Construction of risk prediction model for macular edema after phacoemulsification in diabetic cataract patients
10.3980/j.issn.1672-5123.2025.10.18
- VernacularTitle:糖尿病性白内障超声乳化术后黄斑水肿风险预测模型构建
- Author:
Bing LIU
1
;
Jie QIN
1
;
Jiyun DUAN
1
;
Qianqian LIU
1
;
Bangjian SONG
1
Author Information
1. Department of Ophthalmology, Rizhao Central Hospital, Rizhao 276800, Shandong Province, China
- Publication Type:Journal Article
- Keywords:
diabetic cataract;
cataract phacoemulsification;
macular edema;
nomogram;
prediction model
- From:
International Eye Science
2025;25(10):1650-1655
- CountryChina
- Language:Chinese
-
Abstract:
AIM: To construct a risk nomogram prediction model of macular edema(ME)based on the risk factors of ME after phacoemulsification in diabetic cataract(DC)patients.METHODS: A retrospective collection of data was conducted on 1 751 DC patients(1 751 eyes)who underwent cataract phacoemulsification surgery in the hospital from January 2022 to December 2024. Based on whether they developed ME after surgery, the patients were divided into the ME group(n=138)and the N-ME group(n=1 613). By conducting univariate and Logistic multiple regression analysis, the risk factors for postoperative ME in DC patients undergoing phacoemulsification were identified. A nomogram of risk prediction model was constructed, and the receiver operating characteristic(ROC)curve, calibration curve, Hosmer-Lemeshow goodness of fit test were plotted to evaluate the discrimination and calibration of the model. The decision curve was used to evaluate the clinical return on investment of the model.RESULTS: Age, course of diabetes, proportion of insulin treatment, proportion of retinopathy, best corrected visual acuity(BCVA), central subfield macular thickness(CSMT), macular volume, glycated hemoglobin(HbA1c), vascular endothelial growth factor(VEGF)in the ME group were higher than those in the N-ME group(all P<0.05). Multivariate Logistic regression analysis showed that diabetes course, retinopathy, BCVA, CSMT, macular volume, HbA1c and VEGF were the risk factors for ME after phacoemulsification in DC patients(all P<0.05). A nomogram of risk prediction model was constructed based on risk factors, and the ROC curve suggested good model differentiation [AUC of training set was 0.998(95% CI: 0.997-1.000), and AUC of validation set was 0.999(95% CI: 0.997-1.000)], set: R2=0.917, χ2=0.806, P=0.999; verification set: R2=0.900, χ2=0.675, P=1.000). The decision curve showed that the model had a high net return rate within the probability range of 0.00-1.00 threshold.CONCLUSION: Diabetes course, retinopathy, BCVA, CSMT, macular volume, HbA1c and VEGF are risk factors for ME after cataract phacoemulsification in DC patients. The nomogram of risk prediction model based on this construction has good differentiation and consistency in predicting the risk of ME after cataract phacoemulsification in DC patients.
