遗传性视网膜变性的儿童和成人患者发病时的特征和预测因素:三级眼科诊所数据

Matthew T McLaughlin, Caleb P Ganansky, Ayman W Taher, Melissa A Trudrung, William Van De Car, Jonathan Le, Kyle D. Peterson, Kimberly E Stepien, Melanie A Schmitt
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摘要

遗传性视网膜变性(IRD)是一组由基因变异导致视网膜感光器功能障碍并继发视力损伤的疾病。我们的目的是比较儿童和成人 IRD 患者在一家三级医疗机构 IRD 诊所就诊时的特征。我们对 538 名 IRD 患者进行了回顾性病历审查。获得的信息包括年龄、诊断、发病特征、人口统计学特征、与诊所的距离以及转诊医生。这项研究发现,高度远视、先天性联合畸形、高度屈光不正、高度散光和发育迟缓病史是儿科发病的主要预测因素。在成人患者中,我们发现中心视力下降、周边视力下降、色觉障碍、夜盲症、闪光/漂浮物、白内障、糖尿病、肥胖、心脏病和白内障家族史对发病最有预测性。从 20 英里或更远的地方前来就诊的儿童患者比例更高。此外,转诊成人或儿科患者的医疗服务提供者类型也没有明显差异。这项研究确定了预测 IRD 儿童和成人患者发病的特征,从而弥补了目前的知识空白。更好地了解这些特征有助于更快地识别IRD,教育可能遇到IRD的临床医生,并尽早进行治疗。
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Characteristics and Predictors of Pediatric and Adult Patients with Inherited Retinal Degenerations at Time of Presentation: Tertiary Care Ophthalmology Clinic Data
Inherited Retinal Degenerations (IRDs) are a group of diseases where genetic variants lead to retinal photoreceptor dysfunction and subsequent visual impairment. We aimed to compare the characteristics of pediatric versus adult IRD patients at the time of presentation at a tertiary care IRD clinic. A retrospective chart review of 538 patients with IRDs was conducted. Information obtained included age, diagnosis, presenting characteristics, demographics, distance from the clinic, and referring physician. This study found that high hyperopia, congenital syndactyly, high refractive error, high astigmatism, and a history of developmental delay were most predictive of pediatric presentation. In adults, we found reduced central vision, peripheral vision loss, color vision deficits, nyctalopia, flashes/floaters, cataracts, diabetes mellitus, obesity, cardiac conditions, and a family history of cataract were most predictive of presentation. There was a greater proportion of pediatric patients presenting from 20 or more miles away. Additionally, there was no significant difference between the type of healthcare provider referring adult or pediatric patients. This study identifies characteristics predictive of pediatric and adult presentation in IRD patients thus addressing current knowledge gaps. A better understanding of these characteristics may provide for quicker recognition, education of clinicians likely to encounter IRDs, and allow for earlier treatment.
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