Risk factors for progression of visual field abnormalities in normal-tension glaucoma
Risk factors for progression of visual field abnormalities in normal-tension glaucoma
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DOI：
10.1016/s0002-9394(01)00964-3
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发表时间：
2001-06-01
影响因子：
4.2
通讯作者：
Schulzer, M
中科院分区：
文献类型：
--
作者：
Drance, S;Anderson, DR;Schulzer, M
目得：为了揭示危险因素的高度可变的个人进展率的情况下，未经治疗的正常眼压性glaucoma.METHODS：视野数据收集从160名受试者（160只眼睛）参加了合作正常眼压性青光眼研究的时间间隔，在研究中的眼睛没有接受眼内压降低治疗，在prerandomization和postrandomization间隔。分析包括多变量分析的时间依赖性的考克斯比例风险，Kaplan-Meier分析的“生存”没有增加的视野恶化，和比较的斜率变化的平均偏差的全球指数随时间的推移。结果：大多数偏头痛发生在妇女，但分析表明，性别和偏头痛的存在分别贡献的整体风险。偏头痛的风险比，调整其他变量为2.58（P = .0058），椎间盘出血为2.72（P = .0036），女性为1.85（P = 0.0622），平均偏差指数的平均下降在非偏头痛女性比非偏头痛男性快（P = 0.05），表明遗传影响，亚洲人的进展速度较慢（P = 0.005），少数黑人患者的进展速度更快。然而，自称有青光眼家族史或接受青光眼治疗并不影响进展速度。年龄和未经治疗的眼压水平均不影响未经治疗的疾病进展率，尽管已知它们对患病率有影响。尽管患病率的风险因素有助于选择筛查青光眼的人群，影响进展速度的因素有助于决定个体未经治疗的疾病的预期预后，从而决定随访的频率。要采取的治疗的积极性和积极性。(Am J Ophthalmol 2001;131：699-708，（C）2001，Elsevier Science Inc.版权所有© 2016
PURPOSE: To uncover risk factors for the highly variable individual rates of progression in cases of untreated normal tension glaucoma.METHODS: Visual field data were assembled from 160 subjects (160 eyes) enrolled in the collaborative normal tension glaucoma study during intervals in which the eye under study was not receiving intraocular pressure-lowering treatment during prerandomization and post-randomization intervals. Analyses included multivariate analysis of time-dependent Cox proportional hazard, Kaplan-Meier analysis of "survival" without an increment of visual field worsening, and comparison of slopes of change in mean deviation global index over time.RESULTS: Most migraine occurred in women, but analysis demonstrated that gender and presence of migraine contribute separately to the overall risk. The risk ratio for migraine, adjusted for the other variables was 2.58 (P = .0058), for disk hemorrhage was 2.72 (P = .0036), and for female gender 1.85 (P = .0622), The average fall in the mean deviation index was faster in nonmigrainous women than in nonmigrainous men (P = .05), Suggesting genetic influence, Asians had a slower rate of progression (P = .005), and the few black patients enrolled had a tendency for faster progression. However, self-declared history of family with glaucoma or treated for glaucoma did not affect the rate of progression. Neither age nor the untreated level of intraocular pressure affected the rate of untreated disease progression, despite their known influence on prevalence.CONCLUSIONS: Whereas risk factors for prevalence help select populations within which to screen for glaucoma, the factors that affect the rate of progression help decide the expected prognosis of the individual's untreated disease and thereby the frequency of follow-up and aggressiveness of the therapy to be undertaken. (Am J Ophthalmol 2001;131:699-708, (C) 2001 by Elsevier Science Inc. All rights reserved.).