Thelen U, Gerding H, Clemens S
Klinik und Poliklinik für Augenheilkunde, Westfälische Wilhelms-Universität, Münster.
Ophthalmologe. 1997 Sep;94(9):638-41. doi: 10.1007/s003470050174.
Seasonal variations in the relative incidence of rhegmatogenous retinal detachment were reported as a trend in several studies on the database of relatively limited cohort sizes.
An analysis on this topic was performed with a long-term database. A total of 3073 files of patients with rhegmatogenous retinal detachment, covering 11 years of observation, were reviewed for this study. Patients with signs of long-standing detachment or other predisposing diseases were excluded, so that a basic study population of 2314 patients remained for the analysis.
The averaged seasonal incidence of rhegmatogenous detachments revealed a significant (P < 0.005) mid-summer peak (n in July = 228) and a winter trough (mean of December-January = 161; difference = 36%). Phase and curve fitting of the seasonal variations in the number of retina detachment cases was similar to the seasonal variation of the astronomic duration of the day (P < 0.001). The relation was closer compared to the average duration of light exposure per day calculated from behavioural data and the astronomic length of light phase (P < 0.0002).
This long-time study revealed a close correlation of the relative seasonal incidence of retinal detachment and the seasonal variation of light hours per day. So far, this observations cannot be explained pathogenetically. Two basic hypotheses ought to be investigated further: (1) The influence of light on the generation of toxic oxygen radicals and the subsequent destruction of the vitreous and (2) possible light-induced changes in vitreoretinal adhesion.
在一些队列规模相对有限的数据库研究中,孔源性视网膜脱离的相对发病率呈现出季节性变化趋势。
利用一个长期数据库对该主题进行分析。本研究回顾了3073例孔源性视网膜脱离患者的病历,涵盖11年的观察期。排除有长期脱离体征或其他易感疾病的患者,最终纳入分析的基础研究人群为2314例患者。
孔源性视网膜脱离的平均季节性发病率显示出一个显著的(P < 0.005)仲夏高峰(7月为228例)和一个冬季低谷(12月至1月的均值为161例;差异为36%)。视网膜脱离病例数的季节性变化的相位和曲线拟合与一天的天文时长的季节性变化相似(P < 0.001)。与根据行为数据计算的每日平均光照时长和光照阶段的天文长度相比,这种关系更为密切(P < 0.0002)。
这项长期研究揭示了视网膜脱离的相对季节性发病率与每日光照时长的季节性变化密切相关。到目前为止,这一观察结果在发病机制上尚无法解释。有两个基本假设值得进一步研究:(1)光对有毒氧自由基生成以及随后玻璃体破坏的影响;(2)光可能引起的玻璃体视网膜粘连变化。