Detection of undiagnosed glaucoma by eye health professionals
Detection of undiagnosed glaucoma by eye health professionals
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DOI：
10.1016/j.ophtha.2004.01.029
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发表时间：
2004-08-01
期刊：
影响因子：
13.7
通讯作者：
Taylor, HR
中科院分区：
文献类型：
--
作者：
Wong, EYH;Keeffe, JE;Taylor, HR
目的：研究在过去的12个月内参加过眼科保健提供者的未确诊的开角型青光眼（OAG）的临床特征，并提出有助于早期发现青光眼的策略。设计：基于人群的横断面研究。参与者：1992年至1996年招募时年龄在40岁及以上的永久居民。从城市和农村队列的4744名参与者的聚类分层随机样本进行了研究。对所有符合条件的参与者进行结构化标准化访谈和散瞳眼部检查。获得了关于人口统计学特征、先前的眼病知识、使用眼科护理服务、眼内压、杯盘比、视野和视盘摄影的数据。所有疑似青光眼病例均提交给6名眼科医生组成的专家组，以确定青光眼诊断。主要结果测量：在过去12个月内由眼保健专业人员看到的参与者的临床特征，这些参与者先前未诊断为OAG，先前诊断为OAG，并且没有青光眼。在过去的12个月里，35名先前未确诊的参与者和43名先前确诊的参与者曾拜访过验光师或眼科医生或两者兼而有之。年龄和性别在未确诊和确诊的青光眼病例之间无显著差异。经Logistic回归分析，眼专业类型（比值比[OR]，45.17; 95%置信区间[95%CI]，5.89 - 346.17; P = 0.0002）和视野缺损的存在（OR，0.06; 95%CI，0.01 - 0.69，P = 0.020）是确诊和未确诊青光眼组之间唯一具有统计学意义的变量。不应将眼内压升高作为青光眼检查的唯一触发因素。2004年，美国眼科学会。
Purpose: To examine the clinical features of undiagnosed open-angle glaucoma (OAG) in people who have attended an eye care provider within the previous 12 months and to suggest strategies to assist in the early detection of glaucoma.Design: Population based cross-sectional study.Participants: Permanent residents aged 40 years and older at recruitment during 1992 through 1996.Methods: A cluster-stratified random sample of 4744 participants from the urban and rural cohorts was studied. Structured standardized interviews and dilated ocular examinations were conducted in all eligible participants. Data on demographic characteristics, prior knowledge of eye disease, use of eye care services, intraocular pressures, cup-to-disc ratios, visual fields, and photography of optic discs were obtained. All suspected glaucoma cases were submitted to a panel of 6 ophthalmologists to determine glaucoma diagnosis.Main Outcome Measures: Clinical features of participants seen by eye health professionals within the previous 12 months who have previously undiagnosed OAG, previously diagnosed OAG, and no glaucoma.Results: Thirty-five previously undiagnosed and 43 previously diagnosed participants had visited an optometrist or ophthalmologist or both in the previous 12 months. Age and gender were not significantly different between the undiagnosed and diagnosed glaucoma cases. After logistic regression, the type of eye professional seen (odds ratio [OR], 45.17; 95% confidence interval [95% CI], 5.89-346.17; P = 0.0002) and the presence of visual field defects (OR, 0.06; 95% CI, 0.01-0.69, P = 0.020) were the only statistically significant variables between the diagnosed and undiagnosed glaucoma groups.Conclusions: Raised intraocular pressure should not be relied on as the only triggering factor in glaucoma investigations. 2004 by the American Academy of Ophthalmology.