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视网膜中央静脉阻塞患者发生新生血管性青光眼的危险因素:两年真实世界研究

Risk Factors for Developing Neovascular Glaucoma in Central Retinal Vein Occlusion: Two-Year Real-World Study.

作者信息

Chou Yu-Bai, Chang Hsin-Ho, Chiu Hsun-I, Chou Yiing-Jenq, Pu Christy

机构信息

School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.

Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.

出版信息

Ophthalmic Epidemiol. 2025 Apr;32(2):204-212. doi: 10.1080/09286586.2024.2370260. Epub 2024 Jul 31.

Abstract

PURPOSE

To explore potential risk factors for the development of neovascular glaucoma (NVG) in central retinal vein occlusion (CRVO) over a two-year intensive follow-up period.

METHODS

This study reviewed 1545 patients with CRVO between 2005 and 2019 at Taipei Veterans General Hospital. Inclusion was restricted to (1) patients with acute CRVO within 3 months; (2) patients with ocular neovascularization at initial presentation (3) patients had not received any treatment at the time of CRVO; (4) at least bimonthly follow-up schedule over the course of 2 years. The included patients were screened for potential risk factors for developing NVG and assessed with Kaplan-Meier survival analysis and Cox regression model.

RESULTS

Among the included 123 patients, the cumulative probability of developing NVG was 26.8% (33/123 cases) in overall follow-up period. The mean interval between the onset of CRVO and NVG was 507 days. Neither macular edema nor central macular thickness at baseline was correlated with the development of NVG ( =.104 and .25, respectively). Patients with diabetes mellitus (DM), older age, and poor vision independently played significant risk factors for developing NVG after controlling other covariates. ( =.034, .001, and .013, respectively).

CONCLUSIONS

Patients presenting with CRVO who have comorbidities such as DM, older age, and worse VA warrant closer attention and intensive follow-up for the development of NVG. Additionally, the statistical analysis indicated that the presence of macular edema, increased central macular thickness, CV events, history of glaucoma, and early PRP within 3 months had no significant impact on the likelihood of developing NVG.

摘要

目的

在为期两年的密集随访期内,探讨视网膜中央静脉阻塞(CRVO)患者发生新生血管性青光眼(NVG)的潜在危险因素。

方法

本研究回顾了2005年至2019年台北荣民总医院收治的1545例CRVO患者。纳入标准限定为:(1)发病3个月内的急性CRVO患者;(2)初诊时有眼部新生血管形成的患者;(3)CRVO发病时未接受任何治疗的患者;(4)在2年的随访期间至少每两个月随访一次。对纳入的患者进行了NVG发生潜在危险因素的筛查,并采用Kaplan-Meier生存分析和Cox回归模型进行评估。

结果

在纳入的123例患者中,总体随访期内发生NVG的累积概率为26.8%(33/123例)。CRVO发病至NVG的平均间隔时间为507天。基线时黄斑水肿和中心黄斑厚度均与NVG的发生无关(分别为P = 0.104和P = 0.25)。在控制其他协变量后,糖尿病(DM)患者、年龄较大和视力较差是发生NVG的独立显著危险因素(分别为P = 0.034、P = 0.001和P = 0.013)。

结论

合并DM、年龄较大和视力较差等合并症的CRVO患者,发生NVG时需要密切关注并进行密集随访。此外,统计分析表明,黄斑水肿、中心黄斑厚度增加、心血管事件、青光眼病史以及发病3个月内早期进行全视网膜光凝(PRP)对发生NVG的可能性没有显著影响。

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