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因新生血管性青光眼或原发性开角型青光眼而需要进行青光眼手术的患者全因死亡率比较:一项回顾性队列研究

A Comparison of All-Cause Mortality in Patients Who Required Glaucoma Surgery for Neovascular Glaucoma or Primary Open-Angle Glaucoma: A Retrospective Cohort Study.

作者信息

Palmer Laura D, Kauffman Levi D, Russell Gregory B, Thompson Atalie C, Treadwell Gillian G

机构信息

Wake Forest University School of Medicine, Winston Salem, NC 27101, USA.

Department of Surgical Ophthalmology, Atrium Health Wake Forest Baptist Medical Center, Winston Salem, NC 27157, USA.

出版信息

Vision (Basel). 2025 Jun 13;9(2):49. doi: 10.3390/vision9020049.

Abstract

This retrospective review examines whether there is a difference in all-cause mortality in patients who required surgical intervention for neovascular glaucoma (NVG, N = 186) versus primary open-angle glaucoma (POAG, N = 190). Cox proportional hazard models compared mortality across three models: unadjusted, age-adjusted (Model 1), and age-, hypertension-, and diabetes-adjusted (Model 2). In all models, NVG patients who required glaucoma surgery had a higher all-cause mortality rate compared to those with POAG who underwent similar procedures: unadjusted (HR 2.22, (1.59, 3.10), < 0.0001), Model 1 (HR 2.99, 95% CI (2.12, 4.22), < 0.0001), and Model 2 (HR 1.88, 95% CI (1.27, 2.80), < 0.0018). In Model 1, those with NVG due to PDR had a higher all-cause mortality rate after glaucoma surgery than those with NVG secondary to CRVO (HR 2.00, 95% CI (1.19, 3.45), < 0.0095). Patients treated with CPC had higher all-cause mortality rates than those treated with tube shunt in all models: unadjusted (HR 1.82, 95% CI (1.33, 2.47), < 0.0001), Model 1 (HR 1.91, 95% CI (1.40, 2.61), < 0.0001), and Model 2 (HR 1.50, 95% CI (1.04, 2.16), < 0.03). We observed a higher all-cause mortality rate among patients with NVG requiring glaucoma surgery compared to those with POAG requiring similar surgeries, which could suggest that NVG patients requiring glaucoma surgery had more compromised systemic health.

摘要

这项回顾性研究考察了因新生血管性青光眼(NVG,N = 186)而需要手术干预的患者与原发性开角型青光眼(POAG,N = 190)患者在全因死亡率上是否存在差异。Cox比例风险模型在三种模型中比较了死亡率:未调整模型、年龄调整模型(模型1)以及年龄、高血压和糖尿病调整模型(模型2)。在所有模型中,需要进行青光眼手术的NVG患者的全因死亡率均高于接受类似手术的POAG患者:未调整模型(风险比[HR] 2.22,95%置信区间[CI] [1.59, 3.10],P < 0.0001)、模型1(HR 2.99,95% CI [2.12, 4.22],P < 0.0001)和模型2(HR 1.88,95% CI [1.27, 2.80],P < 0.0018)。在模型1中,因糖尿病性视网膜病变导致NVG的患者在青光眼手术后的全因死亡率高于继发于视网膜中央静脉阻塞的NVG患者(HR 2.00,95% CI [1.19, 3.45],P < 0.0095)。在所有模型中,接受睫状体光凝术(CPC)治疗的患者的全因死亡率均高于接受分流管植入术治疗的患者:未调整模型(HR 1.82,95% CI [1.33, 2.47],P < 0.0001)、模型1(HR 1.91,95% CI [1.40, 2.61],P < 0.0001)和模型2(HR 1.50,95% CI [1.04, 2.16],P < 0.03)。我们观察到,与需要进行类似手术的POAG患者相比,需要进行青光眼手术的NVG患者的全因死亡率更高,这可能表明需要进行青光眼手术的NVG患者的全身健康状况更差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fff/12197471/da3f4f27cf59/vision-09-00049-g001.jpg

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