Abstract：
OBJECTIVE: To describe clinical characteristics and management in a large cohort of patients with retinal detachment due to a giant retinal tear (GRT).
METHODS: We performed a retrospective cohort study with 222 eyes of 206 patients with a primary and non-traumatic GRTs between 2005 and 2022. We analysed the relevant clinical and surgical data from these patients.
RESULTS: Eighty-six per cent (n = 177) of patients were male. We observed no relation between refractive error and GRT size (Spearman\'s rho: r = -0.018, p = 0.83). We achieved a primary and final treatment success in 77%, respectively 92%, of eyes. The final visual outcome was 20/40 or better in 65% and 36% of eyes in fovea-on and fovea-off GRTs respectively. Thirty-five per cent (n = 73) of patients developed a retinal detachment in the fellow eye. The median time until a retinal detachment in the fellow eye occurred after GRT was 20 months, and 10% developed within 1 month. A prediction model for the development of retinal detachment in the fellow eye resulted in a receiver operating characteristics curve with an area under the curve of 0.68 (95% CI: 0.57-0.78, p = 0.001).
CONCLUSIONS: We observed a highly significant gender imbalance in patients with a non-traumatic GRT. One third of patients developed a retinal detachment bilaterally. Ten per cent of fellow eye\'s retinal detachment that develop after GRT, occur within 1 month. Clinical parameters showed limited predictive value for a retinal detachment in the fellow eye. These findings suggest an underlying genetic factor.
METHODS: We performed a retrospective cohort study with 222 eyes of 206 patients with a primary and non-traumatic GRTs between 2005 and 2022. We analysed the relevant clinical and surgical data from these patients.
RESULTS: Eighty-six per cent (n = 177) of patients were male. We observed no relation between refractive error and GRT size (Spearman\'s rho: r = -0.018, p = 0.83). We achieved a primary and final treatment success in 77%, respectively 92%, of eyes. The final visual outcome was 20/40 or better in 65% and 36% of eyes in fovea-on and fovea-off GRTs respectively. Thirty-five per cent (n = 73) of patients developed a retinal detachment in the fellow eye. The median time until a retinal detachment in the fellow eye occurred after GRT was 20 months, and 10% developed within 1 month. A prediction model for the development of retinal detachment in the fellow eye resulted in a receiver operating characteristics curve with an area under the curve of 0.68 (95% CI: 0.57-0.78, p = 0.001).
CONCLUSIONS: We observed a highly significant gender imbalance in patients with a non-traumatic GRT. One third of patients developed a retinal detachment bilaterally. Ten per cent of fellow eye\'s retinal detachment that develop after GRT, occur within 1 month. Clinical parameters showed limited predictive value for a retinal detachment in the fellow eye. These findings suggest an underlying genetic factor.
摘要：
目的：描述由巨大视网膜撕裂（GRT）引起的大量视网膜脱离患者的临床特征和治疗方法。
方法：我们在2005年至2022年间对206例原发性和非创伤性GRT患者的222只眼进行了回顾性队列研究。我们分析了这些患者的相关临床和手术数据。
结果：86％（n=177）的患者为男性。我们观察到屈光不正与GRT大小之间没有关系(Spearman’srho:r=-0.018,p=0.83)。我们取得了77%的初步和最终治疗成功率，分别为92%，的眼睛。在中央凹和中央凹GRT中，最终的视觉结果分别为65％和36％的眼睛为20/40或更好。35％（n=73）的患者发生了视网膜脱离。GRT后直到对侧眼发生视网膜脱离的中位时间为20个月，10%在1个月内发展。对侧眼视网膜脱离发展的预测模型导致受试者工作特征曲线，曲线下面积为0.68（95％CI：0.57-0.78，p=0.001）。
结论：我们观察到非创伤性GRT患者存在显著的性别失衡。三分之一的患者双侧出现视网膜脱离。GRT后发生的眼睛视网膜脱离的百分之十，发生在1个月内。临床参数显示对眼视网膜脱离的预测价值有限。这些发现表明了潜在的遗传因素。
方法：我们在2005年至2022年间对206例原发性和非创伤性GRT患者的222只眼进行了回顾性队列研究。我们分析了这些患者的相关临床和手术数据。
结果：86％（n=177）的患者为男性。我们观察到屈光不正与GRT大小之间没有关系(Spearman’srho:r=-0.018,p=0.83)。我们取得了77%的初步和最终治疗成功率，分别为92%，的眼睛。在中央凹和中央凹GRT中，最终的视觉结果分别为65％和36％的眼睛为20/40或更好。35％（n=73）的患者发生了视网膜脱离。GRT后直到对侧眼发生视网膜脱离的中位时间为20个月，10%在1个月内发展。对侧眼视网膜脱离发展的预测模型导致受试者工作特征曲线，曲线下面积为0.68（95％CI：0.57-0.78，p=0.001）。
结论：我们观察到非创伤性GRT患者存在显著的性别失衡。三分之一的患者双侧出现视网膜脱离。GRT后发生的眼睛视网膜脱离的百分之十，发生在1个月内。临床参数显示对眼视网膜脱离的预测价值有限。这些发现表明了潜在的遗传因素。
