Kiew Sieh Yean, Thomas George N, Thomas Akshay S, Fekrat Sharon
Singapore National Eye Centre, Singapore.
Department of Ophthalmology, National University Hospital, Singapore.
J Vitreoretin Dis. 2019 Nov 6;4(3):186-191. doi: 10.1177/2474126419882829. eCollection 2020 Jun.
This article studies whether the characteristics and clinical course of African American patients with central retinal vein occlusion (CRVO) differ from other racial groups.
This retrospective cohort study included consecutive patients diagnosed with CRVO at Duke Eye Center, Durham, North Carolina. Presenting characteristics, examination findings, treatment course, and functional and structural outcomes were compared based on patient-reported race.
A total of 479 patients with CRVO were included (64.7% white, 22.2% African American, 1.7% mixed race, and 11.4% other races). African American patients were older (68.1 vs 64.3 years, = .049), more likely to be hypertensive ( = .001) and diabetic ( = .000), and had higher rates of open-angle glaucoma ( < .000). Presenting visual acuity (VA) was worse in African Americans (logarithm of the minimum angle of resolution 1.25 vs 0.96, = .010). There were no significant differences in the proportion of patients requiring panretinal photocoagulation, intravitreal antivascular endothelial growth factor (anti-VEGF), or intravitreal corticosteroid; however, analysis of treatment-naive individuals showed a higher number of anti-VEGF injections in the first year in African Americans. Final VA was not significantly different between groups, but African Americans had higher rates of neovascular sequelae (25.0% vs 11.8%, = .019; odds ratio, 2.295, = .088).
African Americans with CRVO presented with more severe visual impairment and more systemic and ocular risk factors for CRVO. Treatment-naive African Americans had a greater treatment burden during the first year of follow-up.
本文研究非裔美国中心性视网膜静脉阻塞(CRVO)患者的特征和临床病程是否与其他种族群体不同。
这项回顾性队列研究纳入了北卡罗来纳州达勒姆市杜克眼科中心连续诊断为CRVO的患者。根据患者报告的种族比较了呈现特征、检查结果、治疗过程以及功能和结构结果。
共纳入479例CRVO患者(64.7%为白人,22.2%为非裔美国人,1.7%为混血,11.4%为其他种族)。非裔美国患者年龄更大(68.1岁对64.3岁,P = 0.049),更易患高血压(P = 0.001)和糖尿病(P = 0.000),开角型青光眼发病率更高(P < 0.000)。非裔美国人的初始视力(VA)更差(最小分辨角对数1.25对0.96,P = 0.010)。在需要全视网膜光凝、玻璃体内抗血管内皮生长因子(抗VEGF)或玻璃体内皮质类固醇治疗的患者比例方面无显著差异;然而,对未接受过治疗的个体分析显示,非裔美国人在第一年接受抗VEGF注射的次数更多。两组的最终视力无显著差异,但非裔美国人新生血管后遗症发生率更高(25.0%对11.8%,P = 0.019;优势比,2.295,P = 0.088)。
患有CRVO的非裔美国人存在更严重的视力损害以及更多的CRVO全身和眼部危险因素。未接受过治疗的非裔美国人在随访的第一年治疗负担更大。