Peters A L
Department of Ophthalmology, University of Natal, King Edward VIII Hospital, Durban.
S Afr Med J. 1995 Mar;85(3):158-9.
Rhegmatogenous retinal detachments seen in black patients attending King Edward VIII Hospital Ophthalmology Clinic over a 5-year period from January 1987 to December 1991 were reviewed. Penetrating trauma and diabetic retinopathy were excluded. There were 114 detachments in 112 patients, which gave incidence of 0.46/100,000 of the population served per annum. This confirms the low incidence of this disorder found in black patients in other series. Patients were comparatively young (37.5% less than 30 years of age), men outnumbered women 2:1, and the incidence of blunt trauma was high (29.8%). Over one-third (36.6%) presented with a blind or poorly sighted opposite eye. Late presentation was common. Large posterior breaks occurred in 15.7% of detachments with severe proliferative vitreoretinopathy in 33.3%. These last characteristics accounted for the use of vitrectomy with tamponade as a primary surgical procedure in 32.5% of cases and contributed to the relatively low success rate of reattachment (72.8%). Some of the findings may be influenced by social disadvantage, but the reason for the low incidence of retinal detachment in black patients is not known. A stronger adherence of the retina to the retinal pigment epithelium in black patients is postulated.
对1987年1月至1991年12月期间在爱德华八世国王医院眼科诊所就诊的黑人患者中发生的孔源性视网膜脱离进行了回顾性研究。排除穿透性外伤和糖尿病性视网膜病变。112例患者中有114次视网膜脱离，每年在所服务人群中的发病率为0.46/10万。这证实了在其他系列研究中发现的黑人患者中这种疾病的低发病率。患者相对年轻（37.5%年龄小于30岁），男性与女性的比例为2:1，钝挫伤的发病率较高（29.8%）。超过三分之一（36.6%）的患者对侧眼失明或视力差。就诊延迟很常见。15.7%的视网膜脱离出现大的后部裂孔，33.3%伴有严重的增殖性玻璃体视网膜病变。这些特征导致32.5%的病例将玻璃体切除联合眼内填充作为主要手术方式，并导致视网膜复位成功率相对较低（72.8%）。一些研究结果可能受到社会不利因素的影响，但黑人患者视网膜脱离发病率低的原因尚不清楚。推测黑人患者视网膜与视网膜色素上皮的粘连更强。
