Analysis of risk factors for retinal detachment in myopic patients and construction of Nomogram prediction model_Chinese Journal of Ocular Fundus Diseases

Authors：

Wang Chanjuan , Li Xiaolu , Mu Tao , Zhang Shaochi , Wang Hui ,  Bi Xiaojun

People's Hospital of Ningxia Hui Autonomous Region (Ningxia Eye Hospital)/The First Affiliated Hospital of Northwest University for Nationalities/Ningxia Clinical Medical Research Center for Blinding Eye Diseases, Yinchuan 750000, China;

Corresponding?author：

Bi Xiaojun, Email: bxj511@163.com

Keywords：

Myopia; Retinal detachment; Risk factors; Nomogram model

DOI：

10.3760/cma.j.cn511434-20221117-00616

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To analyze the risk factors associated with retinal detachment in patients with myopia, and to establish and validate the predictive column-line diagram model. Methods A cross-sectional clinical study. From January 2020 to November 2021, 90 patients with myopia combined with retinal detachment who were diagnosed by ophthalmologic examination in the People's Hospital of Ningxia Hui Autonomous Region were included in the study (observation group). Ninety myopic patients with age- and gender-matched myopia who underwent ophthalmologic examination for myopia during the same period were selected as the control group. The clinical data of the two groups were analyzed, and the indicators with differences were subjected to univariate and multivariate logistic regression analyses. The results of the regression analyses were visualized by using R software to obtain the column charts, and the accuracy of the column charts was verified by the ROC curves of the subjects' work characteristics; the clinical efficacy of the column chart model was verified by the internal data. Results Compared with the control group, patients in the observation group were older, had higher myopic refraction, had more visual fatigue, ocular trauma, and cataracts, had lower choroidal and retinal thickness, and had more history of ophthalmic surgery, and the differences were statistically significant (P＜0.05). The area under the ROC curve (AUC) for age, myopic refraction, retinal thickness, and choroidal thickness were 0.612, 0.613, 0.720, and 0.704, respectively; the optimal cutoff values were 43 years old, －3.5 D, 225 μm, and 144 μm. the ROC values were 0.612, 0.613, 0.720, and 0.704 for age (＞43 years old), myopic refraction (＞－3.5 D), visual fatigue (yes), ocular trauma (yes), cataracts (yes), retinal thickness (≤225 μm), and choroidal thickness (≤144 μm) were the risk factors affecting the development of retinal detachment in myopic patients (P＜0.05). The consistency index of the column chart model for predicting the risk of retinal detachment in patients with myopia was 0.731 (95% confidence interval 0.665-0.824); the risk threshold for predicting the development of retinal detachment in patients was ＞0.07. Conclusions Age ＞43 years, myopic refraction >－3.5 D, presence of visual fatigue, ocular trauma, cataract, retinal thickness ≤225 μm, choroidal thickness ≤144 μm are the risk factors affecting the development of retinal detachment in myopic patients. The column-line diagram model constructed on the basis of the risk factors has good accuracy.

Citation： Wang Chanjuan, Li Xiaolu, Mu Tao, Zhang Shaochi, Wang Hui, Bi Xiaojun. Analysis of risk factors for retinal detachment in myopic patients and construction of Nomogram prediction model. Chinese Journal of Ocular Fundus Diseases, 2023, 39(8): 669-674. doi: 10.3760/cma.j.cn511434-20221117-00616 Copy

