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荷兰孔源性视网膜脱离发病率与近视患病率的相关性研究。

Association of Rhegmatogenous Retinal Detachment Incidence With Myopia Prevalence in the Netherlands.

机构信息

Department of Ophthalmology, University Medical Center Utrecht, Utrecht, the Netherlands.

Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands.

出版信息

JAMA Ophthalmol. 2021 Jan 1;139(1):85-92. doi: 10.1001/jamaophthalmol.2020.5114.

Abstract

IMPORTANCE

The incidence of rhegmatogenous retinal detachment (RRD) is partly determined by its risk factors, such as age, sex, cataract surgery, and myopia. Changes in the prevalence of these risk factors could change RRD incidence in the population.

OBJECTIVE

To determine whether the incidence of RRD in the Netherlands has changed over recent years and whether this change is associated with an altered prevalence of RRD risk factors.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study included data from all 14 vitreoretinal clinics in the Netherlands, as well as a large Dutch population-based cohort study. All patients who underwent surgical repair for a primary RRD in the Netherlands from January 1 to December 31, 2009, and January 1 to December 31, 2016, were analyzed, in addition to all participants in the population-based Rotterdam Study who were examined during these years. Analysis began February 2018 and ended November 2019.

EXPOSURES

RRD risk factors, including age, male sex, cataract extraction, and myopia.

MAIN OUTCOMES AND MEASURES

Age-specific RRD incidence rate in the Dutch population, as well as change in RRD incidence and risk factor prevalence between 2009 and 2016.

RESULTS

In 2016, 4447 persons (median [range] age, 61 [3-96] years) underwent surgery for a primary RRD within the Netherlands, resulting in an RRD incidence rate of 26.2 per 100 000 person-years (95% CI, 25.4-27.0). The overall RRD incidence rate had increased by 44% compared with similar data from 2009. The increase was observed in both phakic (1994 in 2009 to 2778 in 2016 [increase, 39%]) and pseudophakic eyes (1004 in 2009 to 1666 in 2016 [increase, 66%]), suggesting that cataract extraction could not solely account for the overall rise. Over the same period, the prevalence of mild, moderate, and severe myopia among persons aged 55 to 75 years had increased by 15.6% (881 of 4561 [19.3%] vs 826 of 3698 [22.3%]), 20.3% (440 of 4561 [9.6%] vs 429 of 3698 [11.6%]), and 26.9% (104 of 4561 [2.3%] vs 107 of 3698 [2.9%]), respectively, within the population-based Rotterdam Study.

CONCLUSIONS AND RELEVANCE

In this study, an increase was observed in primary RRD incidence in the Netherlands over a 7-year period, which could not be explained by a different age distribution or cataract surgical rate. A simultaneous myopic shift in the Dutch population may be associated, warranting further population-based studies on RRD incidence and myopia prevalence.

摘要

重要性

孔源性视网膜脱离(RRD)的发生率部分取决于其危险因素,如年龄、性别、白内障手术和近视。这些危险因素的流行率的变化可能会改变人群中 RRD 的发生率。

目的

确定近年来荷兰 RRD 的发生率是否发生了变化,以及这种变化是否与 RRD 危险因素的流行率改变有关。

设计、地点和参与者:本队列研究包括荷兰所有 14 家玻璃体视网膜诊所的数据,以及一项大型荷兰基于人群的队列研究的数据。分析了 2009 年 1 月 1 日至 12 月 31 日和 2016 年 1 月 1 日至 12 月 31 日期间在荷兰因原发性 RRD 接受手术修复的所有患者,以及在此期间接受检查的基于人群的鹿特丹研究中的所有参与者。分析于 2018 年 2 月开始,2019 年 11 月结束。

暴露

RRD 危险因素,包括年龄、男性、白内障摘除和近视。

主要结果和措施

荷兰人口中特定年龄的 RRD 发病率,以及 2009 年至 2016 年间 RRD 发病率和危险因素流行率的变化。

结果

2016 年,4447 人(中位[范围]年龄,61[3-96]岁)在荷兰接受了原发性 RRD 手术,RRD 发病率为 26.2/10 万人年(95%CI,25.4-27.0)。与 2009 年的类似数据相比,RRD 的总发病率增加了 44%。在有晶状体眼(2009 年的 1994 例和 2016 年的 2778 例[增加 39%])和无晶状体眼(2009 年的 1004 例和 2016 年的 1666 例[增加 66%])中均观察到这种增加,这表明白内障摘除不能完全解释总体上升。同期,55 岁至 75 岁人群中轻度、中度和重度近视的患病率分别增加了 15.6%(4561 人中的 881 例[19.3%]比 3698 人中的 826 例[22.3%])、20.3%(4561 人中的 440 例[9.6%]比 3698 人中的 429 例[11.6%])和 26.9%(4561 人中的 104 例[2.3%]比 3698 人中的 107 例[2.9%]),在基于人群的鹿特丹研究中。

结论和相关性

在这项研究中,荷兰原发性 RRD 的发生率在 7 年内有所增加,这不能用不同的年龄分布或白内障手术率来解释。荷兰人口中近视的同时向近视转移可能与之相关,需要进一步开展基于人群的 RRD 发病率和近视流行率的研究。

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