SURGICAL OUTCOME AND PROGNOSTIC FACTORS AFTER OPHTHALMIC SURGERY IN ABUSIVE HEAD TRAUMA.
SURGICAL OUTCOME AND PROGNOSTIC FACTORS AFTER OPHTHALMIC SURGERY IN ABUSIVE HEAD TRAUMA.
复制标题
头部虐待性外伤眼科手术后的手术结果和预后因素。
DOI：
10.1097/iae.0000000000003421
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Wu,Wei-Chi
中科院分区：
文献类型：
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作者：
Ho,Ming-Chih;Wu,An-Lun;Wang,Nan-Kai;Chen,Kuan-Jen;Hwang,Yih-Shiou;Lai,Chi-Chun;Wu,Wei-Chi
目的：分析虐待性头部创伤（AHT）患者的临床特征、手术结果和影响视力的危险因素。方法：回顾性分析2001年至2019年行玻璃体切除术的AHT患者的手术结果。我们回顾了患者的人口统计资料、术前和术后的综合眼科发现、手术治疗、视力结果和术后并发症。进行单变量和多变量分析以确定与视力结果相关的预后因素。结果：对14例（18眼）诊断为AHT的儿童行玻璃体切除术。最常见的手术指征是玻璃体出血（n= 6.33%）。在最后一次就诊时，有17只眼睛（94%）出现视网膜附着。玻璃体切除术后最佳矫正视力小于20/200者13眼（72%）。在多变量分析中，视神经萎缩（n= 9,50%）与AHT患儿玻璃体切除术后视力预后差（最终最佳矫正视力低于20/200）显著相关（95%可信区间，1.041-517.963，P= 0.0471）。结论：行玻璃体切除术的AHT患者视网膜附着率较高，但总体视力预后较差。视神经萎缩是AHT患者接受眼科手术后视力不佳的预后因素。
Purpose:To analyze the clinical characteristics, surgical outcomes, and risk factors associated with visual outcomes in patients with abusive head trauma (AHT).Methods:We retrospectively reviewed surgical outcomes of patients with AHT who underwent vitrectomy from 2001 to 2019. The patients' demographics, comprehensive preoperative and postoperative ocular findings, surgical treatments, visual outcomes, and postoperative complications in the medical records were reviewed. Univariable and multivariable analyses were performed to identify the prognostic factors associated with visual outcomes.Results:Fourteen children (18 eyes) diagnosed with AHT who underwent vitrectomy were evaluated. The most common surgical indication was vitreous hemorrhage (n= 6, 33%). Retinal attachment at the final visit was noted in 17 eyes (94%). Thirteen eyes (72%) had a best-corrected visual acuity less than 20/200 after vitrectomy. In the multivariable analysis, optic nerve atrophy (n= 9, 50%) was significantly associated with a poor visual prognosis (final best-corrected visual acuity worse than 20/200) after vitrectomy in children with AHT (95% confidence interval, 1.041–517.963, P= 0.0471).Conclusion:The general visual prognosis was poor for patients with AHT needing vitrectomy, although a high rate of retinal attachment was observed. Optic nerve atrophy is a prognostic factor for poor visual outcomes in patients with AHT who received ophthalmic surgery.