Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado.
Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado.
Ophthalmol Retina. 2020 Aug;4(8):823-828. doi: 10.1016/j.oret.2020.02.010. Epub 2020 Feb 28.
To evaluate the visual outcomes and complications associated with noninfectious uveitis in patients presenting with a rhegmatogenous retinal detachment (RRD).
Retrospective cohort study.
A total of 554 eyes of 523 patients presenting for RRD repair at the Department of Ophthalmology, University of Colorado School of Medicine, between July 2011 and September 2016.
Analysis of risk factors, anatomic outcomes, and visual outcomes related to a history of noninfectious uveitis.
End point rate of reattachment, end point visual acuity (VA), postoperative proliferative vitreoretinopathy (PVR), and rate of reoperation.
A history of uveitis was identified in 5.4% of eyes. Eyes with a history of uveitis were found to have a higher risk for development of any degree of PVR (hazard ratio [HR], 2.2; 95% confidence interval [CI], 1.1-4.4, P = 0.030) and a higher risk of PVR necessitating an additional procedure (HR, 2.7; 95% CI, 1.2-6.0, P = 0.014). Anatomic and visual outcomes did not differ between the 2 groups. Preoperative VA, the distribution of race/ethnicity, age, gender, lens status, macula status, and lattice degeneration status did not vary significantly between the groups. In the analysis of a PVR subgroup, uveitis was not associated with a higher risk of PVR necessitating an additional procedure and did not show a statistically significant difference in end point VA.
A history of uveitis is associated with an increased risk of any degree of PVR and an increased risk of PVR necessitating an additional procedure. However, subgroup analysis suggests that patients with a history of uveitis who develop PVR do not necessarily have a worse visual outcome or a higher risk of additional surgery. There may be a role for perioperative steroids in patients with a history of uveitis who present with a retinal detachment, but further study is warranted to determine if this decreases the risk of PVR or improves visual outcomes.
评估伴有孔源性视网膜脱离（RRD）的非感染性葡萄膜炎患者的视力结果和相关并发症。
回顾性队列研究。
2011 年 7 月至 2016 年 9 月期间，在科罗拉多大学医学院眼科就诊的 523 例患者的 554 只眼接受 RRD 修复。
分析与非感染性葡萄膜炎病史相关的危险因素、解剖结果和视力结果。
再附着终点率、终点视力（VA）、术后增生性玻璃体视网膜病变（PVR）和再手术率。
5.4%的眼中发现有葡萄膜炎病史。有葡萄膜炎病史的眼发生任何程度的 PVR 的风险更高（风险比[HR]，2.2；95%置信区间[CI]，1.1-4.4，P=0.030），需要额外手术治疗 PVR 的风险更高（HR，2.7；95%CI，1.2-6.0，P=0.014）。两组间解剖和视力结果无差异。两组间术前 VA、种族/民族分布、年龄、性别、晶状体状态、黄斑状态和格子样变性状态无显著差异。在 PVR 亚组分析中，葡萄膜炎与需要额外手术治疗的 PVR 风险增加无关，终点 VA 也无统计学差异。
葡萄膜炎病史与任何程度的 PVR 风险增加以及需要额外手术治疗的 PVR 风险增加相关。但是，亚组分析表明，患有葡萄膜炎并发生 PVR 的患者不一定视力结果更差或再次手术的风险更高。对于患有葡萄膜炎并出现视网膜脱离的患者，围手术期使用类固醇可能有一定作用，但需要进一步研究以确定其是否可以降低 PVR 风险或改善视力结果。
