[1]袁祖旭,李素华,张妍,等.近视患者视网膜脱离的危险因素及风险预测模型[J].眼科新进展,2024,44(7):554-557.[doi:10.13389/j.cnki.rao.2024.0107]
 YUAN Zuxu,LI Suhua,ZHANG Yan,et al.Risk factors and risk prediction model of retinal detachment in myopic patients[J].Recent Advances in Ophthalmology,2024,44(7):554-557.[doi:10.13389/j.cnki.rao.2024.0107]
点击复制

近视患者视网膜脱离的危险因素及风险预测模型/HTML
分享到:

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
44卷
期数:
2024年7期
页码:
554-557
栏目:
应用研究
出版日期:
2024-07-01

文章信息/Info

Title:
Risk factors and risk prediction model of retinal detachment in myopic patients
作者:
袁祖旭李素华张妍刘爱新贺广秀
473000 河南省南阳市,南阳市中心医院眼科(袁祖旭,李素华,张妍,贺广秀);473000 河南省南阳市,南阳尖峰眼科医院(刘爱新)
Author(s):
YUAN Zuxu1LI Suhua1ZHANG Yan1LIU Aixin2HE Guangxiu1
1.Department of Ophthalmology,Nanyang Central Hospital,Nanyang 473000,Henan Province,China
2.Nanyang Apex Eye Hospital,Nanyang 473000,Henan Province,China
关键词:
视网膜脱离近视危险因素风险预测模型
Keywords:
retinal detachment myopia risk factors risk prediction model
分类号:
R774
DOI:
10.13389/j.cnki.rao.2024.0107
文献标志码:
A
摘要:
目的 探讨近视患者视网膜脱离的危险因素及风险预测模型。
方法 回顾性分析2021年1月至2023年12月于我院就诊的近视患者的临床资料,选择符合条件的近视性视网膜脱离患者128例(128眼)作为视网膜脱离组,没有视网膜脱离的近视患者128例(128眼)作为对照组。收集两组患者的临床资料,包括年龄、性别、屈光度、文化程度、病侧、是否负重、有无震动、有无白内障、是否存在视疲劳、血压、糖尿病史、眼外伤史、眼科手术史、视网膜厚度等。采用多因素Logistic回归分析确定近视性视网膜脱离的危险因素,并据以建立多因素联合应用的风险预测模型,应用受试者工作特征曲线(ROC)进行预测评估价值分析。
结果 视网膜脱离组患者的年龄、屈光度、收缩压、白内障发生率、视疲劳发生率、眼外伤发生率以及眼科手术史率均显著高于对照组 (均为P<0.05);视网膜脱离组患者的视网膜厚度与脉络膜厚度均显著低于对照组 (均为P<0.05)。近视患者发生视网膜脱离的危险因素为年龄(较大),屈光度(绝对值较大),伴有白内障或视疲劳或眼外伤等眼部疾患或不适状况,脉络膜厚度(较小),视网膜厚度(较小)(均为OR>1,P<0.05) 。年龄、眼部疾患或不适、屈光度、脉络膜厚度、视网膜厚度等5项指标单独及联合应用时ROC曲线下面积(AUC)(0.95CI)分别为0.668(0.382~0.936)、0.645、0.676(0.407~0.942)、0.731(0.503~0.933)、0.745(0.499~0.983)、0.844(0.692~0.983),联合应用预测评估效能更高,AUC(0.844)及灵敏度、特异度、准确度均较单独应用指标有明显提升。
结论 近视患者发生视网膜脱离的危险因素为较大的年龄,较大的屈光度(绝对值),伴有包括白内障、视疲劳、眼外伤在内的眼部疾患或不适,较小的脉络膜厚度、较小的视网膜厚度。由这些因素构建的风险预测模型评估效能较高。
Abstract:
Objective To investigate the risk factors and risk prediction model of retinal detachment in patients with myopia.
Methods The clinical data of myopic patients treated in our hospital from January 2021 to December 2023 were retrospectively analyzed. A total of 128 patients (128 eyes) with myopic retinal detachment who met the requirements were selected as the retinal detachment group, and 128 myopic patients (128 eyes) without retinal detachment were selected as the control group. The clinical data of patients in the two groups were collected and compared, including age, gender, diopter, education level, affected side, whether to bear load or not, whether to vibrate or not, whether to have cataract or not, whether to have asthenopia or not, blood pressure, history of diabetes, history of ocular trauma, history of ophthalmic surgery, and retinal thickness. Risk factors related to retinal detachment in myopia were determined through the multivariate logistic regression analysis, and based on these factors, the risk prediction model was established. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of the model.
Results The age, diopter, systolic blood pressure, cataract incidence, asthenopia incidence, ocular trauma and ophthalmic surgery rates of myopic patients in the retinal detachment group were significantly higher than those in the control group (all P<0.05). The retinal thickness and choroidal thickness of myopic patients in the retinal detachment group were significantly smaller than those in the control group (both P<0.05). The risk factors for retinal detachment in myopic patients were older age, higher diopter (absolute value), accompanied by ocular diseases or discomfort such as cataract, asthenopia and ocular trauma, thinner choroid, and thinner retina (all OR>1, P<0.05). The areas under the ROC curve (0.95CI) for predication of retinal detachment based on age, ocular disease or discomfort, diopter, choroidal thickness, and retinal thickness alone and their combination were 0.668 (0.382-0.936), 0.645, 0.676 (0.407-0.942), 0.731 (0.503-0.933), 0.745 (0.499-0.983), and 0.844 (0.692-0.983), respectively. The area under the curve (0.844), sensitivity, specificity, and accuracy of the prediction model based on the combination of the five indicators were higher, indicating that this model had a better prediction effect.
Conclusion The risk factors for retinal detachment in myopic patients are older age, higher diopter (absolute value), accompanied by ocular diseases or discomfort such as cataract, asthenopia and ocular trauma, thinner choroid, and thinner retina. The risk prediction model constructed based on these factors has a high evaluation effect.

