Prevalence of glaucoma in the Australian National Eye Health Survey
Prevalence of glaucoma in the Australian National Eye Health Survey
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DOI：
10.1136/bjophthalmol-2017-311786
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发表时间：
2019-02-01
影响因子：
4.1
通讯作者：
Dirani, Mohamed
中科院分区：
文献类型：
--
作者：
Keel, Stuart;Xie, Jing;Dirani, Mohamed
目的 估计澳大利亚青光眼的患病率。方法 这是一项以人口为基础的研究，对 3098 名非土著澳大利亚人（50-98 岁）和 1738 名澳大利亚土著人（40-92 岁）进行了按偏远地区分层。每个参与者都接受了标准检查，包括视野评估、眼压测量和免散瞳眼底摄影。两名接受过专科培训的青光眼专家独立评估了相关病例记录（既往眼部病史、最佳矫正视力、倍频技术视野、Van Herick 分级、眼压和视盘中心照片），并根据确定性等级分配诊断：无、可能、很可能或明确的青光眼。结果 共有 4792 名（99.1%，其中 3062 名非土著和 1730 名土著）参与者的至少一只眼睛的视网膜照片可进行青光眼分级。非土著澳大利亚人和土著澳大利亚人的青光眼加权患病率（确定）分别为 1.5%（95% CI 1.0 至 2.2）和 0.6%（95% CI 0.4 至 1.1）。当将明确的青光眼病例和可能的青光眼病例合并起来时，非土著澳大利亚人的发病率为 3.4%（95% CI 2.7 至 4.3），澳大利亚土著居民的发病率为 1.6%（95% CI 1.1 至 2.3）。只有 52.4% 患有青光眼的非土著澳大利亚人和 28.0% 的澳大利亚土著人自我报告已知有青光眼病史。结论 我们估计 198 923 名 50 岁及以上的非土著澳大利亚人和 2139 名 40 岁及以上的土著澳大利亚人患有青光眼。鉴于青光眼未确诊率很高，加上澳大利亚人口显着老龄化，可能需要改进病例检测和获得低视力康复服务，以应对日益增长的青光眼负担。
Aim To estimate the prevalence of glaucoma in Australia. Methods This was a population-based study of 3098 non-Indigenous Australians (50-98 years) and 1738 Indigenous Australians (40-92 years) stratified by remoteness. Each participant underwent a standard examination that included visual field assessment, tonometry and non-mydriatic fundus photography. Two fellowship-trained glaucoma specialists independently assessed relevant case notes (past ocular history, best-corrected visual acuity, frequency doubling technology visual fields, Van Herick grade, intraocular pressure and optic disc-centred photographs) and assigned a diagnosis ranked on a scale of certainty: none, possible, probable or definite glaucoma. Results A total of 4792 (99.1%, 3062 non-Indigenous and 1730 Indigenous) participants had retinal photographs in at least one eye that were gradable for glaucoma. The weighted prevalence of glaucoma (definite) in non-Indigenous Australians and Indigenous Australians was 1.5% (95% CI 1.0 to 2.2) and 0.6% (95% CI 0.4 to 1.1), respectively. When definite and probable cases of glaucoma were combined, rates were 3.4% (95% CI 2.7 to 4.3) among non-Indigenous and 1.6% (95% CI 1.1 to 2.3) in Indigenous Australians. Only 52.4% of non-Indigenous Australians and 28.0% of Indigenous Australians with glaucoma self-reported a known history of glaucoma. Conclusion We estimate that 198 923 non-Indigenous Australians aged 50 years and over and 2139 Indigenous Australians aged 40 years and over have glaucoma. Given the high rates of undiagnosed glaucoma coupled with a significant ageing of the Australian population, improvements in case detection and access to low vision rehabilitation services may be required to cope with the growing burden of glaucoma.