Minami Sakiko, Uchida Atsuro, Nagai Norihiro, Shinoda Hajime, Kurihara Toshihide, Ban Norimitsu, Terasaki Hiroto, Takagi Hitoshi, Tsubota Kazuo, Sakamoto Taiji, Ozawa Yoko
Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
Department of Ophthalmology, St. Marianna University School of Medicine, Kanagawa 216-8511, Japan.
J Clin Med. 2021 Aug 31;10(17):3944. doi: 10.3390/jcm10173944.
To investigate the risk factors for the development of proliferative vitreoretinopathy grade C (PVR-C), independent of prior surgical invasion.
Patients who underwent surgery for rhegmatogenous retinal detachment were prospectively registered with the Japan-Retinal Detachment Registry, organized by the Japanese Retina and Vitreous Society, between February 2016 and March 2017. Data obtained from general ophthalmic examinations performed before and at 1, 3, and 6 months after surgery were analyzed.
We included 2013 eyes of 2013 patients (men, 1326 (65.9%); mean age, 55.2 ± 15.2 years) from amongst 3446 registered patients. Preoperative PVR-C was observed in 3.6% of patients. Propensity score matching revealed that a shorter axial length (AL) was a risk factor for preoperative PVR-C (OR (Odds Ratio), 0.81; 95% CI (Confidence Interval), 0.69 to 0.96; = 0.015), which was a risk factor for surgical failure (OR, 4.22; 95% CI, 1.12 to 15.93; = 0.034); the association was particularly significant for eyes with an AL < 25.0 mm ( = 0.016), while it was insignificant for eyes with an AL ≥ 25.0 mm.
A shorter AL was related to the development of PVR-C before surgical invasion. Our results will help elucidate the fundamental pathogenesis of PVR and caution clinicians to meticulously examine eyes with a shorter AL to detect retinal detachment before PVR development.
探讨增殖性玻璃体视网膜病变C级(PVR-C)发生的危险因素,不考虑既往手术侵袭情况。
2016年2月至2017年3月期间,对因孔源性视网膜脱离接受手术的患者进行前瞻性登记,纳入由日本视网膜和玻璃体学会组织的日本视网膜脱离登记系统。分析手术前以及术后1、3和6个月进行的常规眼科检查所获得的数据。
在3446名登记患者中,我们纳入了2013例患者的2013只眼(男性1326例(65.9%);平均年龄55.2±15.2岁)。3.6%的患者术前观察到PVR-C。倾向评分匹配显示,较短的眼轴长度(AL)是术前PVR-C的危险因素(比值比(OR),0.81;95%置信区间(CI),0.69至0.96;P = 0.015),而PVR-C是手术失败的危险因素(OR,4.22;95%CI,1.12至15.93;P = 0.034);对于AL<25.0mm的眼,这种关联尤为显著(P = 0.016),而对于AL≥25.0mm的眼则不显著。
较短的AL与手术侵袭前PVR-C的发生有关。我们的结果将有助于阐明PVR的基本发病机制,并提醒临床医生仔细检查AL较短的眼,以便在PVR发生前检测到视网膜脱离。