Zhou Ashley, Ong Sally S, Ahmed Ishrat, Arevalo J Fernando, Cai Cindy X, Handa James T
Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA.
J Ophthalmic Inflamm Infect. 2022 Aug 2;12(1):26. doi: 10.1186/s12348-022-00303-4.
While socioeconomic disparities impact clinical care and patient outcomes, their impact on the anatomic and visual outcomes of retinal detachment in patients with viral retinitis is unstudied. This case series included 18 eyes in 18 patients from a single academic institution between January 1, 2008 and December 31, 2018. Patient characteristics including age, sex, race, ethnicity, insurance, immunosuppression, viral retinitis, retinal detachment, retinal detachment repair, visual and anatomic outcomes, missed appointments, and Area Deprivation Index [ADI] were collected. The low-ADI group, indicating less socioeconomic disadvantage, was comprised of twelve patients with national ADIs less than 38, and the high-ADI group of six patients with national ADIs greater than 38. High-ADI patients tended to be younger (average age 38.0 versus 51.3; P = 0.06), of female sex (P = 0.03), and had more missed appointments (median 11.0 vs 0; P = 0.002). A similar number of patients in both the high-ADI and low-ADI groups underwent pars plana vitrectomy alone or pars plana vitrectomy with scleral buckle. Visual acuity was similar in the high-ADI group than in the low-ADI group at baseline, but worse at the final follow-up visit (P = 0.004). Post-operative and final visit ocular hypotony were more common in the high-ADI group (P = 0.02). In our series, socioeconomic disadvantage negatively affects the visual outcomes in patients with viral retinitis associated-retinal detachments. These factors should be considered by ophthalmologists when treating these patients.
虽然社会经济差异会影响临床护理和患者预后,但它们对病毒性视网膜炎患者视网膜脱离的解剖学和视觉预后的影响尚未得到研究。本病例系列纳入了2008年1月1日至2018年12月31日期间来自单一学术机构的18例患者的18只眼。收集了患者的特征,包括年龄、性别、种族、民族、保险、免疫抑制、病毒性视网膜炎、视网膜脱离、视网膜脱离修复、视觉和解剖学预后、失约情况以及地区贫困指数[ADI]。低ADI组表示社会经济劣势较小,由12例全国ADI低于38的患者组成,高ADI组由6例全国ADI高于38的患者组成。高ADI患者往往更年轻(平均年龄38.0岁对51.3岁;P = 0.06),女性居多(P = 0.03),且失约次数更多(中位数11.0对0;P = 0.002)。高ADI组和低ADI组中接受单纯玻璃体切割术或玻璃体切割联合巩膜扣带术的患者数量相似。高ADI组在基线时的视力与低ADI组相似,但在最后一次随访时更差(P = 0.004)。高ADI组术后和最后一次随访时低眼压更为常见(P = 0.02)。在我们的系列研究中,社会经济劣势对病毒性视网膜炎相关视网膜脱离患者的视觉预后产生负面影响。眼科医生在治疗这些患者时应考虑这些因素。