Socioeconomic status as a risk factor for late presentation of glaucoma in Canada
Socioeconomic status as a risk factor for late presentation of glaucoma in Canada
复制标题
社会经济地位是加拿大青光眼晚期发病的一个风险因素
DOI：
10.1016/j.jcjo.2012.10.003
复制
发表时间：
2013-04-01
影响因子：
4.2
通讯作者：
Jin, Ya-Ping
中科院分区：
文献类型：
--
作者：
Buys, Yvonne M.;Jin, Ya-Ping
目的：评估社会经济地位对晚期青光眼的影响。设计：前瞻性，多中心，横断面研究。参与者：新诊断的开角型青光眼。方法：符合条件的新诊断的开角型青光眼患者进行了全面的眼部检查，并根据加拿大眼科学会青光眼指南分为轻度，中度或晚期。社会经济地位是通过将受试者的邮政编码与2006年加拿大人口普查中的家庭收入中位数联系起来来估计的。五个平等的收入组，从最低到最高的收入五分之一被认为是比较关于频率和比例的中度或晚期glaucoma.Results：共290例被列入分析; 151（52.1%）轻度，79（26.9%）中度，60（21.0%）先进的疾病在初步诊断。新诊断的青光眼患者不太可能来自最贫困的社区（16.21%），相比之下，预计五分之一（20%）的患者出现在每个5个社会经济群体（P = 0.56）。与来自最贫穷社区的人相比，来自最富裕社区的人在首次就诊时患中度或晚期青光眼的风险略低（患病率为0.66，95%置信区间：0.43-1.02，P = 0.06）。结论：据我们所知，这是加拿大的第一项研究，提供证据表明社会经济剥夺与青光眼的严重程度相关，特别是对于那些>65岁的人。应考虑针对贫困地区进行青光眼教育，筛查或两者兼而有之。
Objective: To evaluate the effect of socioeconomic status on late presentation of glaucoma.Design: Prospective, multicentre, cross-sectional study.Participants: Newly diagnosed open-angle glaucoma.Methods: Eligible subjects with newly diagnosed open-angle glaucoma underwent a comprehensive ocular examination and were classified as mild, moderate, or advanced according to the Canadian Ophthalmological Society glaucoma guidelines. Socioeconomic status was estimated by linking the subjects' postal code to the median household income in the 2006 Canadian population census at the level of dissemination areas. Five equal income groups ranging from the lowest to the highest income quintile were considered and compared regarding the frequency and proportion of moderate or advanced glaucoma.Results: A total of 290 subjects were included in the analysis; 151 (52.1%) had mild, 79 (26.9%) moderate, and 60 (21.0%) advanced disease at initial diagnosis. Patients with newly diagnosed glaucoma were less likely to come from the poorest neighborhood areas (16.21%) when compared with an expected one fifth (20%) of patients presented in each of the 5 social economic groups (P = 0.56). Compared with people from the poorest neighborhood areas, people from the richest neighborhood areas had a marginally lower risk for having moderate or advanced glaucoma at first presentation (prevalence ratio 0.66, 95% confidence interval: 0.43-1.02, P = 0.06). This association was stronger among those >65 years old (P = 0.006).Conclusions: To the best of our knowledge, this is the first study in Canada to provide evidence that socioeconomic deprivation is associated with greater severity of glaucoma at presentation, specifically for those >65 years old. Consideration should be given to targeting poor neighborhood areas for glaucoma education, screening, or both.