目的:报告临床设置,管理,以及与孔源性视网膜脱离并发脉络膜脱离的预后相关的因素。
方法:回顾性,连续的,包括2014年1月至2021年1月的多中心病例系列。病例来自印度和台湾的三级眼保健中心。
结果:共包括303只眼。平均年龄为43.72±20.64岁(中位数46)。最佳矫正视力为1.79±0.92logMAR(中位数2.10)(Snellen20/1,233)。44例患者(17.91%)接受术前类固醇治疗。最终视力为1.33±0.94logMAR(中位数1.10)(Snellen20/427)。有利的解剖结果见于200/303(66%),而有利的功能结局见于128/303(42.20%)。预测有利解剖结果的因素是无晶状体状态(比值比[OR]2.76),不存在比A级更差的增殖性玻璃体视网膜病变(OR7.69),术前使用类固醇(OR4.50),和使用环绕带(3.85)。预测良好功能结局的因素是视力表现更好(OR3.03),无晶状体状态(或4.93),不存在比A级更差的增殖性玻璃体视网膜病变(OR10.41),术前使用类固醇(OR7.24)。
结论:术前使用类固醇,在手术期间使用环绕带,发现眼的假晶状体状态在孔源性视网膜脱离并发脉络膜脱离中具有更好的结果。
OBJECTIVE: To report the clinical settings, management, and factors associated with outcomes of rhegmatogenous retinal detachment with concurrent choroidal detachment.
METHODS: Retrospective, consecutive, multicenter case series from January 2014 to January 2021 were included. Cases were from a tertiary eye care center in India and Taiwan.
RESULTS: Overall 303 eyes were included. Mean age was 43.72 ± 20.64 years (median 46). Best-corrected presenting visual acuity was 1.79 ± 0.92 logMAR (median 2.10) (Snellen 20/1,233). Forty-four patients (17.91%) received preoperative steroids. Final visual acuity was 1.33 ± 0.94 logMAR (median 1.10) (Snellen 20/427). Favorable anatomic outcome was seen in 200/303 (66%), whereas favorable functional outcome was seen in 128/303 (42.20%). Factors predicting favorable anatomic outcome were absence of phakic lens status (odds ratio [OR] 2.76), absence of proliferative vitreoretinopathy worse than Grade A (OR 7.69), use of preoperative steroids (OR 4.50), and use of an encircling band (3.85). Factors predicting favorable functional outcome were better presenting visual acuity (OR 3.03), absence of phakic lens status (OR 4.93), absence of proliferative vitreoretinopathy worse than Grade A (OR 10.41), and use of preoperative steroids (OR 7.24).
CONCLUSIONS: Administration of preoperative steroids, use of an encircling band during surgery, and pseudophakic status of the eye were found to have better outcomes in rhegmatogenous retinal detachment with concurrent choroidal detachment.