PCV合并玻璃体积血行玻璃体切割术后视力转归预测模型的构建与验证  

Construction and validation of a predictive model for visual outcome after vitrectomy for polypoidal choroidal vasculopathy combined with vitreous hemorrhage

作　　者：肖青[1] 刘晨伟 李玲娜 唐光宝 董明霞[1] 李冬育 刘芳[1] Xiao Qing;Liu Chenwei;Li Lingna;Tang Guangbao;Dong Mingxia;Li Dongyu;Liu Fang(Department of Fundus Disease,Tangshan Eye Hospital,Tangshan 063000,Hebei Province,China;Department of Eye Function,Tangshan Eye Hospital,Tangshan 063000,Hebei Province,China;Department of Retinopathy,Tangshan Eye Hospital,Tangshan 063000,Hebei Province,China)

机构地区：[1]中国河北省唐山市眼科医院眼底病科,063000 [2]中国河北省唐山市眼科医院眼功能科,063000 [3]中国河北省唐山市眼科医院糖网病科,063000

出　　处：《国际眼科杂志》2025年第2期274-280,共7页International Eye Science

基　　金：河北省医学科学研究课题计划项目(No.20231817)。

摘　　要：目的:分析息肉状脉络膜血管病变(PCV)合并玻璃体积血行玻璃体切割术后视力转归的影响因素并建立预测模型。方法:回顾性分析本院2021-06/2024-01接受玻璃体切割术治疗PCV合并玻璃体积血患者129例129眼的临床资料。根据术后早期(24 mo内)视力转归分为提高组71眼、非提高组58眼。另选不同期30例30眼PCV合并玻璃体积血行玻璃体切割术作为外部验证数据,评价预测模型对内部、外部人群术后视力转归的预测价值。结果:非提高组年龄≥60岁、糖尿病、术中椭圆体带(EZ)连续性异常、出血累及黄斑中心凹、术后视网膜瘢痕形成占比高于提高组,是术后视力转归的影响因素(均P<0.05);预测模型预测内部、外部人群术后视力转归的AUC分别为0.824(95%CI:0.750-0.898)、0.809(95%CI:0.723-0.865)。结论:年龄≥60岁、糖尿病、术中EZ连续性异常、出血累及黄斑中心凹、术后视网膜瘢痕形成是PCV合并玻璃体积血患者玻璃体切割术后视力转归的影响因素,基于上述影响因素建立预测模型,该模型对术后视力转归具有一定预测价值。AIM:To analyze the influencing factors of visual outcome after vitrectomy for polypoidal choroidal vasculopathy(PCV)combined with vitreous hemorrhage and establish a predictive model.METHODS:A retrospective analysis was conducted on the clinical data of 129 cases(129 eyes)of patients who underwent vitrectomy for PCV combined with vitreous hemorrhage from June 2021 to January 2024 in our hospital.They were divided into elevated group(71 eyes)and non-elevated group(58 eyes)according to visual outcome at early posoperative stage(within 24 mo).Another 30 cases(30 eyes)of PCV with vitreous hemorrhage undergoing vitrectomy were selected as external validation data.The predictive value of the model for the postoperative visual outcomes of both internal and external populations was evaluated.RESULTS:The non-elevated group had a higher proportion of patients aged≥60 years,diabetes,continuous abnormalities of the ellipsoid zone(EZ)during surgery,bleeding involving the macular fovea,and postoperative retinal scar formation than the elevated group were independent factors affecting postoperative visual acuity(all P<0.05).The AUC of the predictive model for predicting the postoperative visual outcomes of internal and external populations was 0.824(95%CI:0.750-0.898)and 0.809(95%CI:0.723-0.865),respectively.CONCLUSION:Patients aged≥60 years,diabetes,intraoperative continuous abnormalities of EZ,bleeding involving the macular fovea,and postoperative retinal scar formation are influencing factors for visual outcome after vitrectomy in patients with PCV combined with vitreous hemorrhage.A predictive model based on those factors has been established,which has a certain predictive value for postoperative visual outcome.

关 键 词：息肉状脉络膜血管病变(PCV) 玻璃体积血 玻璃体切割术 视力转归 LASSO回归分析 多因素LOGISTIC回归分析 预测 

分 类 号：R779.6[医药卫生—眼科]