睾酮补充治疗与视网膜血管疾病。
TESTOSTERONE SUPPLEMENTATION AND RETINAL VASCULAR DISEASE.
机构信息
Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan.
Center for Preventive Ophthalmology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
出版信息
Retina. 2018 Nov;38(11):2247-2252. doi: 10.1097/IAE.0000000000001869.
PURPOSE
To determine whether testosterone supplementation is associated with retinal artery occlusion (RAO) or retinal vein occlusion (RVO).
METHODS
Retrospective matched cohort study using data from a large national U.S. insurance database. The testosterone cohort consisted of all male patients who filled a prescription for testosterone from 2000 to 2013. Five controls were matched on age (±3 years), sex, race, and similar time in plan (±3 months) for every exposed patient. Exclusion occurred for <2 years in the plan, <1 eye care visit, medications known to affect androgen levels, and systemic diseases associated with occlusions or increased testosterone. Cox proportional hazard regression assessed the hazard of a new diagnosis of RAO or RVO while controlling for age, race, diabetes mellitus, and hypertension.
RESULTS
A total of 35,784 incident testosterone users were compared with 178,860 matched controls. Ninety-three (0.3%) RAOs and 50 (0.1%) RVOs were found in the testosterone cohort and contrasted with 316 (0.2%) RAOs and 232 (0.1%) RVOs in the control group. After multivariate analysis, testosterone supplementation significantly increased the hazard of RAO (hazard ratio: 1.43, 95% confidence interval: 1.12-1.81, P = 0.004), but not of RVO (hazard ratio: 1.03, 95% confidence interval: 0.74-1.42, P = 0.86).
CONCLUSION
Although the incidence of RAO and RVO is low in users of testosterone, supplementation therapy is associated with an increased hazard of RAO, but apparently not of RVO.
目的
确定睾丸素补充是否与视网膜动脉阻塞（RAO）或视网膜静脉阻塞（RVO）有关。
方法
这是一项使用美国大型医疗保险数据库数据进行的回顾性匹配队列研究。睾丸素组由 2000 年至 2013 年期间开处睾丸素处方的所有男性患者组成。每例暴露患者匹配 5 名年龄（±3 岁）、性别、种族和计划时间（±3 个月）相似的对照者。排除方案中<2 年、<1 次眼保健就诊、已知影响雄激素水平的药物以及与阻塞或雄激素升高相关的系统性疾病。采用 Cox 比例风险回归，在控制年龄、种族、糖尿病和高血压的情况下，评估新诊断为 RAO 或 RVO 的风险比。
结果
共比较了 35784 例新发睾丸素使用者和 178860 名匹配对照者。在睾丸素组中发现了 93 例（0.3%）RAO 和 50 例（0.1%）RVO，而在对照组中发现了 316 例（0.2%）RAO 和 232 例（0.1%）RVO。多变量分析后，睾丸素补充显著增加了 RAO 的风险比（风险比：1.43，95%置信区间：1.12-1.81，P=0.004），但对 RVO 无影响（风险比：1.03，95%置信区间：0.74-1.42，P=0.86）。
结论
尽管睾丸素使用者中 RAO 和 RVO 的发生率较低，但补充治疗与 RAO 的风险比增加相关，但与 RVO 无关。
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