目的：分析息肉状脉络膜血管病变(PCV)合并玻璃体积血行玻璃体切割术后视力转归的影响因素并建立预测模型。

方法：回顾性分析本院2021-06/2024-01接受玻璃体切割术治疗PCV合并玻璃体积血患者129例129眼的临床资料。根据术后早期(24 mo内)视力转归分为提高组71眼、非提高组58眼。另选不同期30例30眼PCV合并玻璃体积血行玻璃体切割术作为外部验证数据，评价预测模型对内部、外部人群术后视力转归的预测价值。

结果：非提高组年龄≥60岁、糖尿病、术中椭圆体带(EZ)连续性异常、出血累及黄斑中心凹、术后视网膜瘢痕形成占比高于提高组，是术后视力转归的影响因素(均P<0.05)； 预测模型预测内部、外部人群术后视力转归的AUC分别为0.824(95%CI：0.750-0.898)、0.809(95%CI：0.723-0.865)。

结论：年龄≥60岁、糖尿病、术中EZ连续性异常、出血累及黄斑中心凹、术后视网膜瘢痕形成是PCV合并玻璃体积血患者玻璃体切割术后视力转归的影响因素，基于上述影响因素建立预测模型，该模型对术后视力转归具有一定预测价值。

METHODS: A retrospective analysis was conducted on the clinical data of 129 cases(129 eyes)of patients who underwent vitrectomy for PCV combined with vitreous hemorrhage from June 2021 to January 2024 in our hospital. They were divided into elevated group(71 eyes)and non-elevated group(58 eyes)according to visual outcome at early posoperative stage(within 24 mo). Another 30 cases(30 eyes)of PCV with vitreous hemorrhage undergoing vitrectomy were selected as external validation data. The predictive value of the model for the postoperative visual outcomes of both internal and external populations was evaluated.

RESULTS: The non-elevated group had a higher proportion of patients aged ≥60 years, diabetes, continuous abnormalities of the ellipsoid zone(EZ)during surgery, bleeding involving the macular fovea, and postoperative retinal scar formation than the elevated group were independent factors affecting postoperative visual acuity(all P<0.05). The AUC of the predictive model for predicting the postoperative visual outcomes of internal and external populations was 0.824(95%CI: 0.750-0.898)and 0.809(95%CI: 0.723-0.865), respectively.

CONCLUSION:Patients aged ≥60 years, diabetes, intraoperative continuous abnormalities of EZ, bleeding involving the macular fovea, and postoperative retinal scar formation are influencing factors for visual outcome after vitrectomy in patients with PCV combined with vitreous hemorrhage. A predictive model based on those factors has been established, which has a certain predictive value for postoperative visual outcome.