摘要
目的基于随机森林的算法探索影响单眼先天性白内障术后长期视力预后的因素。方法回顾性队列研究。选择2008年1月至2021年12月住院手术的符合纳入和排除标准的单眼先天性白内障患儿,收集患儿的基线资料、手术资料和随访资料。利用随机森林算法分析影响末次随访时最佳矫正视力(BCVA)的因素,将末次随访时BCVA(logMAR)视为因变量,对因变量与自变量的关系采取两种方式拟合,模型一是将因变量视为连续性变量进行随机森林回归;模型二是将因变量视为二分类变量进行随机森林分类。选取平均准确度下降、平均基尼下降前五位的变量为重要性较高的变量。利用偏依赖关系图分析这些因素对术后视力影响的规律。结果28例患儿纳入本研究,接受白内障摘除手术的中位年龄19.0(4.8~39.3)月龄,IOL植入的中位年龄35.5(30.0~44.0)月龄,白内障摘除联合一期IOL植入年龄中位数36.0(23.0~47.0)月龄;单纯白内障摘除手术的中位年龄5.0(3.5~15.0)月龄;二期IOL植入中位年龄35.0(33.0~42.0)月龄。斜视10(35.7%)例、眼球震颤1(3.6%)例;中位随访时间58.5(36.0~77.0)个月,中位末次最佳矫正视力1.1(0.5~2.0)logMAR,末次随访时有斜视19(67.9%)例。根据两个模型的变量重要性排序,综合筛选出现频次最高的三个变量分别为白内障摘除年龄,植入IOL年龄以及末次随访时存在斜视。白内障摘除年龄与末次随访时BCVA的偏依赖关系显示:在5月龄前二者呈负相关,5~11月龄呈正相关,11~20月龄呈负相关;IOL植入年龄与末次随访时BCVA的偏依赖关系显示:在26月龄前二者呈负相关,在26~57月龄呈正相关,大于57月龄后无变化。末次随访时斜视与BCVA的偏依赖关系显示二者呈负相关。结论白内障摘除年龄、IOL植入年龄以及和末次随访时存在斜视是影响单眼先天性白内障术后远期视力的重要因素。在5月龄前行白内障摘除手术、2岁左右�
Objective To explore the factors influencing long-term visual outcome in unilateral congenital cataract after cataract surgery based on random forest.Methods Retrospective cohort study.Children with unilateral congenital cataracts who were underwent cataract extraction in our in-patient department from January 2008 to December 2021,and met the inclusion and exclusion criteria were selected.Baseline,surgical,and follow-up information and clinical data were collected.Random forest was applied to analyze the factors affecting the best corrected visual acuity(BCVA)at the last follow-up.BCVA(logMAR)at the last follow-up was regarded as the dependent variable,and the relationship between the dependent variable and the independent variable was fitted in two models.In model one,the dependent variable was regarded as a continuous variable for random forest regression,while in model two,the dependent variable was regarded as dichotomous variables for random forest classification.Five variables with top five higher values of mean decrease accuracy or mean decrease Gini were selected as the more important variables.Partial dependence plot was used to analyze the influence of these variables on postoperative visual acuity.Results Twenty-eight children were included in this study.All of the pediatric patients at baseline,the median age at cataract extraction was 19.0(IQR 4.8~39.3)months,the median age at IOL implantation was 35.5(IQR 30.0~44.0)months,among which the median age at cataract extraction with primary IOL implantation was 36.0(IRQ 23.0~47.0)months,the median age at cataract extraction was 5.0(IQR 3.5~15.0)months,and the median age at secondary IOL implantation was 35.0(IQR 33.0~42.0)months.There were 10(35.7%)patients with nystagmus and one(3.6%)patient with strabismus before cataract extraction,respectively.The median follow-up time was 58.5(IQR 36.0~77.0)months,the median BCVA was 1.1(IQR 0.5~2.0)logMAR,and 19(67.9%)patients with strabismus at the last follow-up.According to the rank of importance of variables in
作者
张泸宁
赵超
何梦梅
吴桐
郝壮
郑超
马济远
周健
Zhang Luning;Zhao Chao;He Mengmei;Wu Tong;Hao Zhuang;Zheng Chao;Ma Jiyuan;Zhou Jian(Department of Ophthalmology,Eye Institute of PLA,Xijing Hospital,Air Force Medical University,Xian 710032,China)
出处
《临床眼科杂志》
2023年第2期140-146,共7页
Journal of Clinical Ophthalmology
基金
空军军医大学临床研究项目(2021LC2219)。
关键词
单眼
先天性白内障
最佳校正视力
随机森林
远期预后
影响因素
Unilateral
Congenital cataract
Best corrected visual acuity
Random forest
Long-term prognosis
Factors affecting the prognosis
