Department of Ophthalmology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Dublin, Ireland.
Irish College of General Practitioners, 4/5 Lincoln Place, Dublin 2, Dublin, Ireland.
Ir J Med Sci. 2023 Oct;192(5):2527-2532. doi: 10.1007/s11845-023-03281-1. Epub 2023 Jan 20.
The aim of this retrospective review was to analyse the frequency of patients presenting with flashes and/or floaters (F/F) on bright versus dark days to the eye emergency department of a tertiary referral hospital (the Mater Misericordiae University Hospital) over a 3-year period. The diagnostic and clinical outcomes of F/F presentations were also analysed.
This retrospective study assessed eye casualty attendances between January 2018 and December 2020. Solar irradiation (j/cm) at ground level was retrieved from the records of Met Eireann (Irish National Meteorological Service) via their open access records. A review of electronic patient medical records using the in-house database patient centre was carried out of all patients who attended EED of during the study timeline on the 5 'brightest' and 5 'darkest' days of each year.
Seven hundred forty patient presentations were analysed in total. Overall, 16% (n = 119) of all patients that attended EED during the timeframe of the study presented with F/F. One hundred six patients (89%) presented with floaters, 40 patients (34%) presented with flashing lights/photopsia, and 35 patients (29%) presented with both F/F. More patients presented to EED with F/F on bright days when compared with dark days (74 vs 45, p < 0.05). Eighty-nine percent of all patients with F/F presented with monocular floaters. There were more floater presentations during bright when compared with dark days (70 vs 36, p < 0.05). More patients were diagnosed with PVD on bright days when compared with those diagnosed with PVD on dark days (43vs 15, p < 0.05). More RDs were diagnosed on dark days compared with bright days (7 vs 3, p < 0.05).
This study established that F/F presentations were more likely to present during bright days when compared with dark days. The diagnosis of PVD was more common during bright days, and RDs were diagnosed significantly more frequently on dark days. Although incident solar radiation was correlated with greater floaters/PVD presentation, causation is unlikely, and the duration of PVD may have been longer in patients presenting on bright days (i.e. pseudo-sudden symptoms).
本回顾性研究旨在分析在三年期间，到一家三级转诊医院（仁慈圣母大学医院）的眼科急诊室就诊的患者中，在明亮和黑暗天出现闪光和/或漂浮物（F/F）的频率。还分析了 F/F 表现的诊断和临床结果。
这项回顾性研究评估了 2018 年 1 月至 2020 年 12 月期间的眼科急诊就诊情况。通过爱尔兰国家气象服务机构 Met Eireann 的公开记录，检索了地面水平的太阳辐照度（j/cm）。通过内部数据库患者中心，对在研究期间的每个月的 5 个“最亮”日和 5 个“最暗”日就诊于 EED 的所有患者的电子病历进行了审查。
总共分析了 740 例患者就诊情况。总体而言，在研究期间就诊于 EED 的所有患者中，有 16%（n=119）出现 F/F。106 例患者（89%）出现漂浮物，40 例患者（34%）出现闪光/幻视，35 例患者（29%）同时出现 F/F。与黑暗日相比，更多的患者在明亮日到 EED 就诊时出现 F/F（74 例 vs 45 例，p<0.05）。所有出现 F/F 的患者中，89%为单眼漂浮物。与黑暗日相比，明亮日的漂浮物就诊人数更多（70 例 vs 36 例，p<0.05）。与黑暗日相比，更多的患者在明亮日被诊断为 PVD（43 例 vs 15 例，p<0.05）。与明亮日相比，更多的 RD 在黑暗日被诊断（7 例 vs 3 例，p<0.05）。
本研究表明，与黑暗日相比，F/F 就诊更可能发生在明亮日。在明亮日，PVD 的诊断更为常见，而在黑暗日，RD 的诊断明显更为频繁。尽管太阳辐射的增量与更多的漂浮物/PVD 出现相关，但这种相关性不太可能是因果关系，并且在明亮日就诊的患者中，PVD 的持续时间可能更长（即假性突发症状）。