参考文献/References:

[1] SAMUEL N E,KRISHNAGOPAL S.Foveal and macular thickness evaluation by spectral OCT SLO and its relation with axial length in various degree of myopia[J].J Clin Diagn Res,2015,9(3):NC01-NC04.
[2] BAHIT M C,LOPES R D,WOJDYLA D M,HELD C,HANNA M,VINEREANU D,et al.Non-major bleeding with apixaban versus warfarin in patients with atrial fibrillation[J].Heart,2017,103(8):623-628.
[3] 何建忠,潘铭东,郑永征,陈颖芳.高度近视非黄斑裂孔的后极部孔源性视网膜脱离临床分析[J].包头医学院学报,2023,39(1):46-50.
HE J Z,PAN M D,ZHENG Y Z,CHEN Y F.Clinical analysis of posterior pole rhegmatogenous retinal detachment with non macular hole in high myopia[J].J Baotou Med Coll,2023,39(1):46-50.
[4] FANG Y,YOKOI T,SHIMADA N,DU R,SHINOHARA K,TAKAHASHI H,et al.Development of macular atrophy after pars Plana vitrectomy for myopic traction maculopathy and macular hole retinal detachment in pathologic myopia[J].Retina,2020,40(10):1881-1893.
[5] CAPOROSSI T,ANGELIS L D,PACINI B,TARTARO R,FINOCCHIO L,BARCA F,et al.A human Amniotic Membrane plug to manage high myopic macular hole associated with retinal detachment[J].Acta Ophthalmol,2020,98(2):e252-e256.
[6] 李凤鸣.中华眼科学[M].2版.北京:人民卫生出版社,2005.
LI F M.Chinese ophthalmology[M].2nd ed.Beijing:People’s Medical Publishing House,2005.
[7] HAN X,ONG J S,AN J,CRAIG J E,GHARAHKHANI P,HEWITT A W,et al.Association of myopia and intraocular pressure with retinal detachment in European descent participants of the UK biobank cohort:a Mendelian randomization study[J].JAMA Ophthalmol,2020,138(6):671-678.
[8] 赵佳玮,王相宁,吴强.高度近视伴发孔源性视网膜脱离患者手术治疗后早期眼压升高的临床分析[J].眼科新进展,2020,40(7):667-669.
ZHAO J W,WANG X N,WU Q.Analysis of causes of early high intraocular pressure after surgical treatment of rhegmatogenous retinal detachment with high myopia[J].Rec Adv Ophthalmol,2020,40(7):667-669.
[9] XIN W,CAI X,XIAO Y,JI L,GU Y,LV W,et al.Surgical treatment for type II macular hole retinal detachment in pathologic myopia[J].Medicine,2020,99(17):e19531.
[10] 曾爱萍,刘欣,纪蒙蒙,杜雅丽,金灵.内界膜反转填塞治疗高度近视黄斑孔严重视网膜脱离[J].中华眼外伤职业眼病杂志,2022,8(10):721-727.
ZENG A P,LIU X,JI M M,DU Y L,JIN L.Inverted internal limiting membrane filling for severe retinal detachment secondary to macular hole in high myopia[J].Chin J Ocul Trauma Occup Eye Dis,2022,8(10):721-727.
[11] VAN LEEUWEN R,HAARMAN A E G,VAN DE PUT M A J,KLAVER C C W,LOS L I.Association of rhegmatogenous retinal detachment incidence with myopia prevalence in the Netherlands[J].JAMA Ophthalmol,2021,139(1):85-92.
[12] 赵反宁,陈美玲.VCLE联合IOL植入术治疗高度近视孔源性视网膜脱离的疗效与安全性研究[J].海南医学,2022,33(17):2229-2232.
ZHAO F N,CHEN M L.Efficacy and safety of vitrectomy combined with lensectomy plus intraocular lens implantation in the treatment of rhegmatogenous retinal detachment in high myopia[J].Hainan Med J,2022,33(17):2229-2232.
[13] GERSTENBERGER E,STOFFELNS B,NICKELS S,MNZEL T,WILD P S,BEUTEL M E,et al.Incidence of retinal detachment in Germany:results from the Gutenberg health study[J].Ophthalmologica,2021,244(2):133-140.
[14] 刘桂阳,田蕊,张璐,田敏.玻璃体切割联合内界膜剥离术治疗高度近视黄斑裂孔性视网膜脱离[J].眼科新进展,2021,41(7):655-659.
LIU G Y,TIAN R,ZHANG L,TIAN M.Vitrectomy combined with internal limiting membrane peeling in the treatment of macular hole retinal detachment in high myopic eyes[J].Rec Adv Ophthalmol,2021,41(7):655-659.
[15] LAKAWICZ J M,BOTTEGA W J,FINE H F,PRENNER J L.On the mechanics of myopia and its influence on retinal detachment[J].Biomech Model Mechanobiol,2020,19(2):603-620.

