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[增殖性糖尿病视网膜病变患者玻璃体切除术相关影响因素分析]

[Analysis of factors affecting revitrectomy in patients with proliferative diabetic retinopathy].

作者信息

Du W, Chen W Q, Yu W Z, Qu J F, Shi X, Yin J, Liang J H, Zhao M W

机构信息

Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing 100044, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2022 May 17;102(18):1389-1393. doi: 10.3760/cma.j.cn112137-20210909-02055.

Abstract

To identify prognostic factors for revitrectomy in patients who underwent pars plana vitrectomy (PPV) for complications with proliferative diabetic retinopathy (PDR). This study was a retrospective case-control study. Clinical data of PDR patients (290 eyes) at Peking University People's Hospital from December 2019 to December 2020 were retrospectively collected.According to the number of operations, patients were divided into two groups: single PPV group (227 eyes) and revitrectomy PPV group (63 eyes). Follow-up will be conducted up to 6 months postoperatively. The BCVA was compared before and after PPV between the two groups, and postoperative complications of revitrectomy PPV group were analyzed. Quantitative data are presented as medians [ (, )]. The age of single PPV group patients was 55.0 (47.0, 63.0), and the age of revitrectomy PPV group patients was 49.0 (38.0, 57.0). This difference was statistically significant (=0.027). The LogMAR visual acuity of two groups were 1.7 (1.0, 2.4) and 2.1 (1.4, 2.4) (=0.026) preoperative; the visual acuity of single PPV group was 0.75 (0.43, 1.00) (<0.001), and revitrectomy PPV group was 0.95 (0.60, 1.65) (<0.001) at 6 months postoperative. The visual acuity improvement of single PPV group was better than revitrectomy PPV group (=0.021). Age (=0.043, =0.97, 95%: 0.95-1.00), preoperative BCVA (=0.024, =1.82, 95%: 1.08-3.05), tractional retinal detachment (TRD) (=0.033, =2.16, 95%:1.06-4.37), silicone oil tamponade (=0.028, =0.48, 95%: 0.25-0.92) were prognostic factors of revitrectomy. Young age, low preoperative BCVA, TRD, and silicon oil tamponade were the potential prognostic factors of revitrectomy for PDR patients.

摘要

为了确定接受玻璃体切割术(PPV)治疗增生性糖尿病视网膜病变(PDR)并发症患者再次玻璃体切割术的预后因素。本研究为回顾性病例对照研究。回顾性收集了2019年12月至2020年12月北京大学人民医院PDR患者(290只眼)的临床资料。根据手术次数,患者分为两组:单次PPV组(227只眼)和再次玻璃体切割术PPV组(63只眼)。术后随访至6个月。比较两组PPV前后的最佳矫正视力(BCVA),并分析再次玻璃体切割术PPV组的术后并发症。定量数据以中位数[(,)]表示。单次PPV组患者年龄为55.0(47.0,63.0),再次玻璃体切割术PPV组患者年龄为49.0(38.0,57.0)。这种差异具有统计学意义(=0.027)。两组术前的LogMAR视力分别为1.7(1.0,2.4)和2.1(1.4,2.4)(=0.026);术后6个月,单次PPV组视力为0.75(0.43,1.00)(<0.001),再次玻璃体切割术PPV组视力为0.95(0.60,1.65)(<0.001)。单次PPV组的视力改善优于再次玻璃体切割术PPV组(=0.021)。年龄(=0.043,=0.97,95%:0.95 - 1.00)、术前BCVA(=0.024,=1.82,95%:1.08 - 3.05)、牵拉性视网膜脱离(TRD)(=0.033,=2.16,95%:1.06 - 4.37)、硅油填充(=0.028,=0.48,95%:0.25 - 0.92)是再次玻璃体切割术的预后因素。年轻、术前BCVA低、TRD和硅油填充是PDR患者再次玻璃体切割术的潜在预后因素。

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