHODS
The medical records of 106 eyes of 78 consecutive patients who underwent primary 25-gauge vitrectomy were reviewed.
RESULTS
The incidences of early and late PVH were found to be 18.9 % (20/106 eyes) and 17.9 % (19/106 eyes) respectively. On multiple logistic regression analysis, intraoperative bleeding from new vessels on the disc was identified as the most important factor, with the greatest odds ratio, for the development of early PVH (odds ratio = 3.395, P = 0.134), while the HbA1c level was identified as the most important significant factor, with the greatest odds ratio, for the development of late PVH (odds ratio = 1.403, P = 0.014).
CONCLUSIONS
Early PVH tends to occur in severe PDR cases, while late PVH tends to occur in cases with poor diabetic control.
目的
本研究旨在比较25G玻璃体切除术后增生性糖尿病视网膜病变（PDR）伴术后玻璃体出血（PVH）患者与不伴PVH患者的眼部和全身参数，并探究PVH的预测因素。
方法
回顾了78例连续接受初次25G玻璃体切除术患者的106只眼的病历。
结果
早期和晚期PVH的发生率分别为18.9%（20/106只眼）和17.9%（19/106只眼）。多因素逻辑回归分析显示，视盘新生血管术中出血是早期PVH发生的最重要因素，比值比最大（比值比=3.395，P=0.134），而糖化血红蛋白（HbA1c）水平是晚期PVH发生的最重要显著因素，比值比最大（比值比=1.403，P=0.014）。
结论
早期PVH倾向于发生在重度PDR病例中，而晚期PVH倾向于发生在糖尿病控制不佳的病例中。
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