PDF(Pubmed)
Abstract：
OBJECTIVE: This study sought to compare the long-term outcomes of surgeries for retinal detachment (RD) secondary to viral or parasitic infectious retinitis.
METHODS: A total of 47 eyes that received pars plana vitrectomy with or without scleral buckling due to RD secondary to polymerase chain reaction-proven viral (cytomegalovirus, varicella zoster virus, and herpes zoster virus) or parasitic (toxoplasma and toxocara) retinitis from October 1, 2006, to June 30, 2023, in a single medical center were retrospectively enrolled.
RESULTS: Mean follow-up period was 59.03 ± 55.24 months in viral retinitis and 34.80 ± 33.78 months in parasitic retinitis after primary reattachment surgery. During follow-up, nine eyes (24.3%) with viral retinitis and five eyes (50.0%) with parasitic retinitis developed retinal redetachment. Visual acuity success at final follow-up was achieved in 19 eyes (51.4%) with viral retinitis and six eyes (60.0%) with parasitic retinitis (p = 0.64). The incidence of retinal redetachment during the 1st postoperative year was significantly higher in parasitic retinitis compared with viral retinitis (crude incidence, 0.21 vs. 0.85; p = 0.02). Hazard ratio analysis adjusted for age and sex showed 4.58-fold (95% confidence interval, 1.22-17.27; p = 0.03) increased risk of retinal redetachment in parasitic retinitis compared with viral retinitis during the 1st postoperative year. Tamponade with silicone oil and preoperative diagnostic vitrectomy were associated with significantly decreased risk of retinal redetachment in patients with parasitic retinitis.
CONCLUSIONS: Compared with RD secondary to viral retinitis, RD secondary to parasitic retinitis showed higher incidence of retinal redetachment during the 1st postoperative year. Tamponade with silicone oil and preoperative diagnostic vitrectomy were associated with significantly decreased risk of retinal redetachment in patients with parasitic retinitis.
METHODS: A total of 47 eyes that received pars plana vitrectomy with or without scleral buckling due to RD secondary to polymerase chain reaction-proven viral (cytomegalovirus, varicella zoster virus, and herpes zoster virus) or parasitic (toxoplasma and toxocara) retinitis from October 1, 2006, to June 30, 2023, in a single medical center were retrospectively enrolled.
RESULTS: Mean follow-up period was 59.03 ± 55.24 months in viral retinitis and 34.80 ± 33.78 months in parasitic retinitis after primary reattachment surgery. During follow-up, nine eyes (24.3%) with viral retinitis and five eyes (50.0%) with parasitic retinitis developed retinal redetachment. Visual acuity success at final follow-up was achieved in 19 eyes (51.4%) with viral retinitis and six eyes (60.0%) with parasitic retinitis (p = 0.64). The incidence of retinal redetachment during the 1st postoperative year was significantly higher in parasitic retinitis compared with viral retinitis (crude incidence, 0.21 vs. 0.85; p = 0.02). Hazard ratio analysis adjusted for age and sex showed 4.58-fold (95% confidence interval, 1.22-17.27; p = 0.03) increased risk of retinal redetachment in parasitic retinitis compared with viral retinitis during the 1st postoperative year. Tamponade with silicone oil and preoperative diagnostic vitrectomy were associated with significantly decreased risk of retinal redetachment in patients with parasitic retinitis.
CONCLUSIONS: Compared with RD secondary to viral retinitis, RD secondary to parasitic retinitis showed higher incidence of retinal redetachment during the 1st postoperative year. Tamponade with silicone oil and preoperative diagnostic vitrectomy were associated with significantly decreased risk of retinal redetachment in patients with parasitic retinitis.
摘要：
■本研究旨在比较继发于病毒性或寄生虫感染性视网膜炎的视网膜脱离（RD）手术的长期结果。
■47只眼睛因聚合酶链反应证实的病毒（巨细胞病毒，水痘带状疱疹病毒,和带状疱疹病毒）或寄生虫（弓形虫和弓形虫）视网膜炎从10月1日，2006年6月30日,2023年在一个医疗中心进行了回顾性登记。
■原发性复位手术后，病毒性视网膜炎的平均随访期为59.03±55.24个月，寄生虫性视网膜炎的平均随访期为34.80±33.78个月。随访期间,病毒性视网膜炎9眼(24.3%)和寄生虫性视网膜炎5眼(50.0%)出现视网膜再脱离。在最终随访中，19只眼（51.4％）的病毒性视网膜炎和6只眼（60.0％）的寄生性视网膜炎（p=0.64）获得了视力成功。术后第一年视网膜再脱离的发生率在寄生性视网膜炎中明显高于病毒性视网膜炎（病毒性和寄生性视网膜炎中的粗发生率为0.21vs0.85，分别为；p=0.02）。根据年龄和性别调整的危险比分析显示，术后第一年与病毒性视网膜炎相比，寄生性视网膜炎的视网膜再脱离风险增加了4.58倍（95％置信区间1.22-17.27，p=0.03）。硅油填塞和术前诊断性玻璃体切除术与寄生虫性视网膜炎患者视网膜再脱离的风险显着降低相关。
■与病毒性视网膜炎继发的RD相比，继发于寄生性视网膜炎的RD在术后第一年显示出更高的视网膜再脱离发生率。硅油填塞和术前诊断性玻璃体切除术与寄生虫性视网膜炎患者视网膜再脱离的风险显着降低相关。
■47只眼睛因聚合酶链反应证实的病毒（巨细胞病毒，水痘带状疱疹病毒,和带状疱疹病毒）或寄生虫（弓形虫和弓形虫）视网膜炎从10月1日，2006年6月30日,2023年在一个医疗中心进行了回顾性登记。
■原发性复位手术后，病毒性视网膜炎的平均随访期为59.03±55.24个月，寄生虫性视网膜炎的平均随访期为34.80±33.78个月。随访期间,病毒性视网膜炎9眼(24.3%)和寄生虫性视网膜炎5眼(50.0%)出现视网膜再脱离。在最终随访中，19只眼（51.4％）的病毒性视网膜炎和6只眼（60.0％）的寄生性视网膜炎（p=0.64）获得了视力成功。术后第一年视网膜再脱离的发生率在寄生性视网膜炎中明显高于病毒性视网膜炎（病毒性和寄生性视网膜炎中的粗发生率为0.21vs0.85，分别为；p=0.02）。根据年龄和性别调整的危险比分析显示，术后第一年与病毒性视网膜炎相比，寄生性视网膜炎的视网膜再脱离风险增加了4.58倍（95％置信区间1.22-17.27，p=0.03）。硅油填塞和术前诊断性玻璃体切除术与寄生虫性视网膜炎患者视网膜再脱离的风险显着降低相关。
■与病毒性视网膜炎继发的RD相比，继发于寄生性视网膜炎的RD在术后第一年显示出更高的视网膜再脱离发生率。硅油填塞和术前诊断性玻璃体切除术与寄生虫性视网膜炎患者视网膜再脱离的风险显着降低相关。
