Objective To explore the influencing factors of visual prognosis of macular edema secondary to branch retinal vein occlusion (BRVO-ME) after treatment with ranibizumab, and construct and verify the nomogram model. MethodsA retrospective study. A total of 130 patients with BRVO-ME diagnosed by ophthalmology examination in the Department of Ophthalmology, Liuzhou Red Cross Hospital from January 2019 to December 2021 were selected in this study. All patients received intravitreal injection of ranibizumab. According to the random number table method, the patients were divided into the training set and the test set with a ratio of 3:1, which were 98 patients (98 eyes) and 32 patients (32 eyes), respectively. According to the difference of logarithm of the minimum angle of resolution (logMAR) best corrected visual acuity (BCVA) at 6 months after treatment and logMAR BCVA before treatment, 98 patients (98 eyes) in the training set were divided into good prognosis group (difference ≤－0.3) and poor prognosis group (difference ＞－0.3), which were 58 patients (58 eyes) and 40 patients (40 eyes), respectively. The clinical data of patients in the two groups were analyzed, univariate and multivariate logistic regression analysis were carried out for the different indicators, and the visualization regression analysis results were obtained by using R software. The consistency index (C-index), convolutional neural network (CNN), calibration curve and receiver operating characteristic (ROC) curve were used to verify the accuracy of the nomogram model. ResultsUnivariate analysis showed that age, disease course, outer membrane (ELM) integrity, elliptical zone (EZ) integrity, BCVA, center macular thickness (CMT), outer hyperreflective retinal foci (HRF), inner retina HRF, and the blood flow density of retinal deep capillary plexus (DCP) were risk factors affecting the visual prognosis after treatment with ranibizumab in BRVO-ME patients (P＜0.05). Multivariate logistic regression analysis showed that course of disease, ELM integrity, BCVA and outer HRF were independent risk factors for visual prognosis after ranibizumab treatment for BRVO-ME patients (P＜0.05). The ROC area under the curve of the training set and the test set were 0.846[95% confidence interval (CI) 0.789-0.887) and 0.852 (95%CI 0.794 -0.873)], respectively; C-index were 0.836 (95%CI 0.793-0.865) and 0.845 (95%CI 0.780-0.872), respectively. CNN showed that the error rate gradually stabilized after 300 cycles, with good model accuracy and strong prediction ability. ConclusionsCourse of disease, ELM integrity, BCVA and outer HRF were independent risk factors of visual prognosis after ranibizumab treatment in BRVO-ME patients. The nomogram model based on risk factors has good differentiation and accuracy.
ObjectiveTo investigate the risk factors of high intraocular pressure (IOP) after femtosecond laser in situ keratomileusis (FS-LASIK) in patients with high myopia, and construct and verify nomogram model. MethodsA retrospective clinical study. From January 2019 to January 2021, 327 patients (654 eyes) with high myopia treated with FS-LASIK in the Department of Ophthalmology of the 910th Hospital of the People's Liberation Army Coalition Security Force were included in the study. The patients were categorized into high IOP group and non-high IOP group according to whether high IOP occurred after surgery, which were 60 cases and 120 eyes (18.35%, 60/327) and 267 cases and 534 eyes (81.65%, 267/327), respectively. The clinical data of patients in the two groups were analyzed and observed, and the indicators with differences were subjected to one-way and multifactorial logistic regression analyses, and the results of the regression analyses were visualized to obtain the column line graphs using R3.5.3 software, and the accuracy of the column line graphs was verified by the consistency index (C-index), the calibration curves, and the subject's work characteristic curves (ROC curves). ResultsComparison of the number of cases of affected corneal thickness (χ2=7.424), corneal curvature (χ2=9.849), glucocorticoid treatment (χ2=7.222), intraoperative IOP fluctuation (χ2=11.475), corneal hysteresis (χ2=6.368), and the incidence of intraoperative complications (χ2=6.673) in the hypertensive IOP group and the nonvisualized IOP group were statistically significant (P＜0.05). Binary logistic regression analysis showed that corneal thickness ＞450 μm, corneal curvature≤38 D, glucocorticoid treatment, intraoperative IOP fluctuation, corneal hysteresis ≤8.0 mm Hg (1 mm Hg=0.133 kPa), and intraoperative complications were the risk factors for the occurrence of high IOP after FS-LASIK surgery in patients with high myopia (P＜0.05). The C-index of the column-line graph prediction model based on this was 0.722 (95% confidence interval 0.684-0.760), the calibration curve and the ideal curve were basically the same, and the area under the ROC curve was 0.709. ConclusionsCorneal thickness＞450 μm, keratometric curvature ≤38 D, glucocorticoid treatment, intraoperative fluctuation of intraocular pressure, and corneal hysteresis ≤8.0 mm Hg are the risk factors for the development of hyperopic IOP in highly risk factors for the development of high IOP after FS-LASIK surgery in myopic patients. The column-line diagram model constructed on the basis of the risk factors hava good accuracy.
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. MethodsA 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. ResultsCompared 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. ConclusionsAge ＞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.