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Influencing factors of neovascular glaucoma in patients with proliferative diabetic retinopathy after pars plana vitrectomy |
LONG Kailin WANG Chen ZHAO Kerui DAI Hansheng |
Department of Ophthalmology, Nanchang Bright Eye Hospital, Jiangxi Province, Nanchang 330000, China |
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Abstract Objective To investigate the related factors of neovascular glaucoma (NVG) after pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). Methods The clinical data of 65 PDR patients who underwent PPV in Nanchang Bright Eye Hospital from January 2021 to January 2023 were retrospectively analyzed. According to whether NVG occurred after surgery, they were divided into the occurrence group (n=18) and the non-occurrence group (n=47). The general data of the patients were collected, including gender, age, body mass index, duration of diabetes, PDR stage, insulin injection, cardiovascular and cerebrovascular diseases, preoperative intraocular pressure, fasting blood glucose, anemia, retinal detachment, combined cataract surgery, preoperative anterior chamber angle or iris neovascularization. The general data were analyzed by univariate analysis, and then the factors with statistically significant differences were analyzed by multivariate logistic regression analysis. Results Among the 65 PDR patients treated with PPV, 18 cases of NVG occurred, with an incidence of 27.69%. Univariate analysis showed that there were no significant differences in body mass index, duration of diabetes, PDR stage, insulin injection, preoperative intraocular pressure, retinal detachment, and combined cataract surgery between the two groups (P>0.05). There were statistically significant differences between the two groups in gender, age, whether complicated with cardiovascular and cerebrovascular diseases, fasting blood glucose, anemia, and whether there were anterior chamber angle or iris neovascularization (P<0.05). Multivariate logistic regression analysis showed that male gender (β=1.567, P=0.024, OR=4.792, 95%CI: 1.224-18.766), age<60 years (β=2.380, P=0.003, OR=10.800, 95%CI: 2.225-52.413), cardiovascular and cerebrovascular diseases (β=1.707, P=0.003, OR=5.814, 95%CI: 1.791-18.870), fasting blood glucose ≥7.0 mmol/L (β=1.655, P=0.006, OR=5.231, 95%CI: 1.623-16.853), anemia (β=1.892, P=0.002, OR=6.635, 95%CI: 2.010-21.900), preoperative or iris neovascularization corner of the eye (β=1.905, P=0.004, OR= 6.720, 95%CI: 1.808-24.981) were the independent risk factors (P<0.05 and OR>1). Conclusion There are many influencing factors for NVG after PPV in PDR patients, including male gender, age<60 years old, combined with cardiovascular and cerebrovascular diseases, fasting blood glucose≥7.0 mmol/L, etc. Clinical attention should be paid to relevant conditions and prevention work should be done.
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[1] |
王秀超,杨洪帅.术前注射康帕西普联合25G玻璃体切除术治疗增殖性糖尿病视网膜病变的疗效分析[J].贵州医药,2022,46(8):1247-1248.
|
[2] |
Gubitosi-Klug R,Libman I,Drews KL,et al.Development and Progression of Diabetic Retinopathy in Adolescents and Young Adults With Type 2 Diabetes:Results From the TODAY Study[J].Diabetes care,2022,45(5):1049-1055.
|
[3] |
宋娅琴,马雪英,王笃亲,等.全视网膜光凝技术联合康柏西普对新生血管性青光眼的疗效[J].安徽医科大学学报,2020,55(12):1941-1945.
|
[4] |
杜玮,陈文倩,于文贞,等.增殖性糖尿病视网膜病变患者再次玻璃体切除术的影响因素分析[J].中华医学杂志,2022, 102(18):1389-1393.
|
[5] |
徐晨,纪丽君,苗林.雷珠单抗联合玻璃体切割对增生性糖尿病视网膜病变玻璃体中VEGF、TF表达的影响[J].中国临床医学,2021,28(3):502-506.
|
[6] |
中华医学会眼科学会眼底病学组.我国糖尿病视网膜病变临床诊疗指南(2014年)[J].中华眼科杂志,2014,50(11):851-865.
|
[7] |
葛坚,王利坚.眼科学[M].3版.北京:人民卫生出版社,2015:261-294.
|
[8] |
彭云,郭千千,刘军安,等.深圳市社区糖尿病患者视网膜病变防治知识知晓度及影响因素分析[J].中华眼底病杂志,2021,37(1):21-26.
|
[9] |
黄玥,李旌,张茜,等.康柏西普对增生性糖尿病视网膜病变患者氧化应激水平和炎症因子浓度的影响[J].临床眼科杂志,2022,30(1):5-10.
|
[10] |
冯姝颖,解正高,杨婉笛,等.增生性糖尿病视网膜病变患眼玻璃体切除手术后玻璃体再积血的临床特征分析[J].临床眼科杂志,2021,29(4):294-298.
|
[11] |
王伟,李甦雁,张正培,等.角膜保护剂与平衡盐溶液在增生性糖尿病视网膜病变微创玻璃体手术中对眼表保护作用的比较[J].中华实验眼科杂志,2021,39(11):982- 988.
|
[12] |
刘慧.增殖性糖尿病视网膜病变玻璃体切除术后发生新生血管性青光眼的影响因素[J].河北医科大学学报,2021, 42(11):1357-1361.
|
[13] |
张劲,明媚.增生性糖尿病视网膜病变患者玻璃体、房水和血浆中VEGF表达与IL-6,IL-8和TNF-α水平的相关性研究[J].现代检验医学杂志,2021,36(4):55-59.
|
[14] |
余萍,刘玲玲,周星利,等.视网膜光凝术联合雷珠单抗治疗新生血管青光眼的疗效及对血液流变学和房水炎性因子的影响[J].现代生物医学进展,2021,21(19):3787- 3791.
|
[15] |
孙峰,杨学龙,吴兵.雷珠单抗对糖尿病视网膜病变伴新生血管性青光眼的疗效及血清血管内皮生长因子和胰岛素样生长因子-1水平的影响[J].中国医药导报,2023, 20(2):118-121.
|
[16] |
李雪景,陈冬梅,段佳良,等.联合手术治疗增殖性糖尿病视网膜病变的继发性闭角型新生血管性青光眼的临床效果观察[J].河北医科大学学报,2023,44(3):319-323.
|
[17] |
代莉,李娟,邹明菊.增殖性糖尿病视网膜病变微创玻璃体切割术预后影响因素[J].安徽医药,2022,26(7):1433- 1436.
|
[18] |
祖雪,代光政,林铁柱.增生性糖尿病视网膜病变行玻璃体切割术后发生新生血管性青光眼的风险因素[J].国际眼科杂志,2023,23(5):808-812.
|
[19] |
王曼丽,贾竹敏,付留俊,等.2型糖尿病患者并发糖尿病视网膜病变的影响因素分析[J].临床内科杂志,2022,39(1):47-49.
|
[20] |
范小娥,柯屹峰,任新军,等.增生型糖尿病视网膜病变微创玻璃体切割手术后新生血管性青光眼的危险因素分析[J].中华眼底病杂志,2021,37(1):15-20.
|
|
|
|