相似文献/References:

[1]张楚 邹玉平 邹秀兰 徐哲 王泳.内窥镜引导玻璃体视网膜手术治疗伴有角膜混浊的外伤性视网膜脱离[J].眼科新进展,2012,32(6):000.
[2]计垣.近视的分子遗传学研究进展[J].眼科新进展,2012,32(6):000.
[3]刘刚 马英慧 贾万程.玻璃体切割术联合视网膜光凝或内界膜剥除术治疗黄斑裂孔性视网膜脱离的疗效分析[J].眼科新进展,2012,32(7):000.
[4]张卫霞 曾照年 唐秀侠 孙宏霞 李洪润.Zywave波前像差仪在近视屈光不正测量中的应用[J].眼科新进展,2012,32(7):000.
[5]张冬花 杨仁林 杨芳文.显微外路手术与传统外路手术治疗视网膜脱离的临床疗效比较[J].眼科新进展,2012,32(11):000.
[6]闵红波 刘小红 花雷 韩文龙 储明慧 邵娟英.近视对OCT测量视网膜神经纤维层厚度的影响[J].眼科新进展,2012,32(12):000.
[7]刘太祥 李海祥 石容 王铮.ORK程序中两种切削模式治疗近视术后角膜像差变化及对视觉功能的影响[J].眼科新进展,2013,33(1):000.
[8]张楠 孙晓萍 高延庆 孙新霞.23G TVS与25G TVS治疗复杂性孔源性视网膜脱离的临床疗效观察[J].眼科新进展,2013,33(1):000.
[9]陈月芹 黄振平 薛春燕 葛轶睿.有晶状体眼虹膜固定型人工晶状体植入术后房角宽度的改变[J].眼科新进展,2013,33(6):000.
[10]王凌飞 杨瑞波 赵少贞.CACHET有晶状体眼人工晶状体植入术后视觉质量的临床评价[J].眼科新进展,2013,33(6):000.
[11]陈松,田歌,何广辉.高度近视黄斑裂孔性视网膜脱离的玻璃体视网膜手术治疗进展[J].眼科新进展,2020,40(10):994.[doi:10.13389/j.cnki.rao.2020.0223]
 CHEN Song,TIAN Ge,HE Guanghui.Development of vitreoretinal surgery for macular hole retinal detachment in high myopic eyes[J].Recent Advances in Ophthalmology,2020,40(7):994.[doi:10.13389/j.cnki.rao.2020.0223]

备注/Memo

备注/Memo:
河南省科技厅科技攻关项目(编号:212102310661)
更新日期/Last Update: 2024-07-05