Department of Ophthalmology, Boston Medical Center, Boston University School of Medicine, Boston, MA.
Department of Ophthalmology, Boston Medical Center, Boston University School of Medicine, Boston, MA.
Can J Ophthalmol. 2024 Apr;59(2):102-108. doi: 10.1016/j.jcjo.2022.12.003. Epub 2023 Jan 4.
To evaluate the effect of socioeconomic and demographic factors on outcomes in rhegmatogenous retinal detachments (RRDs).
Retrospective cohort study.
A total of 71 white and 124 black and/or Hispanic patients who had surgical repair of RRDs between October 2013 and September 2021 at a single-centre safety net hospital. Main outcomes were single surgery success rates (SSSR) and postoperative visual acuity at 6-month and final follow-up.
Black and (or) Hispanic patients were significantly younger (black and [or] Hispanic, 50.7 years vs white, 57.6 years; p = 0.003), had lower mean household incomes (black and [or] Hispanic, $80,932 vs white, $92,911; p = 0.007), were more likely to have more than 1 retinal break (black and [or] Hispanic, 65% vs white, 49%; p = 0.04), and had higher rates of proliferative vitreoretinopathy (PVR) at presentation (black and [or] Hispanic, 35% vs white, 18%; p = 0.02). SSSR was similar (black and [or] Hispanic, 73.4% vs white, 73.2%; p = 0.98), but black and (or) Hispanic patients had worse visual acuity postoperatively (black and [or] Hispanic, 20/63 vs white, 20/40 at final follow-up; p = 0.03). While race was linked to visual outcome in univariate testing; multivariate analysis revealed only macula status (p = 0.007 at 6 months; p = 0.01 at final follow-up), presence of PVR (p < 0.001 at both time points), and SSSR (p = 0.003 at final follow-up) as predictors of worse visual outcomes.
Preoperative factors such as higher rates of PVR may contribute to worse vision outcomes in black and (or) Hispanic patients undergoing surgical repair for RRD.
评估社会经济和人口统计学因素对孔源性视网膜脱离（RRD）结局的影响。
回顾性队列研究。
对 2013 年 10 月至 2021 年 9 月在一家单一中心安全网医院接受 RRD 手术修复的 71 名白人患者和 124 名黑人和/或西班牙裔患者进行了回顾性分析。主要结局是单手术成功率（SSSR）和术后 6 个月及最终随访时的视力。
黑人和（或）西班牙裔患者明显更年轻（黑人或西班牙裔，50.7 岁 vs 白人，57.6 岁；p=0.003），家庭平均收入较低（黑人或西班牙裔，$80932 美元 vs 白人，$92911 美元；p=0.007），视网膜裂孔数较多（黑人或西班牙裔，65% vs 白人，49%；p=0.04），初诊时增殖性玻璃体视网膜病变（PVR）发生率较高（黑人或西班牙裔，35% vs 白人，18%；p=0.02）。SSSR 相似（黑人或西班牙裔，73.4% vs 白人，73.2%；p=0.98），但黑人或西班牙裔患者术后视力较差（最终随访时，黑人或西班牙裔患者为 20/63，白人患者为 20/40；p=0.03）。虽然在单因素检验中种族与视力结果相关；但多变量分析显示，只有黄斑状态（6 个月时 p=0.007；最终随访时 p=0.01）、PVR 存在（两个时间点均 p<0.001）和 SSSR（最终随访时 p=0.003）是视力结果较差的预测因素。
术前较高的 PVR 发生率等因素可能导致黑人或西班牙裔患者接受 RRD 手术修复后的视力结果较差。
