视网膜前膜的患病率及相关因素。澳大利亚蓝山眼研究。

Prevalence and associations of epiretinal membranes. The Blue Mountains Eye Study, Australia.

作者信息

Mitchell P, Smith W, Chey T, Wang J J, Chang A

机构信息

Department of Ophthalmology, University of Sydney, Australia.

出版信息

Ophthalmology. 1997 Jun;104(6):1033-40. doi: 10.1016/s0161-6420(97)30190-0.

DOI:10.1016/s0161-6420(97)30190-0

PMID:9186446

Abstract

PURPOSE

The purpose of the study is to determine the prevalence and associations of epiretinal membranes in a defined older Australian population and to assess their influence on visual acuity.

METHODS

Three thousand six hundred fifty-four persons 49 years of age or older, representing 88% of permanent residents from an area west of Sydney, underwent a detailed eye examination, including stereo retinal photography. Epiretinal membranes were diagnosed clinically and from photographic grading.

RESULTS

Signs of epiretinal membranes were found in 243 participants (7%; 95% confidence interval [CI], 6.1, 7.6), bilateral in 31%. The prevalence was 1.9% in persons younger than 60 years of age, 7.2% in persons 60 to 69 years of age, 11.6% in persons 70 to 79 years of age, and 9.3% in persons 80 years of age and older, with slightly higher rates in women. Two stages were identified: an early form without retinal folds, termed "cellophane macular reflex" present in 4.8%, and a later stage with retinal folds, termed "preretinal macular fibrosis" (PMF), found in 2.2% of the population. Preretinal macular fibrosis, but not cellophane macular reflex, had a small, significant effect on visual acuity. Preretinal macular fibrosis was significantly associated with diabetes, after age-gender adjustment, in subjects without signs of diabetic retinopathy (odds ratio, 3.2; 95% CI, 1.4, 7.2). Preretinal macular fibrosis also was associated with increased fasting plasma glucose (odds ratio, 1.2; 95% CI, 1.1, 1.3). Epiretinal membranes were found in 16.8% of persons who had undergone cataract surgery in one or both eyes (including PMF in 3.7%), in 16.1% of retinal vein occlusion cases (PMF in 12.5%), both significantly higher rates than in subjects without these conditions (P < 0.0001), and in 11% of persons with diabetic retinopathy (PMF in 3.6%), not significantly higher (P = 0.17).

CONCLUSIONS

This study has documented the frequency and mild effect on vision of epiretinal membranes in an older population. Diabetes was associated significantly with idiopathic cases, whereas well-known associations with past cataract surgery and retinal disease were confirmed.

摘要

目的

本研究旨在确定特定澳大利亚老年人群中视网膜前膜的患病率及其相关性，并评估其对视力的影响。

方法

对悉尼以西某地区88%的常住居民中年龄在49岁及以上的3654人进行了详细的眼部检查，包括立体视网膜摄影。视网膜前膜通过临床诊断和照片分级来确定。

结果

243名参与者（7%；95%置信区间[CI]，6.1，7.6）发现有视网膜前膜体征，其中31%为双侧。60岁以下人群的患病率为1.9%，60至69岁人群为7.2%，70至79岁人群为11.6%，80岁及以上人群为9.3%，女性患病率略高。确定了两个阶段：一种早期形式，无视网膜皱褶，称为“玻璃纸黄斑反射”，占4.8%；后期阶段有视网膜皱褶，称为“视网膜前黄斑纤维化”（PMF），占2.2%。视网膜前黄斑纤维化而非玻璃纸黄斑反射对视力有微小但显著的影响。在无糖尿病视网膜病变体征的受试者中，经年龄和性别调整后，视网膜前黄斑纤维化与糖尿病显著相关（优势比，3.2；95%CI，1.4，7.2）。视网膜前黄斑纤维化还与空腹血糖升高相关（优势比，1.2；95%CI，1.1，1.3）。在一只或两只眼睛接受过白内障手术的人群中，16.8%发现有视网膜前膜（其中3.7%为PMF），在视网膜静脉阻塞病例中为16.1%（PMF为12.5%），这两个比例均显著高于无这些疾病的受试者（P<0.0001），在糖尿病视网膜病变患者中为11%（PMF为3.6%），无显著升高（P = 0.17）。