Lin Aidi, Xia Honghe, Zhang Anlin, Liu Xinyu, Chen Haoyu
Joint Shantou International Eye Center, Shantou University and the Chinese University of Hong Kong, Shantou 515041, China.
J Clin Med. 2022 Jun 7;11(12):3266. doi: 10.3390/jcm11123266.
Vitreomacular interface plays an important role in the pathogenesis and progression of proliferative diabetic retinopathy (PDR). This study investigated the prevalence and risk factors of vitreomacular interface disorders (VMID) in PDR. The macular optical coherence tomography (OCT) scans of 493 eyes from 378 PDR patients were retrospectively reviewed to detect VMID, including vitreomacular adhesion (VMA), vitreomacular traction (VMT), epiretinal membrane (ERM), lamellar hole-associated epiretinal proliferation (LHEP), and macular hole (MH). The associations between VMID and baseline factors, intraretinal structure, and visual acuity were analyzed. The prevalence was 78.9% for ERM, 13.4% for VMT, 4.8% for MH, 2.2% for LHEP, and 2.0% for VMA, respectively. On multivariable analyses (odds ratio, 95% confidence interval), fibrovascular proliferation (FVP) was positively associated with MH (8.029, 1.873-34.420), VMT (3.774, 1.827-7.798), and ERM (2.305, 1.460-3.640). High-risk PDR was another risk factor of ERM (1.846, 1.101-3.090). Female gender was positively associated with MH (3.836, 1.132-13.006), while vitreous hemorrhage was negatively associated with MH (0.344, 0.133-0.890). Eyes with all VMID subtypes showed more frequent macular cysts and tractional retinal detachment with poorer visual acuity ( ≤ 0.001). Therefore, the prevalence of VMID was considerably high, indicating that this distinct entity should be considered in interventions for PDR.
玻璃体黄斑界面在增殖性糖尿病视网膜病变（PDR）的发病机制和进展中起重要作用。本研究调查了PDR患者玻璃体黄斑界面疾病（VMID）的患病率及危险因素。回顾性分析了378例PDR患者493只眼的黄斑光学相干断层扫描（OCT）图像，以检测VMID，包括玻璃体黄斑粘连（VMA）、玻璃体黄斑牵拉（VMT）、视网膜前膜（ERM）、板层裂孔相关视网膜前增殖（LHEP）和黄斑裂孔（MH）。分析了VMID与基线因素、视网膜内结构及视力之间的关联。ERM的患病率分别为78.9%、VMT为13.4%、MH为4.8%、LHEP为2.2%、VMA为2.0%。多变量分析（比值比，95%置信区间）显示，纤维血管增殖（FVP）与MH（8.029，1.873 - 34.420）、VMT（3.774，1.827 - 7.798）和ERM（2.305，1.460 - 3.640）呈正相关。高危PDR是ERM的另一个危险因素（1.846，1.101 - 3.090）。女性与MH呈正相关（3.836，1.132 - 13.006），而玻璃体积血与MH呈负相关（0.344，0.133 - 0.890）。所有VMID亚型的患眼黄斑囊肿和牵拉性视网膜脱离更为常见，视力较差（≤0.001）。因此，VMID的患病率相当高，提示在PDR的干预措施中应考虑这一独特情况。
