RESUMEN
PURPOSE: To clarify the postoperative incidence of macular edema in patients undergoing surgery to repair rhegmatogenous retinal detachment and identify the associated risk factors. METHODS: In this prospective, observational study, 79 patients who underwent surgery to correct rhegmatogenous retinal detachment using pars plana vitrectomy with silicone oil injection were analyzed. Patients were followed up postoperatively at 7, 30, 90, 180, and 365 days. At each visit, optical coherence tomography was performed to assess the presence or absence of macular edema. were analyzed as possible risk factors for macular edema: age, sex, macular status (attached or detached), presence of vitreoretinal proliferation, history of previous intraocular surgery, reported time of symptoms suggestive of rhegmatogenous retinal detachment up to the date of surgery, and the surgical modality performed. RESULTS: The 1-year macular edema prevalence rate was 26.6%. In the adjusted analysis, older patients had a higher risk of macular edema, and each 1-year increase in age increased the risk of macular edema by 6% (95% confidence interval = 1.00-1.12). The macular status, vitreoretinal proliferation, the surgical technique used, prior intraocular surgery, and the intraocular lens status were not identified as risk factors. However, the incidence of macular edema increased up to 180 days after surgery, peaking at 10.6%, and then decreased until 365 days after surgery. CONCLUSION: Macular edema was a common complication after surgery to treat rhegmatogenous retinal detachment, with its incidence peaking between 30 and 180 days after surgery. Age was an important risk factor for macular edema in this cohort.
Asunto(s)
Edema Macular , Desprendimiento de Retina , Tomografía de Coherencia Óptica , Vitrectomía , Humanos , Desprendimiento de Retina/cirugía , Desprendimiento de Retina/etiología , Masculino , Femenino , Edema Macular/etiología , Edema Macular/epidemiología , Persona de Mediana Edad , Factores de Riesgo , Estudios Prospectivos , Vitrectomía/efectos adversos , Vitrectomía/métodos , Incidencia , Adulto , Estudios de Seguimiento , Tomografía de Coherencia Óptica/métodos , Anciano , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Agudeza Visual , Aceites de Silicona/efectos adversos , Aceites de Silicona/administración & dosificación , Factores de Tiempo , Factores de Edad , Adulto JovenRESUMEN
ABSTRACT Objective: To evaluate the profile and severity of age-related macular degeneration (AMD) in ophthalmology ambulatory of Federal University of Parana in Curitiba, Parana, Brazil. Methods: This was a cross-sectional study with data collected among the 6155 outpatients ophthalmic appointments (november 2011 to november 2013). In this 6155 patients, a total of 346 patients had retinal diseases and were screened by two retinal specialists for signs of AMD. If present, they were submitted to a protocol including a new ophthalmic evaluation comprising visual acuity, tonometry, biomicroscopy, dilated fundus examination and optical coherence tomography (OCT). Results: A total of 6155 patients underwent ophthalmologic evaluation for several reasons. Three hundred and forty six patients had retinal diseases (incidence of 5.6%) and 68 of these (incidence of 19.6% in retinal patients) had AMD. The mean age of all patients was 53 years and in retinal patients was 60 years. In AMD patients mean age was 73 years. Ethnicity, body-mass index (BMI) and smoking habits were evaluated in the 68 patients diagnosed with AMD (34 exudative and 34 non-exudative) but none of those parameters were statistically significant comparing exudative and non-exudative forms. Conclusion: Most of the patients were European descendants. A higher proportion of advanced cases of AMD comparing with literature was found (50% of exudative form). Regarding ethnicity, iris color, smoking habit and BMI, there was no difference comparing exudative and non-exudative forms. These results may be compared to available AMD studies, since there is little information about AMD in Brazil.
RESUMO Objetivo: Avaliar o perfil epidemiológico e severidade da degeneração macular relacionada à idade (DMRI) no ambulatório de oftalmologia da Universidade Federal do Paraná (UFPR) em Curitiba, Paraná, Brasil. Métodos: Estudo transversal com dados coletados referentes as 6155 consultas oftalmológicas realizadas no período de novembro de 2011 a novembro de 2013. Destes, 346 pacientes possuíam doenças retinianas e foram avaliados por dois especialistas em retina à procura de sinais de DMRI. Os confirmados foram submetidos a um protocolo compreendendo acuidade visual, tonometria, biomicroscopia, oftalmoscopia indireta sob midríase e tomografia de coerência óptica (OCT). Resultados: Um total de 6155 pacientes foram submetidos à consulta oftalmológica na UFPR. Trezentos e quarenta e seis pacientes apresentaram doenças retinianas (incidência de 5.6%) e 68 destes (incidência de 19.6% dos pacientes com doenças de retina) apresentaram DMRI. A média de idade dos pacientes do ambulatório geral foi de 53 anos e em pacientes com doenças de retina foi de 60 anos. Pacientes com DMRI tinham em média 73 anos. Etnia, cor da íris, índice de massa corpórea (IMC) e tabagismo foram avaliados nos 68 pacientes diagnosticados com DMRI (34 exsudativa e 34 não exsudativa), mas nenhum dos parâmetros foram estatisticamente significantes. Conclusão: A maioria dos pacientes eram de origem europeia. Comparando com a literatura, uma maior proporção de casos avançados de DMRI (50% de forma exsudativa) foi encontrada. Em relação à etnia, tabagismo e IMC, não houve diferença entre pacientes com forma exsudativa e não exsudativa. Estes resultados podem ser comparados com estudos disponíveis, considerando a pouca informação referente a DMRI existente no Brasil.
