Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua, Taiwan.
PLoS One. 2019 Aug 7;14(8):e0220286. doi: 10.1371/journal.pone.0220286. eCollection 2019.
To evaluate the risk of developing optic neuropathy (ON) in patient with both non-surgery and surgery-indicated chronic rhinosinusitis (CRS) via the national health insurance research database in Taiwan.
METHODOLOGY/PRINCIPAL FINDINGS: 44,176 Patients with a diagnostic code of CRS was selected, which included 6,678 received functional endoscopic sinus surgery (FESS) regarded as the surgery-indicated CRS. Each individual in the study group was matched to two non-CRS patients by age and gender. The outcome was set as the occurrence of ON according to the diagnostic codes occurred after the index date. Poisson regression was used to calculate the adjusted relative risk (aRR) and conditional Cox proportional model was used to estimate the adjusted hazard ratio (aHR). There were 131 and 144 events of ON occurred in the study group and the control group respectively during the follow-up period. The whole study group, whether received FESS or not, demonstrated both significant aRR and aHR compared to the control group after adjusting demographic data, prominent ocular diseases, and systemic co-morbidities. In addition, both the aRR and aHR were higher in CRS patient received FESS than those with CRS but without FESS management.
The existence of CRS, especially the surgery-indicated CRS is a significant risk factor for the following ON using multivariable analysis.
通过台湾全民健康保险研究数据库评估非手术和手术指征慢性鼻-鼻窦炎（CRS）患者发生视神经病变（ON）的风险。
方法/主要发现：选择了 44176 例诊断为 CRS 的患者，其中 6678 例接受了功能性内镜鼻窦手术（FESS），视为手术指征 CRS。研究组中的每个个体均按年龄和性别与两名非 CRS 患者匹配。根据索引日期后发生的诊断代码，将结果设定为 ON 的发生。使用泊松回归计算调整后的相对风险（aRR），并使用条件 Cox 比例模型估计调整后的危险比（aHR）。在随访期间，研究组和对照组分别发生了 131 例和 144 例 ON 事件。在调整人口统计学数据、明显的眼部疾病和全身性合并症后，无论是否接受 FESS，整个研究组与对照组相比，均显示出显著的 aRR 和 aHR。此外，接受 FESS 的 CRS 患者的 aRR 和 aHR 均高于仅患有 CRS 而未接受 FESS 治疗的患者。
多变量分析显示，CRS 的存在，特别是手术指征的 CRS，是发生后续 ON 的一个显著危险因素。
