Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Republic of Korea.
Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka, Finland; Helsinki Retina Research Group, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Ophthalmology. 2024 Apr;131(4):434-444. doi: 10.1016/j.ophtha.2023.11.009. Epub 2023 Nov 14.
To evaluate the ultra-widefield fundus photography (UWF-FP)-guided swept-source OCT (SS-OCT) images of peripheral vitreoretinal abnormality (PVRA) in young asymptomatic myopes.
Cross-sectional, single-center study.
A total of 1966 eyes of 983 consecutive patients aged 18 to 42 years with refractive error in the spherical equivalent of < 0 diopters (D) who visited KEYE Eye Center, Seoul, Republic of Korea, for refractive surgery.
The prevalence of PVRA and their characteristics, including shape, location, presence of pigmentation, membrane, retinal breaks, and detachment, were evaluated. A logistic regression analysis was done to evaluate the risk factors of PVRA and the risk of retinal breaks or detachment among eyes with PVRA.
Among 1966 eyes, 317 (16.1%) had PVRA, and 182 (57.4%) and 135 (42.6%) had focal and linear lesions, respectively. The risk of PVRA was increased with axial length of the eyes (odds ratio [OR], 1.238, 95% confidence interval [CI], 1.112-1.379, P < 0.001), corneal astigmatism (OR, 1.320, 95% CI, 1.148-1.519, P < 0.001), presence of discrete margins of different retinal reflectivity (DMDRR; indicating outer retinal disruption from abnormal vitreoretinal traction) (OR, 1.751, 95% CI, 1.334-2.300, P < 0.001), and posterior vitreous detachment (PVD) at the posterior pole of the retina (OR, 1.833, 95% CI, 1.352-2.485, P < 0.001). Among eyes with PVRA, patient age (OR, 1.063, 95% CI, 1.008-1.121, P = 0.025), linear lesions (OR, 15.234, 95% CI, 7.891-29.407, P < 0.001), and multiple lesions (OR, 3.432, 95% CI, 1.780-6.620, P < 0.001) were independently associated with the presence of retinal breaks or detachment.
The follow-up for PVRA among young myopes should be personalized on the basis of their ocular characteristics, including asymmetric ocular expansion (axial length and astigmatism) and vitreoretinal interface status. The treatment plan for PVRA eyes should emphasize the greater risk of retinal breaks and detachment with increasing age and the presence of linear and multiple lesions.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
评估超广角眼底照相术(UWF-FP)引导的扫频源光学相干断层扫描(SS-OCT)在年轻无症状近视患者周边玻璃体视网膜异常(PVRA)中的图像。
横断面、单中心研究。
共纳入 1966 只眼,来自韩国首尔 KEYE 眼科中心连续就诊的 983 例年龄在 18 至 42 岁之间、等效球镜屈光度<0 屈光度(D)的近视患者。
评估了 PVRA 的患病率及其特征,包括形状、位置、色素沉着、膜、视网膜裂孔和脱离的存在。进行了逻辑回归分析,以评估 PVRA 的风险因素以及具有 PVRA 的眼中视网膜裂孔或脱离的风险。
在 1966 只眼中,有 317 只(16.1%)存在 PVRA,其中 182 只(57.4%)和 135 只(42.6%)分别为局灶性和线性病变。PVRA 的风险随眼球轴长的增加而增加(比值比[OR],1.238,95%置信区间[CI],1.112-1.379,P<0.001)、角膜散光(OR,1.320,95%CI,1.148-1.519,P<0.001)、离散的不同视网膜反射率边缘(DMDRR;表示异常玻璃体视网膜牵引引起的外视网膜中断)(OR,1.751,95%CI,1.334-2.300,P<0.001)和后极部视网膜的后玻璃体脱离(PVD)(OR,1.833,95%CI,1.352-2.485,P<0.001)。在具有 PVRA 的眼中,患者年龄(OR,1.063,95%CI,1.008-1.121,P=0.025)、线性病变(OR,15.234,95%CI,7.891-29.407,P<0.001)和多发性病变(OR,3.432,95%CI,1.780-6.620,P<0.001)与视网膜裂孔或脱离的存在独立相关。
应根据年轻近视患者的眼部特征(包括不对称眼球扩张(轴长和散光)和玻璃体视网膜界面状态)对 PVRA 进行个体化随访。PVRA 眼的治疗计划应强调随着年龄的增长以及线性和多发性病变的存在,视网膜裂孔和脱离的风险更大。