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局部眼科皮质类固醇与中心性浆液性脉络膜视网膜病变风险的时间关联。

Temporal Association between Topical Ophthalmic Corticosteroid and the Risk of Central Serous Chorioretinopathy.

机构信息

Department of Ophthalmology, Chi Mei Medical Center, Tainan 710, Taiwan.

Graduate Institute of Medical Sciences, College of Health Sciences, Chang Jung Christian University, Tainan 711, Taiwan.

出版信息

Int J Environ Res Public Health. 2020 Dec 17;17(24):9455. doi: 10.3390/ijerph17249455.

Abstract

This retrospective, nationwide, matched cohort study investigated the temporal relationship of central serous chorioretinopathy (CSCR) following topical ophthalmic corticosteroid (TOC) use. Using the Longitudinal Health Insurance Database 2000 (LHID2000), we collected patients diagnosed with CSCR between January 2001 and December 2010 (  =  2921) and a control group (  =  17,526). Information for each patient was collected and tracked from the index date until December 2011. TOC users were classified based on (i) the date of the last prescription before diagnosis: current users (≤30 days) and former users (31-182 days and ≥183 days) and (ii) the prescription refill intervals: persistent users (interval ≤90 days) and non-persistent users (interval >90 days). The odds ratio (OR) was estimated from multivariate conditional logistic regression after adjusting for relevant confounders. After adjusting for age, sex, geographic region, index date, previously known comorbidities, the date of last TOC prescription before diagnosis, or prescription refilling intervals, the results revealed that patients were likely to have developed CSCR while using TOCs currently (OR = 30.42, 95% CI = 25.95-35.66, 0.001) and persistently (OR = 7.30, 95% CI = 6.13-8.69, 0.001) as compared to the controls. Our results indicate that current or persistent TOCs use increases the risk of CSCR. Thus, patients requiring TOCs should be advised of this risk, particularly in current or persistent use conditions.

摘要

这项回顾性、全国性、匹配队列研究调查了局部眼用皮质类固醇(TOC)使用后中心性浆液性脉络膜视网膜病变(CSCR)的时间关系。我们使用纵向健康保险数据库 2000(LHID2000),收集了 2001 年 1 月至 2010 年 12 月期间被诊断为 CSCR 的患者(n=2921)和对照组患者(n=17526)。从索引日期到 2011 年 12 月,收集并跟踪了每位患者的信息。根据(i)诊断前最后一次处方的日期,将 TOC 用户分为当前使用者(≤30 天)和前使用者(31-182 天和≥183 天),以及(ii)处方续期间隔:持续使用者(间隔≤90 天)和非持续使用者(间隔>90 天)。在调整了相关混杂因素后,采用多变量条件逻辑回归估计比值比(OR)。调整年龄、性别、地理区域、索引日期、先前已知的合并症、诊断前最后一次 TOC 处方的日期或处方续期间隔后,结果显示,与对照组相比,当前(OR=30.42,95%CI=25.95-35.66, 0.001)和持续(OR=7.30,95%CI=6.13-8.69, 0.001)使用 TOC 的患者更有可能患上 CSCR。我们的结果表明,当前或持续使用 TOC 会增加 CSCR 的风险。因此,需要向使用 TOC 的患者告知这种风险,尤其是在当前或持续使用的情况下。

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