Tianyuan Yao, Muhammad Z. Chauhan, Sami H. Uwaydat
{"title":"口服泼尼松对预防和治疗开球伤后增殖性玻璃体视网膜病变的影响","authors":"Tianyuan Yao, Muhammad Z. Chauhan, Sami H. Uwaydat","doi":"10.1177/24741264241229262","DOIUrl":null,"url":null,"abstract":"Purpose: To determine the impact of oral prednisone on final visual acuity (VA) and prevention of proliferative vitreoretinopathy (PVR) in patients having pars plana vitrectomy (PPV) for globe injuries. Methods: A retrospective chart review was performed of all globe injuries with an initial repair and subsequent PPV between 2009 and 2018. Data included the initial VA, zones of injury, initial closure date, time to secondary intervention (PPV), oral prednisone (1 mg/kg/day) use, the final VA, and enucleation rate. Multivariable regression models were used to assess the impact of oral prednisone use on anatomic and functional outcomes. Results: The mean (±SD) patient age was 46.25 ±18.56 years (range, 13-92); 131 (83.9%) were men. Oral prednisone intake was recorded in 81 patients (52.3%). The prednisone group had significantly more zone 3 involvement ( P = .001), worse initial VA (2.28 vs 1.92; P = .003), and a greater mean number of surgeries ( P = .020) than the no-steroids (control) group but an equivalent final logMAR VA (1.57 vs 1.52; P = .881). The prednisone group had significant VA improvement ( P = .025); however, oral prednisone use did not predict the development of PVR (29.23% vs 12.90%; odds ratio [OR], 2.81; 95% CI, 0.89-8.85) or retinal detachment (27.27% vs 29.58%; OR, 0.59; 95% CI, 0.23-1.56). Conclusions: Despite a worse initial clinical presentation, patients who received oral prednisone had significant visual improvement compared with the control group. However, oral prednisone (1 mg/kg/day) use at the time of injury did not decrease the PVR rate.","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":null,"pages":null},"PeriodicalIF":0.5000,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effect of Oral Prednisone on the Prevention and Management of Proliferative Vitreoretinopathy After Open-Globe Injury\",\"authors\":\"Tianyuan Yao, Muhammad Z. Chauhan, Sami H. Uwaydat\",\"doi\":\"10.1177/24741264241229262\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Purpose: To determine the impact of oral prednisone on final visual acuity (VA) and prevention of proliferative vitreoretinopathy (PVR) in patients having pars plana vitrectomy (PPV) for globe injuries. Methods: A retrospective chart review was performed of all globe injuries with an initial repair and subsequent PPV between 2009 and 2018. Data included the initial VA, zones of injury, initial closure date, time to secondary intervention (PPV), oral prednisone (1 mg/kg/day) use, the final VA, and enucleation rate. Multivariable regression models were used to assess the impact of oral prednisone use on anatomic and functional outcomes. Results: The mean (±SD) patient age was 46.25 ±18.56 years (range, 13-92); 131 (83.9%) were men. Oral prednisone intake was recorded in 81 patients (52.3%). The prednisone group had significantly more zone 3 involvement ( P = .001), worse initial VA (2.28 vs 1.92; P = .003), and a greater mean number of surgeries ( P = .020) than the no-steroids (control) group but an equivalent final logMAR VA (1.57 vs 1.52; P = .881). The prednisone group had significant VA improvement ( P = .025); however, oral prednisone use did not predict the development of PVR (29.23% vs 12.90%; odds ratio [OR], 2.81; 95% CI, 0.89-8.85) or retinal detachment (27.27% vs 29.58%; OR, 0.59; 95% CI, 0.23-1.56). Conclusions: Despite a worse initial clinical presentation, patients who received oral prednisone had significant visual improvement compared with the control group. However, oral prednisone (1 mg/kg/day) use at the time of injury did not decrease the PVR rate.\",\"PeriodicalId\":17919,\"journal\":{\"name\":\"Journal of VitreoRetinal Diseases\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.5000,\"publicationDate\":\"2024-02-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of VitreoRetinal Diseases\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/24741264241229262\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of VitreoRetinal Diseases","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/24741264241229262","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:确定口服泼尼松对因眼球损伤而接受玻璃体旁切除术(PPV)的患者最终视力(VA)和预防增殖性玻璃体视网膜病变(PVR)的影响。方法:对2009年至2018年期间所有初次修复并随后进行PPV的眼球损伤患者进行回顾性病历审查。数据包括初始VA、损伤区域、初始闭合日期、二次干预(PPV)时间、口服泼尼松(1 mg/kg/天)使用情况、最终VA和去核率。多变量回归模型用于评估口服泼尼松对解剖和功能结果的影响。研究结果患者平均年龄(±SD)为 46.25±18.56 岁(13-92 岁不等);131 名患者(83.9%)为男性。81名患者(52.3%)口服泼尼松。泼尼松组的第 3 区受累程度(P = .001)、初始视力(2.28 vs 1.92;P = .003)和平均手术次数(P = .020)均明显多于无类固醇(对照组)组,但最终的对数马尔视力(1.57 vs 1.52;P = .881)却与无类固醇(对照组)组相当。泼尼松组的 VA 有明显改善 ( P = .025);但是,口服泼尼松并不能预测 PVR(29.23% vs 12.90%;几率比 [OR],2.81;95% CI,0.89-8.85)或视网膜脱离(27.27% vs 29.58%;OR,0.59;95% CI,0.23-1.56)的发生。结论尽管初始临床表现较差,但与对照组相比,口服泼尼松的患者视力明显改善。不过,受伤时口服泼尼松(1 毫克/千克/天)并不会降低 PVR 率。
Effect of Oral Prednisone on the Prevention and Management of Proliferative Vitreoretinopathy After Open-Globe Injury
Purpose: To determine the impact of oral prednisone on final visual acuity (VA) and prevention of proliferative vitreoretinopathy (PVR) in patients having pars plana vitrectomy (PPV) for globe injuries. Methods: A retrospective chart review was performed of all globe injuries with an initial repair and subsequent PPV between 2009 and 2018. Data included the initial VA, zones of injury, initial closure date, time to secondary intervention (PPV), oral prednisone (1 mg/kg/day) use, the final VA, and enucleation rate. Multivariable regression models were used to assess the impact of oral prednisone use on anatomic and functional outcomes. Results: The mean (±SD) patient age was 46.25 ±18.56 years (range, 13-92); 131 (83.9%) were men. Oral prednisone intake was recorded in 81 patients (52.3%). The prednisone group had significantly more zone 3 involvement ( P = .001), worse initial VA (2.28 vs 1.92; P = .003), and a greater mean number of surgeries ( P = .020) than the no-steroids (control) group but an equivalent final logMAR VA (1.57 vs 1.52; P = .881). The prednisone group had significant VA improvement ( P = .025); however, oral prednisone use did not predict the development of PVR (29.23% vs 12.90%; odds ratio [OR], 2.81; 95% CI, 0.89-8.85) or retinal detachment (27.27% vs 29.58%; OR, 0.59; 95% CI, 0.23-1.56). Conclusions: Despite a worse initial clinical presentation, patients who received oral prednisone had significant visual improvement compared with the control group. However, oral prednisone (1 mg/kg/day) use at the time of injury did not decrease the PVR rate.