视网膜脱离患者对侧眼：视力和临床表现。

The fellow eye of retinal detachment patients: Vision and clinical presentation.

机构信息

Department of Ophthalmology, University of Calabar Teaching Hospital, Calabar, Nigeria.

Department of Ophthalmology, Eye Foundation Hospital, Lagos, Nigeria.

出版信息

Niger J Clin Pract. 2023 Sep;26(9):1342-1347. doi: 10.4103/njcp.njcp_101_23.

DOI:10.4103/njcp.njcp_101_23

PMID:37794548

Abstract

BACKGROUND

The fellow eye of a retinal detachment is at risk of developing a retinal detachment and other visually debilitating disease.

AIM

To investigate the rate of bilaterality of retinal detachment (RD), the presenting visual acuity (VA), and the presence of ocular morbidity in the fellow eye of patients with RD.

PATIENTS AND METHODS

A multicenter, prospective, cross-sectional study examining the fellow eye of consecutive patients who were diagnosed with different types of RD. The patients were seen within one year and examined in four Nigerian eye hospitals and clinics. Demographics, VA, and clinical findings at the presentation were reported on examination of the fellow eyes.

RESULTS

Twenty-seven (11.4%) out of 237 patients (264 eyes) had an RD in the fellow eye. The mean age of all study patients was 46.2 ± 16.8 years, M/F: 161 (67.9%)/76 (32.1%). The rates of bilaterality for rhegmatogenous, exudative, and tractional RDs were 4.2%, 11.1%, and 31.1%, respectively. Diagnosis of RD in an eye was associated with a risk of developing fellow eye rhegmatogenous retinal detachment (RRD) (P < 0.001) and tractional RD (P < 0.001), respectively. RRD in an eye was associated with a 17% risk of developing RD in the fellow eye (β = -1.6, OR = 0.202, P < 0.001). The BCVA in the fellow eye of the three types of RD varied significantly (P < 0.001). The fellow eye was blind in 25.2% of RRD, 54.1% of tractional retinal detachment (TRD), and 11.1% of exudative retinal detachment (ERD). Bilateral RD eyes were blind in RRD (85.7%), TRD (71.1%), and ERD (50%). One hundred and seven eyes (40.5%) of the total 264 RD eyes studied had other fellow eye events at the presentation.

CONCLUSION

A patient with an RD in one eye is at significant risk of developing a blinding RD in the fellow eye. This risk varies with the type of RD and is highest with TRD. However, RRD, the commonest type of RD, can benefit from prophylactic treatment to the fellow eye RD predisposing lesions.

摘要

背景

视网膜脱离患者的对侧眼有发生视网膜脱离和其他致盲性眼病的风险。

目的

调查视网膜脱离（RD）的双眼发生率、初诊时的视力（VA）和对侧眼的眼部病变情况。

方法

本研究为多中心、前瞻性、横断面研究，纳入了在不同类型 RD 患者中确诊的连续患者的对侧眼。这些患者在一年内接受检查，在四家尼日利亚眼科医院和诊所进行检查。对初诊时的对侧眼的人口统计学、VA 和临床发现进行报告。

结果

在 237 例（264 只眼）患者中，有 27 例（11.4%）对侧眼发生 RD。所有研究患者的平均年龄为 46.2 ± 16.8 岁，男女比例为 161（67.9%）/76（32.1%）。孔源性、渗出性和牵拉性 RD 的双眼发生率分别为 4.2%、11.1%和 31.1%。一眼 RD 的诊断与对侧眼发生孔源性 RD（RRD）（P < 0.001）和牵拉性 RD（P < 0.001）的风险分别相关。一眼发生 RRD 与对侧眼发生 RD 的风险为 17%（β=-1.6，OR=0.202，P < 0.001）。三种类型 RD 的对侧眼最佳矫正视力（BCVA）差异有统计学意义（P < 0.001）。RRD 对侧眼失明的比例为 25.2%，牵拉性 RD 为 54.1%，渗出性 RD 为 11.1%。双侧 RD 眼中 RRD 为 85.7%，TRD 为 71.1%，ERD 为 50%。在研究的 264 只 RD 眼中，有 107 只（40.5%）总在初诊时存在其他对侧眼事件。