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视网膜色素变性患者后囊下白内障的危险因素

Risk Factors for Posterior Subcapsular Cataract in Retinitis Pigmentosa.

作者信息

Fujiwara Kohta, Ikeda Yasuhiro, Murakami Yusuke, Funatsu Jun, Nakatake Shunji, Tachibana Takashi, Yoshida Noriko, Nakao Shintaro, Hisatomi Toshio, Yoshida Shigeo, Yoshitomi Takeshi, Ishibashi Tatsuro, Sonoda Koh-Hei

机构信息

Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan 2Department of Ophthalmology, Graduate School of Medical Sciences, Akita University, Akita, Japan.

Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

出版信息

Invest Ophthalmol Vis Sci. 2017 May 1;58(5):2534-2537. doi: 10.1167/iovs.17-21612.

Abstract

PURPOSE

Posterior subcapsular cataract (PSC) is a frequent complication in patients with retinitis pigmentosa (RP). The risk factors for PSC formation in RP are largely unknown. The purpose of this study was to investigate the risk factors for PSC.

METHODS

We retrospectively studied a total of 322 eyes of 173 patients who were diagnosed with typical RP. We considered the following possible risk factors for PSC: age, sex, hypertension, diabetes mellitus, high myopia, asthma, history of steroid intake, and aqueous flare. Aqueous flare values were measured consecutively in 2012 and 2013 using a laser flare cell meter. The lens including PSC was examined with a slit lamp after dilation with tropicamide 1% and phenylephrine 2.5%.

RESULTS

The geometric mean values of aqueous flare and mean values of visual acuity were significantly higher for the RP patients with PSC compared to those without PSC (P = 0.0003, P = 0.0004, respectively). When the aqueous flare values were assessed continuously, each 1-log-transformed increase in flare levels was associated with an elevation of the likelihood of having PSC after multivariable adjustment (odds ratio: 1.71; 95% confidence interval: 1.05-2.77). There were no significant associations of the other possible risk factors with PSC.

CONCLUSIONS

Our analysis demonstrated that elevated aqueous flare is a significant risk factor for PSC formation. This result might provide insights into the association of inflammation and the pathogenesis of PSC formation in RP.

摘要

目的

后囊下白内障(PSC)是色素性视网膜炎(RP)患者常见的并发症。RP患者发生PSC的危险因素在很大程度上尚不清楚。本研究的目的是调查PSC的危险因素。

方法

我们回顾性研究了173例诊断为典型RP患者的322只眼。我们考虑了以下可能的PSC危险因素:年龄、性别、高血压、糖尿病、高度近视、哮喘、类固醇摄入史和房水闪光。2012年和2013年使用激光闪光细胞仪连续测量房水闪光值。用1%托吡卡胺和2.5%去氧肾上腺素散瞳后,用裂隙灯检查包括PSC在内的晶状体。

结果

与无PSC的RP患者相比,有PSC的RP患者房水闪光的几何平均值和视力平均值显著更高(分别为P = 0.0003,P = 0.0004)。当连续评估房水闪光值时,在多变量调整后,闪光水平每增加1个对数转换单位,发生PSC的可能性就会升高(比值比:1.71;95%置信区间:1.05 - 2.77)。其他可能的危险因素与PSC无显著关联。

结论

我们的分析表明,房水闪光升高是PSC形成的一个重要危险因素。这一结果可能为炎症与RP中PSC形成的发病机制之间的关联提供见解。

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