急性浮动和闪:这个患者有视网膜脱落的风险吗?
Hussein Hollands1, Davin Johnson, Anya C Brox
1Department of Ophthalmology, Queen's University, Kingston, ON, Canada. hussein.hollands@yahoo.com
JAMA
|November 26, 2009
概括
急性浮动和闪通常表明后部玻璃体脱落 (PVD). 主观视力减弱和玻璃体出血是PVD患者视网膜撕裂风险的关键指标.
科学领域:
- 眼科医生 眼科 眼科
- 视网膜疾病 视网膜疾病
- 玻璃甲状腺接口 玻璃甲状腺接口
背景情况:
- 单眼浮动物和/或闪的急性发作是一种常见的表现.
- 后面玻璃体脱落 (PVD) 是最常见的诊断.
- 在PVD患者中,很大一部分患有视网膜撕裂,风险是视力丧失.
研究的目的:
- 量化临床变量与急性PVD患者视网膜撕裂风险之间的关联.
- 为了确定患有浮标和闪的患者视网膜撕裂的高风险特征.
主要方法:
- 对MEDLINE和EMBASE数据库 (1950-2009) 的系统文献审查.
- 包括的研究重点是临床病史和与视网膜撕裂可能性相关的体检结果.
- 分析了17项相关研究,使用概率比率的元分析.
主要成果:
- 在急性PVD患者中,视网膜撕裂的患病率为14%.
- 主观视力减弱 (LR,5.0) 和玻璃体出血 (LR,10) 是视网膜撕裂的重要指标.
- 缺少玻璃性色素 (LR,0.23) 表明风险较低. 没有并发症的PVD在6周内有3.4%的撕裂风险.
结论:
- 初级保健医生必须评估急性浮动/闪患者的PVD和视网膜撕裂风险.
- 评估视力敏度和识别视力减弱或出血等高风险特征至关重要.
- 患有风险增加的患者需要紧急的眼科转诊,以防止视力丧失.
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