RESUMO
PURPOSE: To compare anatomical and functional outcomes of 25-gauge pars plana vitrectomy (PPV) and sulfur hexafluoride gas between inferior and superior rhegmatogenous retinal detachment (RRD). METHODS: A retrospective cohort study of patients with RRD who underwent 25-gauge PPV. Group A consisted of patients with an identified inferior retinal break (4-8 o'clock hours). Group B consisted of patients with an identified superior retinal break. RESULTS: Overall, 59 eyes of 59 patients with a mean age of 60.0 ± 12.3 years were included, with 57.6% being males; 25 with inferior breaks (Group A) and 34 with superior breaks (Group B). The mean follow-up time was 4 months (range 2-16 months). Single-surgery anatomical success was achieved in 96% (24/25) of Group A and 82.4% (28/34) of Group B patients (P = 0.22) with final anatomical success achieved in all cases. In regression analysis, break location (superior versus inferior) did not significantly account for the variation in single-surgery success or visual outcomes. CONCLUSION: Favorable results were achieved using 25-gauge vitrectomy and sulfur hexafluoride gas for primary RRD treatment. No differences in anatomical and functional success rates were observed between inferior and superior retinal break-associated RRD.
Assuntos
Descolamento Retiniano , Vitrectomia , Idoso , Humanos , Pessoa de Meia-Idade , Complicações Pós-Operatórias/cirurgia , Perfurações Retinianas , Estudos Retrospectivos , Resultado do Tratamento , Acuidade VisualRESUMO
BACKGROUND: Continental Africa is facing an epidemic of chronic kidney disease (CKD). APOL1 risk variants have been shown to be strongly associated with an increased risk for non-diabetic kidney disease including HIV nephropathy, primary non-monogenic focal and segmental glomerulosclerosis, and hypertension-attributed nephropathy among African ancestry populations in the USA. The world's highest frequencies of APOL1 risk alleles have been reported in West African nations, overlapping regions with a high incidence of CKD and hypertension. One such region is south-eastern Nigeria, and therefore we sought to quantify the association of APOL1 risk alleles with CKD in this region. METHODS: APOL1 risk variants were genotyped in a case-control sample set consisting of non-diabetic, CKD patients (n = 44) and control individuals (n = 43) from Enugu and Abakaliki, Nigeria. RESULTS: We found a high frequency of two APOL1 risk alleles in the general population of Igbo people of south-eastern Nigeria (23.3%). The two APOL1 risk allele frequency in the CKD patient group was 66%. Logistic regression analysis under a recessive inheritance model showed a strong and significant association of APOL1 two-risk alleles with CKD, yielding an odds ratio of 6.4 (unadjusted p = 1.2E-4); following correction for age, gender, HIV and BMI, the odds ratio was 4.8 (adjusted p = 5.1E-03). CONCLUSION: APOL1 risk variants are common in the Igbo population of south-eastern Nigeria, and are also highly associated with non-diabetic CKD in this area. APOL1 may explain the increased prevalence of CKD in this region.