Myopia as a risk factor for subsequent retinal tears in the course of a symptomatic posterior vitreous detachment
Myopia as a risk factor for subsequent retinal tears in the course of a symptomatic posterior vitreous detachment
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DOI：
10.1186/s12886-017-0629-6
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发表时间：
2017-12-01
影响因子：
2
通讯作者：
Urrets-Zavalia, Julio A.
中科院分区：
文献类型：
--
作者：
Crim, Nicolas;Esposito, Evangelina;Urrets-Zavalia, Julio A.
背景资料：导致玻璃体后脱离（PVD）过程复杂化的视网膜撕裂可能是独特的或多发的，当多发时，它们可能同时或随后在PVD演变的不同时刻发生。我们的研究的目的是分析的患病率随后的视网膜撕裂（SRT）的患者与PVD，并确定可能的危险因素SRT.Methods：一百七十六眼在165个连续的患者，提出一个或多个视网膜撕裂的症状PVD的演变，最低随访12个月，进行了回顾性评价。主要结局指标是描述与SRT形成相关的临床特征，与非后续视网膜裂孔（初次检查时诊断的NSRT-视网膜裂孔）形成相关。为此，将该患者队列分为两个不同的组：第1组包括仅在初始检查时出现一个或多个视网膜裂孔（NSRT）的眼睛，第2组在随访期间进展为进一步的视网膜裂孔（SRT）的眼睛。第1组包括145例患者的154只眼，48.7%为男性，51.3%为女性，平均年龄为56.9 ± 14.0岁（范围= 15-89）; 17.2%的患者既往有对侧眼视网膜撕裂或视网膜脱离;每只眼视网膜撕裂的平均数量为1.42 ± 0.8（范围= 1-5）; 20.8%出现双侧视网膜裂孔; 59.1%为近视眼（p < 0.05）。第2组包括20例患者的22只眼;平均年龄为53.3 ± 13.6岁（范围= 30-69）; 63.6%为男性（p = 0.13），7例患者（31.8%）有SRT或对侧眼视网膜脱离病史（p = 0.13）。每只眼视网膜撕裂的平均数为1.36 +/- 0.5（范围= 1-2）; 18.2%的眼睛注意到双侧视网膜撕裂; 86.4%是近视眼（p = 0.01）; 81.8%发生在120天内，在第一次视网膜撕裂的诊断。SRT最常在近视患者中观察到，并且通常是有症状的。随访必须在初始症状后至少延长4个月。
Background: Retinal tears complicating the course of a posterior vitreous detachment (PVD) may be unique or multiple, and when multiple they may occur simultaneously or subsequently at different moments in the evolution of a PVD. The purpose of our study was to analyze the prevalence of subsequent retinal tears (SRT) in patients with a PVD, and to identify possible risk factors for SRT.Methods: One hundred and seventy six eyes in 165 consecutive patients that presented one or more retinal tears in the evolution of a symptomatic PVD, with a minimum follow-up of 12 months, were retrospectively evaluated. The primary outcome measure was to characterize the clinical features associated with SRT formation against those eyes with non-subsequent retinal tear (NSRT-retinal tear/s diagnosed at initial examination) formation. For that purpose, this cohort of patients was divided into two different groups: group 1 included eyes presenting one or multiple retinal tears only at initial examination (NSRT), and group 2 eyes that progressed to a further retinal tear/s (SRT) during follow-up.Results: Group 1 comprised 154 eyes from 145 patients, 48.7% males and 51.3% females with a mean age of 56.9 +/- 14.0 years (range = 15-89); 17.2% of patients had a previous retinal tear or retinal detachment in the fellow eye; mean number of retinal tears per eye 1.42 +/- 0.8 (range = 1-5); 20.8% presented bilateral retinal tears; 59.1% were myopic eyes (p < 0.05). Group 2 comprised 22 eyes from 20 patients; mean age was 53.3 +/- 13.6 years (range = 30-69); 63.6% were male (p = 0.13), and 7 patients (31.8%) had a history of SRT or retinal detachment in the fellow eye (p = 0.13). The mean number of retinal tears per eye was 1.36 +/- 0.5 (range = 1-2); bilateral retinal tears were noted in 18.2% of eyes; 86.4% were myopic eyes (p = 0.01); 81.8% occurred within a 120 days-period following diagnosis of the first retinal tear.Conclusions: Multiple retinal tears may be diagnosed in the evolution of a PVD. SRT are most frequently observed in myopic patients, and are usually symptomatic. Follow-up must extend for at least 4 months after the initial symptoms.