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14.	袁敬改, 陳月, 顧朝暉, 等. 患者年齡及眼軸長度對高度近視白內障患者術后黃斑中心凹視網膜和脈絡膜厚度影響[J]. 臨床眼科雜志, 2021, 29(6): 487-491. DOI: 10.3969/j.issn.1006-8422.2021.06.002.Yuan JG, Chen Y, Gu ZH, et al. Effect of patient age and ocular axis length on postoperative macular center recess retinal and choroidal thickness in highly myopic cataract patients[J]. J Clin Ophthalmol, 2021, 29(6): 487-491. DOI: 10.3969/j.issn.1006-8422.2021.06.002.
15.	包力, 楊濤, 王曉悅, 等. 近視患者視網膜及脈絡膜厚度分析[J]. 華西醫學, 2017, 32(10): 1520-1524. DOI: 10.7507/1002-0179.201610140.Bao L, Yang T, Wang XY, et al. Analysis of retinal and choroidal thickness in myopic patients[J]. West China Medical Journal, 2017, 32(10): 1520-1524. DOI: 10.7507/1002-0179.201610140.
16.	楊帆, 王淑霞. 132例近視性視網膜脫離臨床分析[J]. 中國實用醫藥, 2014, 9(29): 118-119. DOI: 10.14163/j.cnki.11-5547/r.2014.29.284.Yang F, Wang SX. Clinical analysis of 132 cases of myopic retinal detachment[J]. China Prac Med, 2014, 9(29): 118-119. DOI: 10.14163/j.cnki.11-5547/r.2014.29.284.
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1. 曲藝, 董方田. 高度近視黃斑裂孔視網膜脫離手術治療現狀與進展[J]. 中華眼底病雜志, 2016, 32(5): 557-560. DOI: 10.3760/cma.j.issn.1005-1015.2016.05.030.Qu Y, Dong FT. The development of surgery for macular hole with retinal detachment in high myopic eyes[J]. Chin J Ocul Fundus Dis, 2016, 32(5): 557-560. DOI: 10.3760/cma.j.issn.1005-1015.2016.05.030.
2. 閭雯娟, 游佳, 李明, 等. 硅油眼復發性視網膜脫離的臨床特征及手術術式選擇的分析[J]. 醫學理論與實踐, 2023, 36(14): 2361-2363. DOI: 10.19381/j.issn.1001-7585.2023.14.006.Lyu WJ, You J, Li M, et al. Analysis of clinical characteristics and choice of surgical procedure in recurrent retinal detachment in silicone oil eyes[J]. J Med Theor & Prac, 2023, 36(14): 2361-2363. DOI: 10.19381/j.issn.1001-7585.2023.14.006.
3. 陳鈺虹, 朱鴻, 王泓. 孔源性視網膜脫離術后視功能恢復的影響因素[J]. 眼科新進展, 2018, 38(4): 396-400. DOI: 10.13389/j.cnki.rao.2018.0093.Chen YH, Zhu H, Wang H. Influencing factors of visual function recovery after foramen ovale retinal detachment[J]. Rec Adv Ophthalmol, 2018, 38(4): 396-400. DOI: 10.13389/j.cnki.rao.2018.0093.
4. 柳紅利, 艾明, 萬瑋, 等. 圖文式臨床護理路徑在復雜性視網膜脫離患者健康教育中的應用[J]. 現代臨床護理, 2016, 15(11): 72-75. DOI: 10.3969/j.issn.1671-8283.2016.11.018.Liu HL, Ai M, Wan W, et al. Application of graphic clinical nursing pathway in health education for patients with complex retinal detachment[J]. Modern Clinical Nursing, 2016, 15(11): 72-75. DOI: 10.3969/j.issn.1671-8283.2016.11.018.
5. 姚宜, 韓麗榮, 閔云花, 等. 高度近視黃斑裂孔視網膜脫離玻璃體視網膜手術的療效觀察[J]. 中國眼耳鼻喉科雜志, 2016, 16(1): 26-29. DOI: 10.14166/j.issn.1671-2420.2015.06.008.Yao Y, Han LR, Min YH, et al. Efficacy observation of vitreoretinal surgery for macular tear retinal detachment in high myopia[J]. Chin J Ophthalmol and Otorhinolaryngol, 2016, 16(1): 26-29. DOI: 10.14166/j.issn.1671-2420.2015.06.008.
6. 葉建, 張靜, 季麗萍, 等. CONUT評分在乳腺癌患者術后復發轉移中的預測價值[J]. 腫瘤代謝與營養電子雜志, 2022, 9(1): 101-105.Ye J, Zhang J, Ji LP, et al. Predictive value of CONUT score in postoperative recurrent metastasis in breast cancer patients[J]. Electron J Metab Nutr Cancer, 2022, 9(1): 101-105.
7. 張勇, 余一朗, 單鵬飛, 等. 乳腺癌患者改良根治術后復發轉移的相關危險因素分析[J]. 中華普外科手術學雜志, 2021, 15(4): 418-421. DOI: 10.3877/cma.j.issn.1674-3946.2021.04.018.Zhang Y, Yu YL, Shan PF, et al. Analysis of risk factors associated with recurrent metastasis after modified radical surgery in breast cancer patients[J]. Chin J Gen Surg, 2021, 15(4): 418-421. DOI: 10.3877/cma.j.issn.1674-3946.2021.04.018.
8. Bahit MC, Lopes RD, Wojdyla DM, et al. Non-major bleeding with apixaban versus warfarin in patients with atrial fibrillation[J]. Heart, 2017, 103(8): 623-628. DOI: 10.1136/heartjnl-2016-309901.
9. Samuel NE, Krishnagopal S. Foveal and macular thickness evaluation by spectral OCT SLO and its relation with axial length in various degree of myopia[J]. J Clin Diagn Res, 2015, 9(3): 1-4. DOI: 10.7860/JCDR/2015/11780.5676.
