利用真实世界的数据评估视网膜脱离与局部使用匹罗卡品的关联性。

IF 4.1 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology Pub Date : 2024-11-06 DOI:10.1016/j.ajo.2024.10.035

ABDELRAHMAN M. ELHUSSEINY , MUHAMMAD Z. CHAUHAN , SAYENA JABBEHDARI , NAYEF ALSHAMMARI , SARAH JONG , PAUL H. PHILLIPS , AHMED B. SALLAM

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引用次数: 0

摘要

目的：研究局部皮洛卡品与新发流变性视网膜脱离（RRD）风险之间的关系：设计：回顾性临床队列研究：我们利用电子健康记录研究网络 TriNetX 对开始使用皮洛卡品后发生 RRD（ICD-10：H33.0x）的风险进行了研究。主要研究组包括首次接受局部皮洛卡品（1.25% 或任何剂量，其他适应症除外）治疗的 40 岁以上成年患者。我们的对照组包括开始使用人工泪液的老花眼患者，他们在研究期间没有局部使用皮洛卡品的历史。我们根据人口统计学、全身合并症和已知的 RRD 危险因素，采用倾向得分匹配法（PSM）对两组患者进行了匹配：匹配后，皮洛卡品组三个月的 RRD 风险（0.53%）明显高于对照组（0.25%）（RR：2.18，95% CI：1.07-4.45，P=0.03）。研究组 6 个月的 RRD 风险仍然较高，为 0.60%，而对照组为 0.31%（RR：1.93，95% CI：1.01-3.67，P=0.04）。一年后，皮洛卡品组的风险增至 0.78%，对照组为 0.33%（RR：2.33，95% CI：1.28-4.27，P=0.005）。Cox比例危险模型显示，使用皮洛卡平与RRD风险增加3.14倍相关（95% CI：1.66-5.93，P=0.005）：我们的研究量化了与局部使用皮洛卡品相关的 RRD 风险增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Using Real-World Data to Assess the Association of Retinal Detachment With Topical Pilocarpine Use

Purpose

To examine the association between topical pilocarpine and the risk of new-onset rhegmatogenous retinal detachment (RRD).

Design

Retrospective clinical cohort study.

Methods

We used an aggregated electronic health records research network, TriNetX, to examine the risk of RRD (ICD-10: H33.0x) following the initiation of pilocarpine. The primary study group included adult patients over 40 years who received topical pilocarpine (1.25% or any dose with the exclusion of other indications) for the first time. Our control group consisted of patients with presbyopia who were started on artificial tears and had no history of topical pilocarpine use during the study period. We matched both cohorts using propensity score matching (PSM) based on demographics, systemic comorbidities, and known risk factors for RRD.

Results

After matching, the three-month risk of RRD was significantly higher in the pilocarpine group (0.53%) compared to the control (0.25%) (RR: 2.18, 95% CI: 1.07-4.45, P = .03). The 6-month risk of RRD remained elevated at 0.60% in the study group versus 0.31% in the control group (RR: 1.93, 95% CI: 1.01-3.67, P = .04). At one year, the risk increased to 0.78% in the pilocarpine group and 0.33% in the control group (RR: 2.33, 95% CI: 1.28-4.27, P = .005). A Cox proportional hazards model indicated that pilocarpine use was associated with a 3.14-fold increased risk of RRD (95% CI: 1.66-5.93, P < .001) compared to controls after adjusting for demographics and comorbidities. Additional risk factors for RRD included male sex (aHR: 2.36, P = .001), myopia (aHR: 2.36, P = .001), vitreous degeneration (aHR: 2.22, P = .020), lattice degeneration (aHR: 3.71, P = .010), and pseudophakia (aHR: 3.48, P < .001).

Conclusions

Our study quantified the increased risk of RRD associated with topical pilocarpine use.

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来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.