Palmer Laura D, Peterson Jared D, Evans Joni K, Nelson Mark H, Asrani Sanjay, Thompson Atalie C
Wake Forest University School of Medicine, 475 Vine St, Winston Salem, NC, 27101, USA.
Department of Surgical Ophthalmology, Atrium Health Wake Forest Baptist Medical Center, Winston Salem, NC, USA.
Ophthalmol Ther. 2024 Nov;13(11):3013-3024. doi: 10.1007/s40123-024-01039-1. Epub 2024 Sep 29.
To investigate the impact of posterior vitreous detachment (PVD) on the risk of developing neovascular glaucoma (NVG) in eyes with occlusions of the retinal artery (RAO) or retinal vein (RVO).
Single-center retrospective case-control study of adults with a history of RVO/RAO. Cases (N = 101) who developed NVG were age and sex matched 1:2 to controls who did not develop NVG (N = 202). Multivariable logistic regression was used to estimate the association between history of PVD and risk of NVG while controlling for other related demographic or clinical factors.
In initial bivariate analyses, there was no difference in risk of NVG based on eye, lens status, hypertension, history of panretinal photocoagulation (PRP), or retinal surgery (all p > 0.10), a borderline difference based on diabetic retinopathy (DR) (p = 0.06) and prior anti-vascular endothelial growth factor (anti-VEGF) treatment (p = 0.08), and a significant difference based on race/ethnicity, type of vascular event, and PVD status (all p < 0.05). In the final multivariable model, patients without PVD were significantly more likely to develop NVG (OR = 3.07, p = 0.0001) independent of the other covariates. Risk of NVG was greater in those with DR (OR = 1.98, p = 0.0440) and in those with central RVO vs. branch RVO/hemiretinal RVO (OR = 5.77, p < 0.0001). Non-White/Non-Hispanics (OR = 2.56, p = 0.0051) and Hispanics (OR = 3.65, p = 0.0288) were more likely than White patients to develop NVG.
Progression to NVG after retinal vascular occlusion is more likely in Non-White/Hispanic patients, those with concomitant DR, and those with CRVO/CRAO. The absence of PVD increases the risk for NVG. Further studies are necessary to understand this relationship.
探讨玻璃体后脱离（PVD）对视网膜动脉阻塞（RAO）或视网膜静脉阻塞（RVO）患者发生新生血管性青光眼（NVG）风险的影响。
对有RVO/RAO病史的成年人进行单中心回顾性病例对照研究。发生NVG的病例（N = 101）按年龄和性别1:2匹配未发生NVG的对照（N = 202）。多变量逻辑回归用于估计PVD病史与NVG风险之间的关联，同时控制其他相关的人口统计学或临床因素。
在初始双变量分析中，基于眼别、晶状体状态、高血压、全视网膜光凝（PRP）病史或视网膜手术，NVG风险无差异（所有p>0.10），基于糖尿病视网膜病变（DR）有临界差异（p = 0.06）和既往抗血管内皮生长因子（抗VEGF）治疗（p = 0.08），基于种族/族裔、血管事件类型和PVD状态有显著差异（所有p<0.05）。在最终的多变量模型中，无PVD的患者发生NVG的可能性显著更高（OR = 3.07，p = 0.0001），独立于其他协变量。DR患者（OR = 1.98，p = 0.0440）以及中心性RVO患者与分支性RVO/半侧视网膜RVO患者相比，NVG风险更高（OR = 5.77，p<0.0001）。非白人/非西班牙裔（OR = 2.56，p = 0.0051）和西班牙裔（OR = 3.65，p = 0.0288）比白人患者更易发生NVG。
视网膜血管阻塞后进展为NVG在非白人/西班牙裔患者、合并DR的患者以及中心性视网膜静脉阻塞/视网膜中央动脉阻塞（CRVO/CRAO）患者中更常见。无PVD会增加NVG风险。有必要进行进一步研究以了解这种关系。
