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孤立性特发性视网膜血管炎的视力结果和不良预后因素

Maleki A, Cao JH, Silpa-Archa S, et al.

期刊名称:Retina

卷期:2016年第36卷第10期

摘要

目的:本研究旨在阐述孤立性特发性视网膜血管炎的临床病程、视力结果和预后。研究方法:将80名孤立性特发性视网膜血管炎患者(150只眼)作为研究对象。采集来自马萨诸塞州眼科研究与手术机构(MERSI)数据库的关于这些患者2005年9月到2015年2月的初次就诊和随访过程中的人口学资料、临床数据、并发症,以及眼底荧光血管造影和光学相干断层扫描结果。研究结果:75名患者(93.7%)需要采用免疫调节疗法进行治疗。这75名患者中,有60名患者(75%)能够达到症状持久缓解的效果。并且能够显著独立预测视力结果差的因素为较低初始视力(OR:3.78;95%置信区间:1.75-8.16;P = 0.001),黄斑囊样水肿(OR:5.54;95%置信区间:1.81-16.99;P = 0.003),及黄斑区缺血症状(OR:5.12;95%置信区间:1.12-23.04;P = 0.036)。研究结论:我们的患者中有大多数(67.25%)采用免疫调节疗法治疗后获得良好的视力结果(最近的随访最佳矫正视力等于或优于20 / 40,并且较基线处获得1行或2行的视力增益)。我们发现,黄斑囊样水肿、黄斑缺血及第一次访问期间的较低最佳矫正视力是患者视力结果差的重要独立风险因素。

PURPOSE:To describe the clinical course, visual outcome, and prognosis of isolated, idiopathic retinal vasculitis.METHODS:Eighty patients (150 eyes) with isolated, idiopathic retinal vasculitis were included. Demographic data, clinical data, complications at the initial visit and during follow-up, fluorescein angiography, and optical coherence tomography findings were collected from the Massachusetts Eye Research and Surgery Institution (MERSI) database from September 2005 to February 2015.RESULTS:Seventy-five (93.7%) patients required treatment with immunomodulatory therapy. Of those 75 patients, 60 (75%) patients were able to achieve durable remission. Factors which were independently significant predictive of poor visual outcome were lower initial visual acuity (OR: 3.78; 95% CI: 1.75-8.16; P = 0.001), cystoid macular edema (OR: 5.54; 95% CI: 1.81-16.99; P = 0.003), and macular ischemia (OR: 5.12; 95% CI: 1.12-23.04; P = 0.036).CONCLUSION:The majority (67.25%) of our patients enjoyed a good visual outcome (most recent visit best-corrected visual acuity equal to or better than 20/40 and within one line or better from the baseline) with immunomodulatory therapy. We found that cystoid macular edema, macular ischemia, and lower best-corrected visual acuity during the first consultation visit were significant independent risk factors for poor visual outcome.


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