10. McCarty CA, Taylor HR. Myopia and vision 2020[J]. Am J Ophthalmol, 2000, 129(4): 525-527. DOI: 10.1016/s0002-9394(99)00444-4.
11. 王聰, 張永鵬. 視網膜脫離行玻璃體切除聯合惰性氣體填充術后視力下降原因分析[J]. 中國中醫眼科雜志, 2017, 27(3): 171-174. DOI: 10.13444/j.cnki.zgzyykzz.2017.03.008.Wang C, Zahng YP. Analysis of causes of vision loss after vitrectomy combined with inert gas filling for retinal detachment[J]. Chinese Journal of Traditional Chinese Ophthalmology, 2017, 27(3): 171-174. DOI: 10.13444/j.cnki.zgzyykzz.2017.03.008.
12. 王麗霞, 王幼生, 王小川, 等. 高度近視患者黃斑部視網膜厚度光學相干斷層掃描分析[J]. 臨床醫學工程, 2016, 23(3): 261-263. DOI: 10.3969/j.issn.1674-4659.2016.03.0261.Wang LX, Wang YS, Wang XC, et al. Optical coherence tomography analysis of macular retinal thickness in patients with high myopia[J]. Clinical Medical Engineering, 2016, 23(3): 261-263. DOI: 10.3969/j.issn.1674-4659.2016.03.0261.
13. Wu J, Zhang H, Li L, et al. A nomogram for predicting overall survival in patients with low-grade endometrial stromal sarcoma: a population-based analysis[J]. Cancer Commun (Lond), 2020, 40(7): 301-312. DOI: 10.1002/cac2.12067.
14. 袁敬改, 陳月, 顧朝暉, 等. 患者年齡及眼軸長度對高度近視白內障患者術后黃斑中心凹視網膜和脈絡膜厚度影響[J]. 臨床眼科雜志, 2021, 29(6): 487-491. DOI: 10.3969/j.issn.1006-8422.2021.06.002.Yuan JG, Chen Y, Gu ZH, et al. Effect of patient age and ocular axis length on postoperative macular center recess retinal and choroidal thickness in highly myopic cataract patients[J]. J Clin Ophthalmol, 2021, 29(6): 487-491. DOI: 10.3969/j.issn.1006-8422.2021.06.002.
15. 包力, 楊濤, 王曉悅, 等. 近視患者視網膜及脈絡膜厚度分析[J]. 華西醫學, 2017, 32(10): 1520-1524. DOI: 10.7507/1002-0179.201610140.Bao L, Yang T, Wang XY, et al. Analysis of retinal and choroidal thickness in myopic patients[J]. West China Medical Journal, 2017, 32(10): 1520-1524. DOI: 10.7507/1002-0179.201610140.
16. 楊帆, 王淑霞. 132例近視性視網膜脫離臨床分析[J]. 中國實用醫藥, 2014, 9(29): 118-119. DOI: 10.14163/j.cnki.11-5547/r.2014.29.284.Yang F, Wang SX. Clinical analysis of 132 cases of myopic retinal detachment[J]. China Prac Med, 2014, 9(29): 118-119. DOI: 10.14163/j.cnki.11-5547/r.2014.29.284.
17. 紀曉倩, 吳昌凡, 方嚴. 脈絡膜厚度在近視發病機制中的研究進展[J]. 臨床眼科雜志, 2016, 24(1): 88-90. DOI: 10.3969/j.issn.1006-8422.2016.01.032.Ji XQ, Wu CF, Fang Y. Progress of choroidal thickness in the pathogenesis of myopia[J]. J Clin Ophthalmol, 2016, 24(1): 88-90. DOI: 10.3969/j.issn.1006-8422.2016.01.032.
18. Huang W, Wang W, Zhou M, et al. Peripapillary choroidal thickness in healthy Chinese subjects[J/OL]. BMC Ophthalmol, 2013, 13: 23[2013-06-10].https://pubmed.ncbi.nlm.nih.gov/23758729/. DOI: 10.1186/1471-2415-13-23.
19. 歐陽倩如. 微創后鞏膜加固術對高度近視進展控制的有效性和安全性研究[D]. 北京: 北京大學, 2021.OuYang JR. A study on the effectiveness and safety of minimally invasive posterior scleral reinforcement in controlling the progression of high myopia[D]. Beijing: Peking University, 2021.
20. 吳雪梅, 朱琦, 王乾, 等. 白內障術后視網膜脫離的危險因素及其行視網膜復位術后視力恢復的相關因素分析[J]. 臨床眼科雜志, 2017, 25(2): 133-136. DOI: 10.3969/j.issn.1006-8422.2017.02.011.Wu XM, Zhu Q, Wang Q, et al. Analysis of risk factors for retinal detachment after cataract surgery and their correlates of visual recovery after retinal resurfacing[J]. J Clin Ophthalmol, 2017, 25(2): 133-136. DOI: 10.3969/j.issn.1006-8422.2017.02.011.
21. 董菁. 近視人群患原發性視網膜脫離的危險因素與干預[J]. 護士進修雜志, 2007, 22(4): 347-348. DOI: 10.3969/j.issn.1002-6975.2007.Dong Q. Risk factors and interventions for primary retinal detachment in a myopic population[J]. Journal of Nursing Education, 2007, 22(4): 347-348. DOI: 10.3969/j.issn.1002-6975.2007.

Chinese Journal of Ocular Fundus Diseases

Analysis of risk factors for retinal detachment in myopic patients and construction of Nomogram prediction model

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