Estimating the rate of progressive visual field damage in those with open-angle glaucoma, from cross-sectional data
Estimating the rate of progressive visual field damage in those with open-angle glaucoma, from cross-sectional data
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DOI：
10.1167/iovs.07-0866
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发表时间：
2008-01-01
影响因子：
4.4
通讯作者：
Foster, Paul J.
中科院分区：
文献类型：
--
作者：
Broman, Aimee Teo;Quigley, Harry A.;Foster, Paul J.
目的.通过使用基于人群的横断面研究的数据来估计开角型青光眼（OAG）受试者的视野进展率。采用青光眼视神经病变的标准，在9次随机抽样人群调查中确定OAG受试者。受试者为欧洲人、非洲人、中国人和西班牙裔。OAG损伤的测量是自动视野测试（Humphrey Field Analyzer; Carl Zeiss Meditec，Inc.，都柏林，CA）。进展率是所有受试者最差眼睛的损伤平均值除以自发病以来的平均时间。发病时间根据年龄别患病率估计。共有1066名OAG受试者提供了视野数据。每年分贝的平均恶化是：欧洲人，-1.12;西班牙人，-1.26;非洲人，-1.33;中国人-1.56（种族间差异，P = 0.16）。中国受试者的平均病程最短，为10.5年（95% CI：8.8-12.6），非洲受试者的平均病程最长，为15.4年（95% CI：14.6-15.9）。进展率与年龄或性别无关。通过结合疾病持续时间和进展率，该模型预测，在患者的一生中，15%或更少的最差眼睛将达到视野损伤量表的终点。OAG受试者中最差眼每年典型恶化的估计值表明进展速度略快于一些基于临床的研究。该比率在种族或性别之间没有显著差异，但在已知的接受过治疗的OAG患者和人工晶状体受试者中更差。
PURPOSE. To estimate the rate of visual field progression in open-angle glaucoma (OAG) subjects, by using data from population-based cross-sectional studies.METHODS. Subjects with OAG were identified in nine surveys of randomly sampled populations using standard criteria for glaucomatous optic neuropathy. Subjects were of European, African, Chinese, and Hispanic ethnicity. The measure of OAG damage was the mean deviation (MD) of an automated visual field test (Humphrey Field Analyzer; Carl Zeiss Meditec, Inc., Dublin, CA). The rate of progression was the mean of all subjects' damage in the worse eye divided by an average time since onset. Time since onset was estimated from age-specific prevalence rates.RESULTS. A total of 1066 subjects with OAG contributed visual field data. The mean worsening in decibels per year was: European-derived, -1.12; Hispanic, -1.26; African-derived, -1.33; and Chinese -1.56 (difference among ethnicities, P = 0.16). The mean duration of disease was lowest among Chinese persons at 10.5 years (95% CI: 8.8-12.6) and was highest in African-derived subjects at 15.4 years (95% CI: 14.6-15.9). The progression rate was not consistently related to age or gender. By combining disease duration and progression rate, the model predicted that 15% or fewer of the worse eyes would reach the end of the field damage scale in the patient's lifetime.CONCLUSIONS. The estimates of typical worsening per year in the worse eye among subjects with OAG suggested slightly more rapid progression than in some clinic-based studies. The rate did not differ significantly by ethnicity or gender, but was worse in those with known, treated OAG and in pseudophakic subjects.