Retina Division, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.
Department of Epidemiology and Population Health, School of Medicine, Stanford University, Stanford, California; Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
Ophthalmol Retina. 2024 Sep;8(9):924-931. doi: 10.1016/j.oret.2024.03.005. Epub 2024 Mar 12.
In this study, we aimed to characterize the frequency and distribution of ocular surgeries in patients with inherited retinal diseases (IRDs) and evaluate associated patient and disease factors.
Retrospective cohort.
Subjects aged ≥ 18 years who were followed at the Johns Hopkins Genetic Eye Disease Center.
We studied a retrospective cohort of patients with an IRD diagnosis to analyze the occurrence of laser and incisional surgeries. Subjects were categorized into 2 groups: central dysfunction (macular/cone/cone-rod dystrophy, "MCCRD group") and panretinal or peripheral dysfunction (retinitis pigmentosa-like, "RP group"). Genetic testing status was recorded. The association of patient and disease factors on the frequency, distribution, and timing of surgeries was analyzed.
Prevalence, prevalence odds ratio (POR), hazard ratio (HR) of ophthalmic procedures by phenotype.
A total of 1472 eyes of 736 subjects were evaluated. Among them, 31.3% (n = 230) had undergone ocular surgery, and 78.3% of those (n = 180/230) had a history of more than 1 surgery. A total of 602 surgical procedures were analyzed. Cataract extraction with intraocular lens implantation (CEIOL) was the most common (51.2%), followed by yttrium aluminum garnet capsulotomy, refractive surgery, retinal surgery, and others. Cataract extraction with intraocular lens implantation occurred more frequently in RP than in MCCRD subjects (POR, 2.59; P = 0.002). Retinitis pigmentosa subjects underwent CEIOL at a younger age than patients with MCCRD (HR, 2.11; P < 0.001).
Approximately one-third of patients with IRD had a history of laser or incisional surgery. Cataract extraction with intraocular lens implantation was the most common surgery; its frequency and timing may be associated with the IRD phenotype. This data may inform the design of prospective research. Such efforts may illuminate routine clinical decision-making and contribute to surgical strategy development for cell and gene therapy delivery.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
本研究旨在描述遗传性视网膜疾病（IRDs）患者眼部手术的发生频率和分布情况，并评估相关的患者和疾病因素。
回顾性队列研究。
在约翰霍普金斯遗传眼病中心接受治疗的年龄≥18 岁的患者。
我们对患有 IRD 诊断的患者进行了回顾性队列研究，以分析激光和切开手术的发生情况。将患者分为两组：中心功能障碍（黄斑/视锥/视锥-杆营养不良，“MCCRD 组”）和全视网膜或周边功能障碍（类视色素变性，“RP 组”）。记录了基因检测状态。分析了患者和疾病因素对手术频率、分布和时间的影响。
根据表型计算眼科手术的患病率、患病率优势比（POR）和风险比（HR）。
共评估了 736 名患者的 1472 只眼。其中，31.3%（230/736）的患者接受了眼部手术，其中 78.3%（180/230）的患者有多次手术史。共进行了 602 次手术。白内障超声乳化吸除联合人工晶状体植入术（CEIOL）最为常见（51.2%），其次是钇铝石榴石囊切开术、屈光手术、视网膜手术等。白内障超声乳化吸除联合人工晶状体植入术在 RP 患者中比在 MCCRD 患者中更为常见（POR，2.59；P=0.002）。RP 患者接受 CEIOL 的年龄小于 MCCRD 患者（HR，2.11；P<0.001）。
大约三分之一的遗传性视网膜疾病患者有激光或切开手术史。白内障超声乳化吸除联合人工晶状体植入术是最常见的手术；其频率和时间可能与 IRD 表型有关。这些数据可能为前瞻性研究提供信息。这些研究可能有助于阐明常规临床决策，并为细胞和基因治疗输送的手术策略制定做出贡献。
在本文末尾的脚注和披露中可能会发现专有或商业披露。
