Nkanga Dennis George, Agweye Chineze Thelma, Okonkwo Ogugua Ndubuisi, Ovienria Wilson, Adenuga Olukorede, Akanbi Toyin, Udoh Martha-Mary Ekong, Oyekunle Idris, Ibanga Affiong Andem
Department of Ophthalmology, University of Calabar Teaching Hospital, Calabar, Nigeria.
Department of Ophthalmology, Eye Foundation Hospital, Lagos, Nigeria.
J West Afr Coll Surg. 2023 Oct-Dec;13(4):58-62. doi: 10.4103/jwas.jwas_40_23. Epub 2023 Sep 16.
To determine the causes of tractional retinal detachment (TRD) in Nigerians.
A prospective, multicentre study evaluating eyes diagnosed to have TRD. History, clinical examination (including visual acuity, intraocular pressure measurement, anterior segment examination and dilated fundoscopy) and systemic evaluation (including previous diagnosis of diabetes, hypertension, sickle-cell disease and others) were performed in TRD eyes out of a cohort of retinal detachment eyes.
The prevalence of TRD of the 237 patients diagnosed with RD within a one-year study period was 25.7% (61 patients). Eighty eyes were diagnosed with TRD. Thirty-eight eyes of nineteen patients (31%) were bilateral, and 42 (69%) were unilateral. There were 38 male patients (62.3%) and 23 female patients (37.7%). The mean age was 52.3 ± 12.7 years (11-69 years). 88.5% of all TRD patients had an associated systemic disease, diabetes being the most common disease in 88.8% of them. Proliferative diabetic retinopathy was the most common cause of TRD (77.5%) and the most common cause of bilateral TRD. Both trauma and proliferative sickle-cell retinopathy occurred in 3.8% of the eyes. 68.8% of TRD eyes were blind at the presentation. However, the causes of TRD did not show any significant association with blindness ( = 0.819).
Proliferative diabetic retinopathy poses a significant threat to vision, being the most common cause of TRD. Early detection and treatment of proliferative retinopathy in diabetes and sickle-cell disease, and trauma prevention will significantly reduce the burden of blindness due to TRD.
确定尼日利亚人牵引性视网膜脱离（TRD）的病因。
一项前瞻性、多中心研究，评估被诊断患有TRD的眼睛。对一组视网膜脱离患者中的TRD患眼进行病史、临床检查（包括视力、眼压测量、前段检查和散瞳眼底检查）以及全身评估（包括既往糖尿病、高血压、镰状细胞病等诊断）。
在为期一年的研究期内诊断为视网膜脱离的237例患者中，TRD的患病率为25.7%（61例患者）。80只眼睛被诊断为TRD。19例患者的38只眼睛（31%）为双侧，42只眼睛（69%）为单侧。有38例男性患者（62.3%）和23例女性患者（37.7%）。平均年龄为52.3±12.7岁（11 - 69岁）。所有TRD患者中有88.5%患有相关全身性疾病，其中糖尿病是最常见的疾病，占88.8%。增殖性糖尿病视网膜病变是TRD最常见的病因（77.5%），也是双侧TRD最常见的病因。外伤和增殖性镰状细胞视网膜病变在3.8%的患眼中出现。68.8%的TRD患眼在就诊时已失明。然而，TRD的病因与失明之间未显示出任何显著关联（P = 0.819）。
增殖性糖尿病视网膜病变对视力构成重大威胁，是TRD最常见的病因。早期发现和治疗糖尿病及镰状细胞病中的增殖性视网膜病变，以及预防外伤，将显著减轻TRD导致的失明负担。
