摘要
目的探讨近视患者视网膜脱离的危险因素及风险预测模型。方法回顾性分析2021年1月至2023年12月于我院就诊的近视患者的临床资料,选择符合条件的近视性视网膜脱离患者128例(128眼)作为视网膜脱离组,没有视网膜脱离的近视患者128例(128眼)作为对照组。收集两组患者的临床资料,包括年龄、性别、屈光度、文化程度、病侧、是否负重、有无震动、有无白内障、是否存在视疲劳、血压、糖尿病史、眼外伤史、眼科手术史、视网膜厚度等。采用多因素Logistic回归分析确定近视性视网膜脱离的危险因素,并据以建立多因素联合应用的风险预测模型,应用受试者工作特征曲线(ROC)进行预测评估价值分析。结果视网膜脱离组患者的年龄、屈光度、收缩压、白内障发生率、视疲劳发生率、眼外伤发生率以及眼科手术史率均显著高于对照组(均为P<0.05);视网膜脱离组患者的视网膜厚度与脉络膜厚度均显著低于对照组(均为P<0.05)。近视患者发生视网膜脱离的危险因素为年龄(较大),屈光度(绝对值较大),伴有白内障或视疲劳或眼外伤等眼部疾患或不适状况,脉络膜厚度(较小),视网膜厚度(较小)(均为OR>1,P<0.05)。年龄、眼部疾患或不适、屈光度、脉络膜厚度、视网膜厚度等5项指标单独及联合应用时ROC曲线下面积(AUC)(0.95 CI)分别为0.668(0.382~0.936)、0.645、0.676(0.407~0.942)、0.731(0.503~0.933)、0.745(0.499~0.983)、0.844(0.692~0.983),联合应用预测评估效能更高,AUC(0.844)及灵敏度、特异度、准确度均较单独应用指标有明显提升。结论近视患者发生视网膜脱离的危险因素为较大的年龄,较大的屈光度(绝对值),伴有包括白内障、视疲劳、眼外伤在内的眼部疾患或不适,较小的脉络膜厚度、较小的视网膜厚度。由这些因素构建的风险预测模型评估效能较高。
Objective To investigate the risk factors and risk prediction model of retinal detachment in patients with myopia.Methods The clinical data of myopic patients treated in our hospital from January 2021 to December 2023 were retrospectively analyzed.A total of 128 patients(128 eyes)with myopic retinal detachment who met the requirements were selected as the retinal detachment group,and 128 myopic patients(128 eyes)without retinal detachment were selected as the control group.The clinical data of patients in the two groups were collected and compared,including age,gender,diopter,education level,affected side,whether to bear load or not,whether to vibrate or not,whether to have cataract or not,whether to have asthenopia or not,blood pressure,history of diabetes,history of ocular trauma,history of ophthalmic surgery,and retinal thickness.Risk factors related to retinal detachment in myopia were determined through the multivariate logistic regression analysis,and based on these factors,the risk prediction model was established.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of the model.Results The age,diopter,systolic blood pressure,cataract incidence,asthenopia incidence,ocular trauma and ophthalmic surgery rates of myopic patients in the retinal detachment group were significantly higher than those in the control group(all P<0.05).The retinal thickness and choroidal thickness of myopic patients in the retinal detachment group were significantly smaller than those in the control group(both P<0.05).The risk factors for retinal detachment in myopic patients were older age,higher diopter(absolute value),accompanied by ocular diseases or discomfort such as cataract,asthenopia and ocular trauma,thinner choroid,and thinner retina(all OR>1,P<0.05).The areas under the ROC curve(0.95 CI)for predication of retinal detachment based on age,ocular disease or discomfort,diopter,choroidal thickness,and retinal thickness alone and their combination were 0.668(0.382-0.936),0.645,0.676(0.407-0
作者
袁祖旭
李素华
张妍
刘爱新
贺广秀
YUAN Zuxu;LI Suhua;ZHANG Yan;LIU Aixin;HE Guangxiu(Department of Ophthalmology,Nanyang Central Hospital,Nanyang 473000,Henan Province,China;Nanyang Apex Eye Hospital,Nanyang 473000,Henan Province,China)
出处
《眼科新进展》
CAS
北大核心
2024年第7期554-557,共4页
Recent Advances in Ophthalmology
基金
河南省科技厅科技攻关项目(编号:212102310661)。
关键词
视网膜脱离
近视
危险因素
风险预测模型
retinal detachment
myopia
risk factors
risk prediction model
