Factors associated with undiagnosed open-angle glaucoma: The Thessaloniki Eye Study
Factors associated with undiagnosed open-angle glaucoma: The Thessaloniki Eye Study
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DOI：
10.1016/j.ajo.2007.09.013
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发表时间：
2008-02-01
影响因子：
4.2
通讯作者：
Wilson, M. Roy
中科院分区：
文献类型：
--
作者：
Topouzis, Fotis;Coleman, Anne L.;Wilson, M. Roy
目的：确定希腊塞萨洛尼基老年人群中与未确诊开角型青光眼 (OAG)、原发性开角型青光眼 (POAG) 和假性剥脱性青光眼 (PEXG) 相关的因素。设计：基于人群的横断面研究。方法：随机选择 60 岁以上的受试者 (n = 2,554) 参与该研究。根据具体标准并使用青光眼的两级定义，将受试者分类为患有 POAG 或 PEXG。未诊断的青光眼被定义为既没有事先诊断出青光眼或高眼压症，也没有接受过青光眼治疗或青光眼手术。以年龄、性别、青光眼家族史、白内障手术史、视力、垂直视杯与视盘 (C/D) 比率、眼压、高级青光眼干预研究视野评分、自上次眼科医生就诊以来的时间和 OAG 类型作为协变量进行逻辑回归分析。 结果：未确诊青光眼的患病率为 57.1% (56/98) POAG 的患病率显着高于 PEXG 的 34.9% (15/43) (P = .017)。与 PEXG 患者相比，POAG 患者未确诊的风险增加了三到四倍（分别为 P = .02 和 P = .04）。去年未去看眼科医生的 OAG 患者未确诊的风险增加六倍 (P = .003)。在 POAG 中，较小的垂直 C/D 比与未确诊风险增加具有统计学显着相关性 (P = .008)。结论：缺乏定期去看眼科医生是未确诊 OAG 的一个主要因素。 POAG 比 PEXG 更容易未被诊断。由于 C/D 比值与未诊断的 POAG 相关，因此建议眼科医生采用涉及视盘彻底评估的标准化方案。
PURPOSE: To identify factors associated with undiagnosed open-angle glaucoma (OAG), primary open-angle glaucoma (POAG), and pseudoexfoliative glaucoma (PEXG) in an elderly population in Thessaloniki, Greece.DESIGN: Cross-sectional population-based study.METHODS: Randomly selected subjects >= 60 years (n = 2,554) participated in the study. Subjects were classified as having POAG or PEXG according to specific criteria and using a two,scale definition of glaucoma. Undiagnosed glaucoma was defined as absence of either prior diagnosis of glaucoma or ocular hypertension or prior medical treatment for glaucoma or prior glaucoma surgery. Logistic regression analyses were performed with age, gender, family history of glaucoma, history of cataract surgery, visual acuity, vertical cup-to,disk (C/D) ratio, intraocular pressure, Advanced Glaucoma Intervention Study visual field score, time since last eye doctor visit, and type of OAG as covariates.RESULTS: The prevalence of undiagnosed glaucoma was 57.1% (56/98) for POAG, significantly higher than the prevalence of 34.9% (15/43) for PEXG (P = .017). POAG patients presented three to four times increased risk to be undiagnosed compared with PEXG patients (P = .02 and P = .04, respectively). Patients with OAG who had not visited an ophthalmologist during the last year had six times an increased risk to be undiagnosed (P = .003). In POAG, smaller vertical C/D ratio was statistically significantly associated with an increased risk to be undiagnosed (P = .008).CONCLUSIONS: Lack of regular visits to an ophthalmologist was a major factor for undiagnosed OAG. POAG was more likely to be undiagnosed than PEXG. Since C/D ratio was associated with undiagnosed POAG, standardized protocols involving thorough evaluation of the optic disk are recommended for ophthalmologists.