Canadian glaucoma study - 2. Risk factors for the progression of open-angle glaucoma
Canadian glaucoma study - 2. Risk factors for the progression of open-angle glaucoma
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DOI：
10.1001/archopht.126.8.1030
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发表时间：
2008-08-01
影响因子：
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通讯作者：
Trope, Graham E.
中科院分区：
文献类型：
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作者：
Chauhan, Balwantray C.;Mikelberg, Frederick S.;Trope, Graham E.
目的：为了确定系统和眼部的危险因素视野进展在开角型glaucoma.Methods：在加拿大青光眼研究，258例患者（131名男性和127名女性;中位年龄，65.0岁）的多中心前瞻性纵向研究，基线全身措施包括评估外周血管痉挛和血液病理学，凝血功能障碍和免疫病理学标志物。患者每隔4个月随访一次，进行视野检查、视盘成像和标准化的眼压控制干预方案。单变量和比例风险模型被用来确定因素，预测progress.Main结果测量：视野进展与标准自动perimetry.Results：中位数随访时间为5.3年，167例（64.7%）完成5年或以上，67例（26.0%）完成7年或以上。基线抗心磷脂抗体水平异常（风险比[ HR]，3.86; 95%置信区间[ CI]，1.60-9.31），基线年龄较高（每年HR，1.04; 95% CI，1.01-1.07），女性（HR，1.94; 95% CI，1.09-3.46），平均随访眼内压较高（HR/1 mmHg，1.19; 95%CI，1.05-1.36）与疾病进展相关。加拿大青光眼研究确定了4个独立的青光眼领域进展的预测因素。临床实践应用：在确认眼内压在青光眼进展中的重要性的同时，本研究确定了其他值得关注的风险因素。试验注册：clinicaltrials.gov标识符：NCT 00262626。
Objective: To determine systemic and ocular risk factors for visual field progression in open-angle glaucoma.Methods: In the Canadian Glaucoma Study, a multi-center prospective longitudinal study of 258 patients (131 men and 127 women; median age, 65.0 years), baseline systemic measures included assessment of peripheral vasospasm and markers for hematopathology, coagulopathy, and immunopathology. Patients were followed up at 4-month intervals with perimetry, optic disc imaging, and a standardized interventional protocol for intraocular pressure control. Univariate and proportional hazards models were used to identify factors that predicted progression.Main Outcome Measure: Visual field progression with standard automated perimetry.Results: Median follow-up was 5.3 years, with 167 patients (64.7%) completing 5 years or more and 67 patients (26.0%) completing 7 years or more. Abnormal baseline anticardiolipin antibody levels (hazard ratio [ HR], 3.86; 95% confidence interval [ CI], 1.60-9.31), higher baseline age (HR per year, 1.04; 95% CI, 1.01-1.07), female sex (HR, 1.94; 95% CI, 1.09-3.46), and higher mean follow-up intraocular pressure (HR per 1 mm Hg, 1.19; 95% CI, 1.05-1.36) before progression were associated with progression.Conclusions: The Canadian Glaucoma Study identified 4 independent predictive factors for glaucomatous field progression.Application to Clinical Practice: While confirming the importance of intraocular pressure in glaucoma progression, this study determined other risk factors that merit awareness.Trial Registration: clinicaltrials.gov Identifier: NCT00262626.