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白内障手术与帕金森病诊断的关系。

Incidence of cataract surgeries in relation to diagnosis of Parkinson's disease.

机构信息

Kuopio Research Centre of Geriatric Care, School of Pharmacy, University of Eastern Finland, P.O. Box 1627, Kuopio FI-70211, Finland.

Kuopio Research Centre of Geriatric Care, School of Pharmacy, University of Eastern Finland, P.O. Box 1627, Kuopio FI-70211, Finland.

出版信息

Arch Gerontol Geriatr. 2023 Jan;104:104842. doi: 10.1016/j.archger.2022.104842. Epub 2022 Oct 17.

Abstract

BACKGROUND

Parkinson's disease (PD) causes also visual dysfunction including decreased visual acuity, even already at the prodromal phase of disease. Still, it has been suggested that persons with PD may be less likely to be referred for cataract surgery, although early management increases the chances for successful cataract surgery.

METHODS

Data from nationwide register-based Finnish Study on Parkinson's Disease (N=22189) was used. This study included 17546 persons with PD diagnosed in 1996-2015 and 114817 comparison persons who were at least 45 years old. Comparison persons were matched for age (+/-1 year, sex and hospital district on the date of PD diagnosis (index date). Incidence of cataract surgeries was investigated from ten years before to ten years after the index date. Information on cataract surgeries and comorbidities were extracted from several nationwide healthcare registers.

RESULTS

The incidence rate of cataract surgeries was 20.4/1000 and 18.7/1000 person-years (PY) for persons with or without PD, respectively. Before PD diagnosis, rate of surgeries was higher in persons with PD (incidence rate 16.5 vs 13.7 /1000PY, IRR, 95%CI 1.21, 1.16-1.26). After PD diagnosis there was no difference in the incidence rate. Persons who had undergone cataract surgery were older and had more eye diseases and other comorbidities compared to those without surgery.

CONCLUSIONS

Diagnosis of PD does not decrease the incidence of cataract surgeries. Conversely, the incidence may be increased prior to PD diagnosis, probably due to other eye diseases and prodromal symptoms of PD.

摘要

背景

帕金森病(PD)还会导致视觉功能障碍,包括视力下降,即使在疾病的前驱期也是如此。尽管早期治疗可以增加白内障手术成功的机会,但仍有人认为 PD 患者不太可能被转介进行白内障手术。

方法

本研究使用了基于全国注册的芬兰帕金森病研究(N=22189)的数据。该研究纳入了 1996 年至 2015 年间诊断的 17546 名 PD 患者和至少 45 岁的 114817 名对照者。对照者按年龄(+/-1 岁)、性别和 PD 诊断日期(索引日期)所在的医院区域进行匹配。从索引日期前 10 年到后 10 年,调查了白内障手术的发生率。白内障手术和合并症的信息从几个全国性的医疗保健登记处提取。

结果

PD 患者和无 PD 患者的白内障手术发生率分别为 20.4/1000 和 18.7/1000 人年。在 PD 诊断前,PD 患者的手术率较高(发生率 16.5 比 13.7/1000PY,IRR,95%CI 1.21,1.16-1.26)。PD 诊断后,发生率无差异。与未接受手术的患者相比,接受过白内障手术的患者年龄更大,且患有更多眼部疾病和其他合并症。

结论

PD 的诊断并不会降低白内障手术的发生率。相反,在 PD 诊断之前,发病率可能会增加,这可能是由于其他眼部疾病和 PD 的前驱症状所致。

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