Ahmed M Alshaikhsalama,Amer F Alsoudi,Ali Mukhtar,Karen Wai,Euna Koo,Andrea Kossler,Chase Ludwig,Prithvi Mruthyunjaya,Ehsan Rahimy
{"title":"长期使用大麻和术后增殖性玻璃体视网膜病变的风险。","authors":"Ahmed M Alshaikhsalama,Amer F Alsoudi,Ali Mukhtar,Karen Wai,Euna Koo,Andrea Kossler,Chase Ludwig,Prithvi Mruthyunjaya,Ehsan Rahimy","doi":"10.1001/jamaophthalmol.2025.1851","DOIUrl":null,"url":null,"abstract":"Importance\r\nProliferative vitreoretinopathy (PVR) is a major cause of retinal detachment (RD) repair failure, resulting in poor visual outcomes. Cannabis use continues to increase globally and may affect PVR development through its anti-inflammatory and neuroprotective properties, although this association remains unclear.\r\n\r\nObjective\r\nTo assess the risk of developing PVR among patients with concomitant cannabis use who underwent primary RD repair.\r\n\r\nDesign, Setting, and Participants\r\nThis retrospective cohort study examined data from electronic health records for a multicenter research network extracted for the period February 1, 2005, to February 1, 2025. Participants were patients who underwent initial RD repair with pars plana vitrectomy (PPV) with or without scleral buckle (SB), primary SB, or pneumatic retinopexy. The records were used to identify patients diagnosed with concomitant cannabis-related disorder together with confirmatory testing of cannabis in urine or blood compared with a control group without documented use. Exclusion criteria were a history proliferative diabetic retinopathy or less than 6 months of follow-up.\r\n\r\nExposures\r\nPrimary RD repair and cannabis-related disorder.\r\n\r\nMain Outcome Measures\r\nRelative risk (RR) of developing PVR and requiring a subsequent complex RD repair at 6 months and 1 year of follow-up.\r\n\r\nResults\r\nAfter propensity score matching, each cohort had 1193 patients. The mean (SD) age was 53.2 (16.1) years; 1662 were male (69.7%), 641 were female (26.9%), and for 83 patients (3.5%), the sex was unknown. At 6 months, patients with concomitant cannabis use with RD repaired by any method had a reduced risk of developing subsequent PVR (25 events [2.10%] vs 52 events [4.36%]; RR, 0.48; 95% CI, 0.30-0.77; P = .002) and requiring complex RD repair (37 [3.10%] vs 60 [5.03%]; RR, 0.62; 95% CI, 0.41-0.92; P = .02) when compared with controls. Similar results were observed at 1 year for both outcomes.\r\n\r\nConclusions and Relevance\r\nPatients who underwent initial repair for RD with concomitant cannabis use were less likely to develop PVR and require subsequent complex RD repair compared with matched patients without documented cannabis exposure; however, the absolute difference in rates was small. While this protective association noted with cannabis use could be due to the population using it rather than an effect of the cannabis itself, the findings suggest that cannabis use might have a role in reducing PVR development. Intervention trials would be needed to try to control for confounding factors.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"10 1","pages":""},"PeriodicalIF":7.8000,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Long-Term Cannabis Use and Risk of Postoperative Proliferative Vitreoretinopathy.\",\"authors\":\"Ahmed M Alshaikhsalama,Amer F Alsoudi,Ali Mukhtar,Karen Wai,Euna Koo,Andrea Kossler,Chase Ludwig,Prithvi Mruthyunjaya,Ehsan Rahimy\",\"doi\":\"10.1001/jamaophthalmol.2025.1851\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Importance\\r\\nProliferative vitreoretinopathy (PVR) is a major cause of retinal detachment (RD) repair failure, resulting in poor visual outcomes. Cannabis use continues to increase globally and may affect PVR development through its anti-inflammatory and neuroprotective properties, although this association remains unclear.\\r\\n\\r\\nObjective\\r\\nTo assess the risk of developing PVR among patients with concomitant cannabis use who underwent primary RD repair.\\r\\n\\r\\nDesign, Setting, and Participants\\r\\nThis retrospective cohort study examined data from electronic health records for a multicenter research network extracted for the period February 1, 2005, to February 1, 2025. Participants were patients who underwent initial RD repair with pars plana vitrectomy (PPV) with or without scleral buckle (SB), primary SB, or pneumatic retinopexy. The records were used to identify patients diagnosed with concomitant cannabis-related disorder together with confirmatory testing of cannabis in urine or blood compared with a control group without documented use. Exclusion criteria were a history proliferative diabetic retinopathy or less than 6 months of follow-up.