台灣年輕群體之裂孔性視網膜剝離發生率與眼球共病

Incidence and ocular comorbidities of rhegmatogenous retinal detachment among younger people in Taiwan

目標：分析年輕群體眼球之裂孔性視網膜剝離發生率與共病。方法：本研究以全民健保資料庫為基礎，將健保之百萬人資料抽樣檔回溯追蹤十年2001-2010年資料，透過健保門診明細檔及醫令檔，分析0-44歲之裂孔性視網膜剝離個案每年新發生個案之發生率，並用勝算比及95%信賴區間統計共病資料。結果：臺灣2001-2010年45歲以下群體之裂孔性視網膜剝離發生率為每十萬人口16.4位，其中年輕女性高峰在25-29歲每十萬人口中有23位，年輕男性持續增加在40-44歲達到每十萬人口28.3位。再者，將已發生裂孔性視網膜剝離與未發生裂孔性視網膜剝離年輕群體相較，發現前者前一年的統計顯著疾病有高度近視（OR7.38, 95%CI3.97-13.72），其他病理性疾病有玻璃體出血（OR72.57, 95%CI9.93-530.55）、周邊網膜變性（格子狀變性）（OR5.11, 95%CI2.44-10.67）。結論：台灣年輕群體之裂孔性視網膜剝離人數居高不下，平均男性多於女性。統計發現高度近視和視網膜病理變化之共病結果，可以提供未來預防裂孔性視網膜剝離之參考。

Objectives: The ocular incidence rate and comorbidities of rhegmatogenous retinal detachment (RRD) in young groups were analyzed. Methods: This retrospective study was population-based and data were analyzed using the Taiwan Longitudinal Health Insurance Database 2000. The ages of the subjects included in the young RRD group ranged from 0 years to 44 years. The annual incidence rate was calculated by dividing the number of new cases by the population size of individuals with health insurance coverage. Odds ratio (OR) with 95% confidence interval (CI) was used to analyze the comorbidities. Results: From 2001 to 2010, the incidence rate of RRD for individuals under 45 years of age in Taiwan was 16.4 per 100,000. The young female group, aged 25-29 years, peaked first at 23.0 per 100,000, whereas the young male group, aged 40-44 years, increased continually and peaked at 28.3 per 100,000. The young RRD group was highly comorbid with some diseases and statistically more associated with high myopia (OR 7.38, 95% CI 3.97-13.72) than the young non-RRD group. Other pathological changes in the young RRD group were vitreous hemorrhage (OR 72.57, 95% CI: 9.93-530.55) and lattice degeneration (OR 5.11, 95% CI: 2.44-10.67) as compared with young non-RRD subjects. Conclusions: The young population of Taiwan shows high number of RRD cases dominated by males. The co-morbid analysis of high myopia and pathological changes of retinal degeneration can provide references for RRD prevention in young residents.