双侧视网膜脱离的成年患者第二只眼发生增殖性玻璃体视网膜病变的风险。

IF 4.4 Q1 OPHTHALMOLOGY

Ophthalmology. Retina Pub Date : 2024-12-01 DOI:10.1016/j.oret.2024.06.007

E. Anne Shepherd MD , Samuel A. Minaker MD, MSc , Prithvi R. Bomdica MD, MBA , Sam Rezaei BA , Nick Boucher BS , Nitika Aggarwal BT , Mathew W. MacCumber MD, PhD

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引用次数: 0

摘要

目的：研究曾发生并发增殖性玻璃体视网膜脱离（RRD）的患者，其同侧眼发生流变性视网膜脱离（RRD）的发生率和风险因素：多中心、回顾性观察研究：方法：评估PVR发生的风险因素，特别是同侧眼有记录的PVR、性别、年龄、晶状体状态、现视力和最终视力：主要结果测量：术后 6 个月内发生 PVR 的几率：在 57,264 名患者中，11% 的患者至少有一只眼睛出现 PVR。在首次 RRD 后未出现 PVR 的 50989 名患者中，有 4834 名患者的同侧眼出现了 RRD。其中 166 名患者的第二只眼出现了 PVR，同侧眼的 PVR 发生率为 3%。在 6275 名接受初级 RRD 修复术后出现 PVR 的患者中，有 406 名患者的同侧眼继续出现 RRD。其中 42 名患者的第二只眼发生了 PVR，PVR 率为 10%。回归模型还包括年龄、性别和视力，得出的几率比为 3.42（P结论：与没有 PVR 病史的患者相比，有 RRD 病史且一只眼有 PVR 的患者在 RRD 后第二只眼发生 PVR 的几率要高出约 3.5 倍。如果患者的第二只眼有 RRD，这一发现可能会影响手术决策和预防性抗 PVR 治疗的使用。有 PVR 病史的患者第二只眼的最终视力要好于没有 PVR 病史的患者，这可能表明外科医生已经在采取措施预防患者第二只眼的 PVR。

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Risk of Proliferative Vitreoretinopathy in the Second Eye in Adult Patients with Bilateral Retinal Detachment

Purpose

To examine the incidence and risk factors of proliferative vitreoretinopathy (PVR) in the patients who develop rhegmatogenous retinal detachment (RRD) in their fellow eye after having a prior RRD complicated by PVR.

Design

Multicenter, retrospective observational study.

Subjects

Eyes with retinal detachment and PVR between 2015 and 2023 were identified through the Vestrum Health Database.

Methods

Risk factors for PVR development, specifically documented PVR in the fellow eye, gender, age, lens status, and presenting and final visual acuity (VA), were evaluated.

Main Outcome Measures

Odds ratio (OR) for PVR development during 6 months postoperative period.

Results

Of 57 264 patients, 11% had PVR in ≥1 eye. Of the 50 989 patients who did not develop PVR after the initial RRD, 4834 developed RRD in the fellow eye. One hundred sixty-six of these patients developed PVR in their second eye for a PVR rate of 3% in the fellow eye. Of the 6275 patients who developed PVR after primary RRD repair, 406 of these patients went on to develop RRD in their fellow eye. Forty-two of these patients developed PVR in their second eye for a PVR rate of 10%. A regression model that also included age, gender, and VA led to an OR of 3.42 (P < 0.001). The OR of PVR development generally decreased with age. Pseudophakic patients had a higher OR for PVR development, 1.48 (P = 0.017). Initial patients with VA 20/40 to 20/80 had an OR of 2.15 (P = 0.003). Patients with VA worse than 20/200 had an OR of 2.89 for PVR development (P < 0.001).

Conclusions

Patients with a history RRD with PVR in 1 eye have approximately 3.5 times higher rate of PVR in their second eye after RRD compared with patients without a history of PVR. This finding potential impacts surgical decisions and use of prophylactic anti-PVR therapy if the patient’s second eye has RRD. The final VA in the second eye of patients with a history of PVR is better than for the second eye of patients with no history of PVR, which may indicate surgeons are already taking steps to prevent PVR in the patient’s second eye.