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对侧眼孔源性视网膜脱离的特征、风险及预防

Characteristics, Risks, and Prevention of Rhegmatogenous Retinal Detachment in the Contralateral Eye.

作者信息

Al-Dwairi Rami, Saleh Omar, Mohidat Hasan, Al Beiruti Seren, Alshami Ali, El Taani Leen, Sharayah Abdullah, Al Sharie Ahmed H, Aleshawi Abdelwahab

机构信息

Division of Ophthalmology, Department of Special Surgery, Faculty of Medicine, Jordan University of Science & Technology, Irbid 22110, Jordan.

Department of Pathology and Microbiology, Faculty of Medicine, Jordan University of Science & Technology, Irbid 22110, Jordan.

出版信息

J Clin Med. 2025 Jan 2;14(1):222. doi: 10.3390/jcm14010222.

DOI:10.3390/jcm14010222
PMID:39797305
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11721734/
Abstract

: Rhegmatogenous retinal detachment (RRD) is a potentially blinding retinal disorder. RRD in the first eye is a well-recognized risk factor for bilateral RRD since risk factors that predispose to RRD affect both eyes. In this study, we assess the presenting factors that predispose individuals to bilateral RRD and evaluate the role of prophylactic retinopexy in preventing fellow-eye RRD. : Retrospectively, all patients who underwent RRD repair through pars plana vitrectomy were included. A medical database was utilized to extract the data. The primary outcome was to report the development of RRD in the fellow eyes according to the presenting risk factors. Secondary outcomes included the prophylactic effect of laser retinopexy for the fellow eye. : In this study, 348 patients were included. The mean age of the patients was 46.3 years. Bilateral RRD was developed in 13.7% of the patients. It was found that total RRD in the first eye (-value = 0.045), the presence of lattice degeneration in the first eye (-value = 0.036), the presence of high-risk breaks (-value = 0.0001) or lattice degeneration (-value = 0.0004) in the fellow eye, the involvement of the inferior-nasal quadrant in the first eye (-value = 0.043), and the presence of connective tissue diseases (-value = 0.008) were significantly associated with the development of fellow-eye RRD. Performing prophylactic retinopexy was associated with a reduction in the incidence of fellow-eye RRD (with or without high-risk breaks) (-value = 0.0001). It was not associated with a reduction in the risk of fellow-eye RRD in cases of lattice degeneration alone. : Recognition of certain perioperative risk factors (such as high-risk retinal tears) during the presentation of first-eye RRD is crucial. Prophylactic laser retinopexy may have a critical role in preventing fellow-eye RRD. Patients' awareness should be raised about the symptoms of RRD.

摘要

孔源性视网膜脱离(RRD)是一种有潜在致盲风险的视网膜疾病。由于导致RRD的危险因素会影响双眼,因此第一眼发生RRD是双眼发生RRD的一个公认风险因素。在本研究中,我们评估了导致个体发生双眼RRD的相关因素,并评估预防性视网膜光凝术在预防对侧眼RRD中的作用。

方法

回顾性纳入所有通过玻璃体切除术进行RRD修复的患者。利用医学数据库提取数据。主要结局是根据呈现的危险因素报告对侧眼RRD的发生情况。次要结局包括激光视网膜光凝术对侧眼的预防效果。

结果

本研究纳入了348例患者。患者的平均年龄为46.3岁。13.7%的患者发生了双眼RRD。研究发现,第一眼发生完全性RRD(P值 = 0.045)、第一眼存在格子样变性(P值 = 0.036)、对侧眼存在高危裂孔(P值 = 0.0001)或格子样变性(P值 = 0.0004)、第一眼下鼻象限受累(P值 = 0.043)以及存在结缔组织病(P值 = 0.008)与对侧眼RRD的发生显著相关。进行预防性视网膜光凝术与对侧眼RRD(无论有无高危裂孔)发生率的降低相关(P值 = 0.0001)。单独发生格子样变性的情况下,预防性视网膜光凝术与对侧眼RRD风险的降低无关。

结论

在第一眼RRD发病时识别某些围手术期危险因素(如高危视网膜裂孔)至关重要。预防性激光视网膜光凝术在预防对侧眼RRD中可能起关键作用。应提高患者对RRD症状的认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ded/11721734/bf3191ef8e1b/jcm-14-00222-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ded/11721734/bf3191ef8e1b/jcm-14-00222-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ded/11721734/bf3191ef8e1b/jcm-14-00222-g001.jpg

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