The Prevalence and Types of Glaucoma in an Urban Chinese Population The Singapore Chinese Eye Study
The Prevalence and Types of Glaucoma in an Urban Chinese Population The Singapore Chinese Eye Study
复制标题
DOI：
10.1001/jamaophthalmol.2015.1110
复制
发表时间：
2015-08-01
影响因子：
8.1
通讯作者：
Aung, Tin
中科院分区：
文献类型：
--
作者：
Baskaran, Mani;Foo, Reuben C.;Aung, Tin
青光眼的重要性在老龄化人口中是一个重大的公共卫生挑战。Danjong Pagar Eye研究报告了1997年新加坡华人人群中青光眼的患病率和危险因素，从而确立了该人群中较高的盲目率。目的了解新加坡华人成年人青光眼的患病率和相关危险因素，并与1997年的研究结果进行比较。设计、设置和参与了一项基于人群的调查，调查对象为4605名符合条件的个人，我们从新加坡西南部选取了3353名40岁或以上的中国成年人。参与者从2009年2月9日至2011年12月19日在一家三级保健研究机构接受检查。研究对象均接受裂隙灯眼科检查、压平眼压测量、中央角膜厚度测量、房角镜检查和扩张性眼底检查。主要结果和测量方法由国际地理与流行病学眼科学会指南定义的青光眼和根据2010年新加坡华人人口普查计算的年龄标准化患病率估计。结果3353例被调查者中，134例(4.0%)发生青光眼，其中原发性开角型青光眼57例(1.7%)，原发性闭角型青光眼49例(1.5%)，继发性青光眼28例(0.8%)。青光眼的年龄标化患病率(95%CI)为3.2%(2.7%-3.9%)；POAG为1.4%(1.1%-1.9%)；PACG为1.2%(0.9%-1.6%)。在多变量模型中，POAG与年龄较大、男性和眼压较高有关。在134名患有青光眼的参与者中，114人(85.1%；95%的可信区间，78.1%-90.1%)不知道自己的诊断。继发性青光眼致盲患病率(95%CI)为14.3%(5.7%~31.5%)，其次为PACG 10.2%(4.4%~21.8%)和POAG 8.8%(3.8%~18.9%)。与1997年报告的3.2%相比，我们没有发现青光眼患病率的差异(差异，-0.04%；95%可信区间，-1.2至1.2；P=.97)。结论与相关性新加坡华人青光眼的患病率可能在2.7%至3.9%之间，继发性青光眼是最能削弱视力的类型。与大约12年前的先前研究相比，我们无法确定有何不同。我们报告了以前未诊断的疾病的很高比例，这表明有必要提高公众对这种潜在致盲疾病的认识。
IMPORTANCE Glaucoma represents a major public health challenge in an aging population. The Tanjong Pagar Eye Study reported the prevalence and risk factors of glaucoma in a Singapore Chinese population in 1997, which established the higher rates of blindness in this population.OBJECTIVES To determine the prevalence and associated risk factors for glaucoma among Chinese adults in Singapore and to compare the results with those of the 1997 study. DESIGN, SETTING, AND PARTICIPANTS In a population-based survey of 4605 eligible individuals, we selected 3353 Chinese adults 40 years or older from the southwestern part of Singapore. Participants underwent examination at a single tertiary care research institute from February 9, 2009, through December 19, 2011.EXPOSURES All participants underwent slitlamp ophthalmic examination, applanation tonometry, measurement of central corneal thickness, gonioscopy, and a dilated fundus examination.MAIN OUTCOMES AND MEASURES Glaucoma as defined by the International Society of Geographical and Epidemiological Ophthalmology guidelines and age-standardized prevalence estimates computed as per the 2010 Singapore Chinese census. Blindness was defined as logMAR visual acuity of 1.00 (Snellen equivalent, 20/200 or worse).RESULTS Of the 3353 respondents, 134 (4.0%) had glaucoma, including primary open-angle glaucoma (POAG) in 57 (1.7%), primary angle-closure glaucoma (PACG) in 49 (1.5%), and secondary glaucoma in 28 (0.8%). The age-standardized prevalence (95% CI) of glaucoma was 3.2%(2.7%-3.9%); POAG, 1.4%(1.1%-1.9%); and PACG, 1.2%(0.9%-1.6%). In a multivariate model, POAG was associated with being older and male and having a higher intraocular pressure. Of the 134 participants with glaucoma, 114 (85.1%; 95% CI, 78.1%-90.1%) were not aware of their diagnosis. Prevalence (95% CI) of blindness caused by secondary glaucoma was 14.3%(5.7%-31.5%), followed by 10.2%(4.4%-21.8%) for PACG and 8.8% (3.8%-18.9%) for POAG. We could not identify a difference in the prevalence of glaucoma compared with the 3.2% reported in 1997 (difference, -0.04%; 95% CI, -1.2 to 1.2; P = .97).CONCLUSIONS AND RELEVANCE The prevalence of glaucoma among Singapore Chinese likely ranges from 2.7% to 3.9%, with secondary glaucoma being the most visually debilitating type. We could not identify a difference compared with previous studies approximately 12 years earlier. We report a high proportion of previously undiagnosed disease, suggesting the need to increase public awareness of this potentially blinding condition.