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从治疗模式角度评估与脉络膜脱离相关的孔源性视网膜脱离的危险因素:一项回顾性研究。

Evaluation of the risk factors for rhegmatogenous retinal detachment associated with choroidal detachment from the viewpoint of treatment patterns: a retrospective study.

作者信息

Gao Kai, Chen Zi-Ye, Lin Zhuang-Ling, Liu Ya-Ping, Liu Bao-Yi, Ma Yuan, Chen Zi-Tong, Tuxun Rebiya, Jiang Lan, Xu Zhuo-Jun, Tsai Chin-Ling, Lai Kun-Bei, Li Tao

机构信息

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, Guangdong Province, China.

出版信息

Int J Ophthalmol. 2025 Jun 18;18(6):1071-1076. doi: 10.18240/ijo.2025.06.13. eCollection 2025.

Abstract

AIM

To compare the proportion of rhegmatogenous retinal detachment (RRD) associated with choroidal detachment (RRDCD) in the emergency surgery group with the routine inpatient surgery group and determine risk factors for RRDCD.

METHODS

A total of 694 patients (694 eyes) diagnosed with RRD in the emergency surgery (the median duration of RRD was 5d) group were included from the Department of Ophthalmic Emergency, and 692 patients (eyes) in the routine inpatient surgery group (the median duration was 15d) were selected randomly from the Ocular Fundus Department. Demographics, refractive status, macular status, lens status, extent of retinal detachment, number of retinal breaks, duration of symptoms before surgery, and the incidence of RRDCD were compared. A logistic regression analysis was used to determine potential risk factors for RRDCD.

RESULTS

Compared to the routine inpatient surgery group, the emergency surgery group had a significant less median time to surgery (<0.001) and a decreased proportion of RRDCD (2.88% 10.84%, <0.001). Logistic regression analysis revealed that a prolonged duration of RRD [OR 3.51, 95% confidence interval (CI) 1.98-6.23], pseudophakia/aphakia status [OR 2.74, 95%CI (1.50-4.98)], multiple retinal breaks [OR 1.67, 95%CI (1.03-2.70)], and a substantial extent of RRD [OR 11.58, 95%CI (7.12-18.84)] were independent risk factors for RRDCD.

CONCLUSION

Emergency surgical pattern of RRD demonstrates a lower incidence of RRDCD. The adoption of an expedited surgical approach has the potential to reduce the duration of RRD, possibly correlating with a decreased risk of RRDCD development.

摘要

目的

比较急诊手术组与常规住院手术组中合并脉络膜脱离的孔源性视网膜脱离(RRDCD)的比例,并确定RRDCD的危险因素。

方法

从眼科急诊部纳入694例诊断为RRD的患者(694只眼)(RRD的中位病程为5天)作为急诊手术组,从眼底病科随机选取692例患者(眼)作为常规住院手术组(中位病程为15天)。比较两组的人口统计学特征、屈光状态、黄斑状态、晶状体状态、视网膜脱离范围、视网膜裂孔数量、手术前症状持续时间以及RRDCD的发生率。采用逻辑回归分析确定RRDCD的潜在危险因素。

结果

与常规住院手术组相比,急诊手术组的中位手术时间显著缩短(<0.001),RRDCD的比例降低(2.88%对10.84%,<0.001)。逻辑回归分析显示,RRD病程延长[比值比(OR)3.51,95%置信区间(CI)1.98 - 6.23]、人工晶状体/无晶状体状态[OR 2.74,95%CI(1.50 - 4.98)]、多个视网膜裂孔[OR 1.67,95%CI(1.03 - 2.70)]以及RRD范围较大[OR 11.58,95%CI(7.12 - 18.84)]是RRDCD的独立危险因素。

结论

RRD的急诊手术模式显示RRDCD的发生率较低。采用快速手术方法有可能缩短RRD的病程,这可能与降低RRDCD发生风险相关。

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