Incidence of Sympathetic Ophthalmia after Inciting Events
Incidence of Sympathetic Ophthalmia after Inciting Events
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DOI：
10.1016/j.ophtha.2021.09.011
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发表时间：
2022-03-01
期刊：
影响因子：
13.7
通讯作者：
Kaburaki, Toshikatsu
中科院分区：
文献类型：
--
作者：
Hashimoto, Yohei;Matsui, Hiroki;Kaburaki, Toshikatsu
目的：分析诱发事件（眼外伤或参与者：2012年至2019年期间发生诱发事件的患者）后交感性眼炎（SO）的发生率。SO发作定义为SO诊断的第一天。研究方法：使用日本全国性行政索赔数据库，我们计算了按性别、10岁年龄组和主要或重复分类变量分层的激发事件后SO的累积发生率，使用Kaplan-Meier方法反映了过去一年中的激发事件史（无激发事件、无创伤的激发事件或有创伤的激发事件）。我们还通过考克斯回归估计了调整后的风险比（aHR）。然后，我们将人群限制为在观察期内仅发生1次激发事件的人群，以研究每个激发事件的纯效应。主要观察指标：60个月内SO的累积发生率。结果：共有888 041例激发事件（704 717例患者）符合条件。SO病例总数为263例，60个月内SO的累积发生率为0.044%。女性与SO的发生无关（aHR，1.01; 95%置信区间[CI]，0.79-1.29; P 1/4 0.95）。40 ~ 49岁年龄组的发生率最高，为0.104%（aHR vs. 80岁年龄组[0.041%]，2.44 [95%CI，1.56-3.80]; P < 0.001）。有创伤和无创伤的重复刺激事件显示SO的发生率（分别为0.469%和0.072%）高于原发刺激事件（0.036%）（aHR分别为11.68 [7.74-17.64]和2.21 [95%CI，1.59-3.07]; P分别< 0.001和P < 0.001）。玻璃体切除术后SO的发生率明显低于外伤后（0.016%比0.073%），巩膜扣带术后SO的发生率更低。结论：60个月内SO的累积发生率估计至少为0.044%。反复的刺激事件，特别是那些有创伤的，增加了SO发展的风险。外伤引起SO的可能性是玻璃体切除术的4 ~ 5倍。目前的研究结果将是有价值的咨询病人的风险SO后，创伤和前进行眼内手术。Ophthalmology 2022;129：344352（c）2021美国眼科学会
Purpose: To analyze the incidence of sympathetic ophthalmia (SO) after inciting events (eye trauma or Participants: Patients experiencing inciting events between 2012 and 2019. Onset of SO was defined as the first date of SO diagnosis. Methods: Using a nationwide administrative claims database in Japan, we calculated the cumulative incidence of SO after inciting events stratified by sex, 10-year age groups, and a categorical variable of primary or repeated, reflecting the history of inciting events in the past year (no inciting events, inciting events without trauma, or inciting events with trauma) using the Kaplan-Meier approach. We also estimated the adjusted hazard ratio (aHR) by Cox regression. We then restricted the population to those with only 1 inciting event during the observation period to investigate the pure effect of each inciting event. Main Outcome Measures: Cumulative incidence of SO over 60 months. Results: A total of 888 041 inciting events (704 717 patients) were eligible. The total number of SO cases was 263, and the cumulative incidence of SO was 0.044% over 60 months. Female sex was not associated with onset of SO (aHR, 1.01; 95% confidence interval [CI], 0.79-1.29; P 1/4 0.95). The group 40 to 49 years of age showed the highest incidence of 0.104% among the age groups (aHR vs. 80 years of age group [0.041%], 2.44 [95% CI, 1.56-3.80]; P < 0.001). Repeated inciting events with and without trauma showed higher incidences of SO (0.469% and 0.072%, respectively) than primary inciting events (0.036%) (aHR 11.68 [7.74-17.64] and 2.21 [95% CI, 1.59-3.07], respectively); P < 0.001 and P < 0.001, respectively). The incidence of SO after vitrectomy was much lower than after trauma (0.016% vs. 0.073%), and the incidence after scleral buckling was even lower. Conclusions: The cumulative incidence of SO over 60 months was estimated to be 0.044% at minimum. Repeated inciting events, especially those with trauma, increased the risk of SO developing. Trauma was 4 to 5 times as likely to induce SO than vitrectomy. The present findings will be valuable for counseling patients about the risks of SO after trauma and before performing intraocular surgeries. Ophthalmology 2022;129:344352 (c) 2021 by the American Academy of Ophthalmology