Papavasileiou E, Vasalaki M, Velissaris S, Garnavou-Xirou C, Zygoura V, Theodorou O, Zakir R, Duguid G, Sandinha T, Steel D, Jackson T L
Western Eye Hospital-Imperial College Healthcare NHS Trust, Ophthalmology, London, United Kingdom.
Hell J Nucl Med. 2017 Sep-Dec;20 Suppl:160. doi: 10.1111/j.1755-3768.2017.02684.
The purpose of this multicentre retrospective study was to investigate the characteristics and role of ethnicity and socioeconomic status amongst patients with idiopathic macular holes (IMH) and the surgical outcome.
Consecutive patients undergoing primary IMH surgery at three vitreoretinal units in the UK (King's College Hospital, London, UK, Western Eye Hospital, London, UK, Sunderland Eye Infirmary, Sunderland, UK) between January 2007 and May 2017 were included. The main outcome measure was anatomical closure of IMH.
Two hundred and thirty three primary IMH surgeries were included. All patients underwent pars plana vitrectomy, internal limiting membrane peeling, and gas tamponade. 69.10% of patients were European Caucasian, 6.44% were Asian, and 24.46% were Afro-Caribbean. The mean base macular hole diameter (BD) was 475.5mcm. Mean BD was 432.2mcm in European Caucasian patients, 481.3mcm in Asians (P=0.005), and 505.61mcm in Afro-Caribbeans (P=0.006). Regression analysis demonstrated that BD and Afro-Caribbean ethnicity were independent significant risk factors for surgical failure. Those who have longer duration of symptoms (Afro-Caribbeans) and leave in more deprived places (Afro-Caribbeans) in England where found to have lower success rate on macular hole closure.
Asian and Afro-Caribbean patients present with larger IMH than European Caucasians. In addition to IMH base diameter, black origin and lower socioeconomic status are independent risk factors for surgical failure. This study presents a large population-based data analysis on ethnic variation in macular holes and may assist in the management and predicting the surgical outcome.
本多中心回顾性研究旨在调查特发性黄斑裂孔（IMH）患者的种族和社会经济状况特征及作用，以及手术结果。
纳入2007年1月至2017年5月期间在英国三个玻璃体视网膜科室（英国伦敦国王学院医院、英国伦敦西部眼科医院、英国桑德兰眼科医院）接受原发性IMH手术的连续患者。主要观察指标为IMH的解剖学闭合情况。
纳入233例原发性IMH手术。所有患者均接受了玻璃体切除术、内界膜剥除术和气体填塞。69.10%的患者为欧洲白种人，6.44%为亚洲人，24.46%为非洲加勒比裔。黄斑裂孔平均基底直径（BD）为475.5微米。欧洲白种人患者的平均BD为432.2微米，亚洲人为481.3微米（P = 0.005），非洲加勒比裔为505.61微米（P = 0.006）。回归分析表明，BD和非洲加勒比裔种族是手术失败的独立显著危险因素。在英国，那些症状持续时间较长（非洲加勒比裔）且居住在更贫困地区（非洲加勒比裔）的患者，黄斑裂孔闭合成功率较低。
亚洲和非洲加勒比裔患者的IMH比欧洲白种人更大。除了IMH基底直径外，黑人血统和较低的社会经济地位是手术失败的独立危险因素。本研究提供了基于大量人群的黄斑裂孔种族差异数据分析，可能有助于管理和预测手术结果。
