Nishimura Shunsuke, Okuda Tetsuhiko, Higashide Tomomi, Sugiyama Kazuhisa
Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
Clin Ophthalmol. 2025 Jan 3;19:11-18. doi: 10.2147/OPTH.S499960. eCollection 2025.
The factors that contribute to the progression of macular involvement in RRD have not been extensively investigated. The purpose of this study is to evaluate the association between the preoperative characteristics and macular status of the eyes with rhegmatogenous retinal detachment (RRD).
This is a retrospective cohort study. All patients with RRDs who underwent initial pars plana vitrectomy or scleral buckling were included. Patients with RRD and macular hole retinal detachment, traumatic RD, proliferative diabetic retinopathy, proliferative vitreoretinopathy grade C or higher, diabetic retinopathy, or retinal vein occlusion were excluded. High myopia was defined as an axial length > of 26.5 mm.
A total of 1026 eyes of 1026 patients (mean, 55.4±15.5 years) were included. There was a significant difference in the male (68.4%) to female (31.6%) ratio (the chi-squared test: < 0.001). A total of 351 patients (34.2%) had high myopia. The 50-59 years age group had the highest number of eyes with high myopia. The proportion of highly myopic eyes in the 40-49 years group was the highest. Multiple logistic regression analysis indicated that prior cataract extraction and shorter axial length (≤24.5 mm) were significantly associated with macula-off RRD ( = 0.018, = 0.043, respectively). Superior and temporal retinal breaks significantly increased and superior nasal retinal breaks significantly decreased the odds ratio of macular detachment ( = 0.018, < 0.001, and < 0.001, respectively).
Previous cataract extraction, shorter axial length, and superior and temporal retinal breaks are important risk factors for macular detachment.
导致孔源性视网膜脱离(RRD)黄斑受累进展的因素尚未得到广泛研究。本研究的目的是评估孔源性视网膜脱离(RRD)患者术前特征与黄斑状态之间的关联。
这是一项回顾性队列研究。纳入所有接受初次玻璃体切除术或巩膜扣带术的RRD患者。排除患有RRD合并黄斑裂孔性视网膜脱离、外伤性视网膜脱离、增殖性糖尿病视网膜病变、增殖性玻璃体视网膜病变C级或更高、糖尿病视网膜病变或视网膜静脉阻塞的患者。高度近视定义为眼轴长度>26.5mm。
共纳入1026例患者的1026只眼(平均年龄55.4±15.5岁)。男性(68.4%)与女性(31.6%)比例存在显著差异(卡方检验:<0.001)。共有351例患者(34.2%)患有高度近视。50 - 59岁年龄组高度近视的眼数最多。40 - 49岁组高度近视眼的比例最高。多因素logistic回归分析表明,既往白内障摘除术和较短的眼轴长度(≤24.5mm)与黄斑脱离的RRD显著相关(分别为=0.018,=0.043)。上方和颞侧视网膜裂孔显著增加,上方鼻侧视网膜裂孔显著降低黄斑脱离的比值比(分别为=0.018,<0.001,<0.001)。
既往白内障摘除术、较短的眼轴长度以及上方和颞侧视网膜裂孔是黄斑脱离的重要危险因素。