Awareness of incident open-angle glaucoma in a population study
Awareness of incident open-angle glaucoma in a population study
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DOI：
10.1016/j.ophtha.2007.06.013
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发表时间：
2007-10-01
期刊：
影响因子：
13.7
通讯作者：
Leske, M. Cristina
中科院分区：
文献类型：
--
作者：
Hennis, Anselm;Wu, Suh-Yuh;Leske, M. Cristina
目的：评估巴巴多斯眼科研究中与开角型青光眼 (OAG) 发病率相关的因素。设计：队列研究，9 年应答率为 81% 至 85%。参与者：4,314 名非洲裔参与者，基线年龄 40 至 84 岁。方法：标准化研究访问包括对人口、医疗、保健和其他因素的访谈；各种眼科测量；眼底摄影；主要结果指标：确定的 OAG 是在眼科确认后根据视野和视盘标准定义的，无论眼压 (IOP) 是多少。事先未进行 OAG 诊断/治疗的确定事件参与者被认为不知情。逻辑回归分析评估了与 OAG 不知晓相关的因素。结果以优势比 (OR) 和 95% 置信区间 (CI) 表示。结果：9 年来，125 名参与者新出现了明确的 OAG，其中 53% 之前不知道。在基线时，不知情组的平均眼压（OR，0.86；95% Cl，0.79-0.94）明显低于知晓组，并且远视程度更高（OR，2.69；95% Cl，1.08-6.69）。大多数不知情和知情的参与者在上一年接受过 2 次医疗护理（72.7% 对比 83.1%）。然而，不知情组的人寻求眼部护理的频率低于意识到的组（最后一次就诊是在去年，33.4% vs. 64.4%）；这些就诊主要是为了眼镜（71.4% vs. 12.5%），大多数人仅在研究访视期间进行青光眼检查（72.7% vs. 37.3%）。不知情组报告称，去配镜师/验光师的次数多于私人眼科医生（OR，4.20；95% Cl，1.00-17.66），而去公共眼科诊所的次数较少（OR，0.18；95% Cl，0.04-0.86）。结论：超过一半的 OAG 事件参与者不知道自己的诊断。不知情与较低的眼压、远视和眼保健使用模式有关。尽管不知情组的人定期就医，但进行眼部护理和 OAG 检测的次数却很有限。与私人眼科医生相比，当配镜师/验光师作为常规眼科护理来源时，不知情的可能性高 4 倍，而公共眼科来源的可能性则低 80% 左右。这些发现强调了未确诊 OAG 的高频率以及全面检查在疾病检测中的重要性。
Purpose: To evaluate factors related to awareness of incident open-angle glaucoma (OAG) in the Barbados Eye Studies.Design: Cohort study with 81 % to 85% response rate over 9 years.Participants: Four thousand three hundred fourteen participants of African descent, 40 to 84 years old at baseline.Methods: Standardized study visits included an interview on demographic, medical, health care, and other factors; various ophthalmic measurements; fundus photography; and comprehensive ophthalmologic examinations for those referred.Main Outcome Measures: Definite OAG was defined by both visual field and optic disc criteria after ophthalmologic confirmation, regardless of intraocular pressure (IOP). Definite incident participants without prior OAG diagnosis/treatment were considered unaware. Logistic regression analyses evaluated factors associated with OAG unawareness.Results were expressed as odds ratios (ORs) with 95% confidence intervals (CIs). Results: Over 9 years, 125 participants newly developed definite OAG, of whom 53% were previously unaware. At baseline, the unaware group had significantly lower mean IOP (OR, 0.86; 95% Cl, 0.79-0.94) and more hyperopia (OR, 2.69; 95% Cl, 1.08-6.69) than those aware. Most unaware and aware participants had :2 medical care visits in the previous year (72.7% vs. 83.1 %). However, those in the unaware group sought eye care less frequently than those aware (last visit in preceding year, 33.4% vs. 64.4%); these visits were mainly for eyeglasses (71.4% vs. 12.5%), with most having glaucoma tests only during study visits (72.7% vs. 37.3%). The unaware group reported more visits to opticians/optometrists than to private ophthalmologists (OR, 4.20; 95% Cl, 1.00-17.66) and fewer visits to a public ophthalmologic clinic (OR, 0.18; 95% Cl, 0.04-0.86).Conclusions: Over half of participants with incident OAG were unaware of their diagnosis. Unawareness was related to lower IOP, hyperopia, and eye care utilization patterns. Although persons in the unaware group had regular visits for medical care, visits for eye care and OAG testing were limited. Unawareness was 4 times more likely when opticians/optometrists were the regular eye care source, compared with private ophthalmologists, and about 80% less likely with a public ophthalmologic source. These findings highlight the high frequency of undiagnosed OAG and importance of comprehensive examinations in disease detection.