目的:确定镰状细胞状态患者发生大血管视网膜血管阻塞的风险是否存在差异。
方法:回顾性队列研究。
方法:将患有镰状细胞病或由眼科医生评估的性状的患者与没有镰状细胞病或也由眼科医生评估的性状的配对对照进行比较。
方法:这项研究使用了来自国家数据库(2006-2024)的去识别数据,使用国际疾病分类10代码选择视网膜血管阻塞。根据年龄进行倾向评分匹配,性别,种族,种族,吸烟,高血压,糖尿病,血脂异常,肥胖,导致HBSS,HbSC,和镰状细胞性状(SCT)队列和匹配的对照组。
方法:视网膜血管阻塞诊断的风险比和95%置信区间(CI),包括视网膜中央动脉阻塞(CRAO),视网膜分支动脉阻塞(BRAO),视网膜中央静脉阻塞(CRVO),视网膜分支静脉阻塞(BRVO),角膜营养不良作为阴性对照,鉴于镰状细胞疾病或性状。
结果:在倾向得分匹配后,HbSS(n=10,802,平均值±标准偏差年龄为38.6±20.6岁),HbSC(n=4,296,34.3±17.8年),和SCT(n=15,249,39.8±23.7年)队列与对照组(n=10,802,38.7±20.7年;n=4,296,34.6±18.0年;n=15,249,39.9±23.8年,分别)。镰状细胞病(HbSS)患者发生视网膜血管阻塞的风险较高(RR2.33;95%CI1.82-3.00),CRAO(RR2.71;95%CI1.65-4.47)和BRAO(RR4.90;95%CI2.48-9.67)高于匹配对照。与没有镰状细胞病的匹配对照组相比,患有HbSC疾病的患者发生任何视网膜血管阻塞的风险更高(RR3.14;95%CI1.95-5.06)。具有镰状细胞特征的患者发生视网膜血管阻塞的风险(RR1.01;95%CI0.81-1.26)并未高于匹配的对照组。
结论:在一项回顾性队列研究中,HbSS镰状细胞病患者发生视网膜血管阻塞的风险增加,更具体地说,CRAO和BRAO与没有镰状细胞病的患者相比。
OBJECTIVE: To determine if differences exist in the risk of developing large vessel retinal vascular occlusions in patients with sickle cell states.
METHODS: Retrospective cohort study.
METHODS: Patients with sickle cell disease or trait evaluated by an ophthalmologist were compared to matched controls without sickle cell disease or trait also evaluated by an ophthalmologist.
METHODS: This study used deidentified data from a national database (2006-2024), using International Classification of Diseases 10 codes to select for retinal vascular occlusions. Propensity score matching was performed with respect to age, sex, race, ethnicity, smoking, hypertension, diabetes, dyslipidemias, and obesity, resulting in HbSS, HbSC, and sickle cell trait (SCT) cohorts and matched control cohorts.
METHODS: Risk ratios and 95% confidence intervals (CI) of retinal vascular occlusion diagnosis, including central retinal artery occlusion (CRAO), branch retinal artery occlusion (BRAO), central retinal venous occlusion (CRVO), branch retinal venous occlusion (BRVO), and corneal dystrophy as a negative control, given sickle cell disease or trait.
RESULTS: After propensity score matching, HbSS (n=10,802, mean ± standard deviation age of 38.6 ± 20.6 years), HbSC (n=4,296, 34.3 ± 17.8 years), and SCT (n=15,249, 39.8 ± 23.7 years) cohorts were compared to control cohorts (n=10,802, 38.7 ± 20.7 years; n=4,296, 34.6 ± 18.0 years; n=15,249, 39.9 ± 23.8 years, respectively). Patients with sickle cell disease (HbSS) had higher risk of developing any retinal vascular occlusion (RR 2.33; 95% CI 1.82-3.00), CRAO (RR 2.71; 95% CI 1.65-4.47) and BRAO (RR 4.90; 95% CI 2.48-9.67) than matched controls. Patients with HbSC disease had higher risk (RR 3.14; 95% CI 1.95-5.06) of developing any retinal vascular occlusion than matched controls without sickle cell disease. Patients with sickle cell trait did not have higher risk of developing retinal vascular occlusions (RR 1.01; 95% CI 0.81-1.26) than matched controls.
CONCLUSIONS: In a retrospective cohort study, patients with HbSS sickle cell disease have an increased risk of developing retinal vascular occlusions, and more specifically CRAO and BRAO compared to patients without sickle cell disease.