a Beijing Tongren Eye Center , Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory , Beijing , China.
b Department of Ophthalmology , Beijing Fuxing Hospital, Capital Medical University , Beijing , China.
Curr Eye Res. 2019 Mar;44(3):329-333. doi: 10.1080/02713683.2018.1540705. Epub 2018 Nov 6.
This study was undertaken to assess the associations between the anatomic outcomes of patients who underwent vitrectomy for rhegmatogenous retinal detachment associated with choroidal detachment (RRDCD) and their preoperative variables.
A total of 175 patients with RRDCD who underwent vitrectomy in one eye were included in the analysis. The primary outcome measured was the retinal status after primary vitrectomy and at the end of follow-up.
The retinal reattachment rate was 72.57% after primary surgery, and the final total reattachment rate was 89.14% after follow-up. Binary logistic regression analysis identified that the retinal reattachment rate after primary vitrectomy was significantly associated with older age (odds ratio = 1.03, p = 0.02), mild proliferative vitreoretinopathy (PVR) (PVR grade C vs. PVR grades A-B: odds ratio = 0.31, p = 0.04; PVR grade D vs. PVR grades A-B: odds ratio = 0.03, p < 0.01), and intravitreal steroid treatment (odds ratio = 4.60, p = 0.02), and that the final retinal reattachment rate was independently associated with older age (odds ratio = 1.05; p = 0.01).
Vitrectomy is a good surgical option for RRDCD. Older age, mild preoperative PVR, and perioperative intravitreal triamcinolone acetonide injections increase the primary reattachment rates after one operation. Older age was the only independent prognostic factor for the final retinal reattachment in patients with RRDCD.
本研究旨在评估接受玻璃体切割术治疗伴脉络膜脱离的孔源性视网膜脱离(RRDCD)患者的解剖学结果与其术前变量之间的关系。
共纳入 175 例接受单眼玻璃体切割术治疗 RRDCD 的患者进行分析。主要观察指标为初次玻璃体切割术后和随访结束时的视网膜状态。
初次手术后视网膜复位率为 72.57%,随访结束时总复位率为 89.14%。二项逻辑回归分析发现,初次玻璃体切割术后视网膜复位率与年龄较大(比值比=1.03,p=0.02)、轻度增生性玻璃体视网膜病变(PVR)(PVR 分级 C 与 A-B 相比:比值比=0.31,p=0.04;PVR 分级 D 与 A-B 相比:比值比=0.03,p<0.01)和玻璃体内皮质类固醇治疗(比值比=4.60,p=0.02)显著相关,而最终视网膜复位率与年龄较大(比值比=1.05;p=0.01)独立相关。
玻璃体切割术是治疗 RRDCD 的一种良好手术选择。年龄较大、术前轻度 PVR 和围手术期玻璃体内曲安奈德注射可提高一次手术后的初次复位率。年龄较大是 RRDCD 患者最终视网膜复位的唯一独立预后因素。