遗传性视网膜疾病患者接受眼科手术的频率和分布。

IF 4.4 Q1 OPHTHALMOLOGY

Ophthalmology. Retina Pub Date : 2024-09-01 DOI:10.1016/j.oret.2024.03.005

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引用次数: 0

摘要

目的：本研究旨在描述遗传性视网膜疾病（IRD）患者眼部手术的频率和分布情况，并评估相关的患者和疾病因素：设计：回顾性队列：约翰-霍普金斯大学遗传性眼病（GEDi）中心随访的 18 岁及以上受试者：我们对确诊为IRD的患者进行了回顾性队列研究，分析了激光手术和切口手术的发生率。受试者被分为两组：中心功能障碍（黄斑/锥体/锥体-杆状营养不良，"MCCRD 组"）和全视网膜或周边功能障碍（类色素性视网膜炎，"RP 组"）。记录了基因检测情况。分析了患者和疾病因素对手术频率、分布和时间的影响：主要结果测量指标：按表型划分的眼科手术的患病率、患病几率比（POR）和危险比（HR）：结果：共对 736 名受试者的 1472 只眼睛进行了评估。结果：共对 736 名受试者的 1472 只眼睛进行了评估，其中 31.3%（n=230）的受试者接受过眼科手术，78.3%（n=180/230）的受试者有不止一次手术史。共对 602 例手术进行了分析。最常见的手术是白内障摘除加人工晶体植入术（CEIOL）（51.2%），其次是 YAG 包膜切开术、屈光手术、视网膜手术和其他手术。RP受试者的CEIOL发生率高于MCCRD受试者（POR 2.59，P = 0.002）。RP患者接受CEIOL的年龄比MCCRD患者小（HR = 2.11，P < 0.001）：结论：约三分之一的IRD患者有激光或切口手术史。CEIOL是最常见的手术；其频率和时间可能与IRD表型有关。这些数据可为前瞻性研究的设计提供参考。这些工作可能会对常规临床决策有所启发，并有助于制定细胞和基因治疗的手术策略。

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Frequency and Distribution of Ophthalmic Surgical Procedures among Patients with Inherited Retinal Diseases

Objective

In this study, we aimed to characterize the frequency and distribution of ocular surgeries in patients with inherited retinal diseases (IRDs) and evaluate associated patient and disease factors.

Design

Retrospective cohort.

Participants

Subjects aged ≥ 18 years who were followed at the Johns Hopkins Genetic Eye Disease Center.

Methods

We studied a retrospective cohort of patients with an IRD diagnosis to analyze the occurrence of laser and incisional surgeries. Subjects were categorized into 2 groups: central dysfunction (macular/cone/cone-rod dystrophy, “MCCRD group”) and panretinal or peripheral dysfunction (retinitis pigmentosa–like, “RP group”). Genetic testing status was recorded. The association of patient and disease factors on the frequency, distribution, and timing of surgeries was analyzed.

Main Outcome Measures

Prevalence, prevalence odds ratio (POR), hazard ratio (HR) of ophthalmic procedures by phenotype.

Results

A total of 1472 eyes of 736 subjects were evaluated. Among them, 31.3% (n = 230) had undergone ocular surgery, and 78.3% of those (n = 180/230) had a history of more than 1 surgery. A total of 602 surgical procedures were analyzed. Cataract extraction with intraocular lens implantation (CEIOL) was the most common (51.2%), followed by yttrium aluminum garnet capsulotomy, refractive surgery, retinal surgery, and others. Cataract extraction with intraocular lens implantation occurred more frequently in RP than in MCCRD subjects (POR, 2.59; P = 0.002). Retinitis pigmentosa subjects underwent CEIOL at a younger age than patients with MCCRD (HR, 2.11; P < 0.001).

Conclusions

Approximately one-third of patients with IRD had a history of laser or incisional surgery. Cataract extraction with intraocular lens implantation was the most common surgery; its frequency and timing may be associated with the IRD phenotype. This data may inform the design of prospective research. Such efforts may illuminate routine clinical decision-making and contribute to surgical strategy development for cell and gene therapy delivery.