\\r\\n\\r\\nExposures\\r\\nPrimary RD repair and cannabis-related disorder.\\r\\n\\r\\nMain Outcome Measures\\r\\nRelative risk (RR) of developing PVR and requiring a subsequent complex RD repair at 6 months and 1 year of follow-up.\\r\\n\\r\\nResults\\r\\nAfter propensity score matching, each cohort had 1193 patients. The mean (SD) age was 53.2 (16.1) years; 1662 were male (69.7%), 641 were female (26.9%), and for 83 patients (3.5%), the sex was unknown. At 6 months, patients with concomitant cannabis use with RD repaired by any method had a reduced risk of developing subsequent PVR (25 events [2.10%] vs 52 events [4.36%]; RR, 0.48; 95% CI, 0.30-0.77; P = .002) and requiring complex RD repair (37 [3.10%] vs 60 [5.03%]; RR, 0.62; 95% CI, 0.41-0.92; P = .02) when compared with controls. Similar results were observed at 1 year for both outcomes.\\r\\n\\r\\nConclusions and Relevance\\r\\nPatients who underwent initial repair for RD with concomitant cannabis use were less likely to develop PVR and require subsequent complex RD repair compared with matched patients without documented cannabis exposure; however, the absolute difference in rates was small. While this protective association noted with cannabis use could be due to the population using it rather than an effect of the cannabis itself, the findings suggest that cannabis use might have a role in reducing PVR development. 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Long-Term Cannabis Use and Risk of Postoperative Proliferative Vitreoretinopathy.
Importance
Proliferative vitreoretinopathy (PVR) is a major cause of retinal detachment (RD) repair failure, resulting in poor visual outcomes. Cannabis use continues to increase globally and may affect PVR development through its anti-inflammatory and neuroprotective properties, although this association remains unclear.
Objective
To assess the risk of developing PVR among patients with concomitant cannabis use who underwent primary RD repair.
Design, Setting, and Participants
This retrospective cohort study examined data from electronic health records for a multicenter research network extracted for the period February 1, 2005, to February 1, 2025. Participants were patients who underwent initial RD repair with pars plana vitrectomy (PPV) with or without scleral buckle (SB), primary SB, or pneumatic retinopexy. The records were used to identify patients diagnosed with concomitant cannabis-related disorder together with confirmatory testing of cannabis in urine or blood compared with a control group without documented use. Exclusion criteria were a history proliferative diabetic retinopathy or less than 6 months of follow-up.
Exposures
Primary RD repair and cannabis-related disorder.
Main Outcome Measures
Relative risk (RR) of developing PVR and requiring a subsequent complex RD repair at 6 months and 1 year of follow-up.
Results
After propensity score matching, each cohort had 1193 patients. The mean (SD) age was 53.2 (16.1) years; 1662 were male (69.7%), 641 were female (26.9%), and for 83 patients (3.5%), the sex was unknown. At 6 months, patients with concomitant cannabis use with RD repaired by any method had a reduced risk of developing subsequent PVR (25 events [2.10%] vs 52 events [4.36%]; RR, 0.48; 95% CI, 0.30-0.77; P = .002) and requiring complex RD repair (37 [3.10%] vs 60 [5.03%]; RR, 0.62; 95% CI, 0.41-0.92; P = .02) when compared with controls. Similar results were observed at 1 year for both outcomes.
Conclusions and Relevance
Patients who underwent initial repair for RD with concomitant cannabis use were less likely to develop PVR and require subsequent complex RD repair compared with matched patients without documented cannabis exposure; however, the absolute difference in rates was small. While this protective association noted with cannabis use could be due to the population using it rather than an effect of the cannabis itself, the findings suggest that cannabis use might have a role in reducing PVR development. Intervention trials would be needed to try to control for confounding factors.
期刊介绍:
JAMA Ophthalmology, with a rich history of continuous publication since 1869, stands as a distinguished international, peer-reviewed journal dedicated to ophthalmology and visual science. In 2019, the journal proudly commemorated 150 years of uninterrupted service to the field. As a member of the esteemed JAMA Network, a consortium renowned for its peer-reviewed general medical and specialty publications, JAMA Ophthalmology upholds the highest standards of excellence in disseminating cutting-edge research and insights. Join us in celebrating our legacy and advancing the frontiers of ophthalmology and visual science.