Nine-year incidence of open-angle glaucoma in the Barbados Eye Studies
Nine-year incidence of open-angle glaucoma in the Barbados Eye Studies
复制标题
DOI：
10.1016/j.ophtha.2006.08.051
复制
发表时间：
2007-06-01
期刊：
影响因子：
13.7
通讯作者：
Hennis, A.
中科院分区：
文献类型：
--
作者：
Leske, M. Cristina;Wu, S. Y.;Hennis, A.
目的：确定巴巴多斯眼科研究中非洲裔参与者9年开角型青光眼（OAG）的发病率。设计：9年队列研究，参与率为81%至85%。参与者：3222名基线时无明确OAG的患者，随访时有发生OAG的风险。方法：标准化方案包括自动视野检查和各种眼科测量，并对转诊患者进行全面的眼科检查。眼底照片由蒙面分级者独立评价。通过乘积限方法估计发生率。相对危险度（RR）比和95%置信区间（Cls）基于离散时间的考克斯回归模型。主要结果测量：9年明确OAG的发病率，基于视野缺损和青光眼性视神经病变的发展，并经眼科证实。基于125例新发病例，9年明确OAG的发生率为4.4%（95% CI，3.7%-5.2%），或平均0.5%/年。发病率随着年龄的增长而显著增加，从40 - 49岁的2.2%增加到70岁或以上的7.9%，男性的发病率往往高于女性（4.9% vs. 4.1%; RR，1.3; 95% CI，0.9-1.8）。超过一半（53%）的新发病例未被发现，其中三分之一的患者的眼压为21 mmHg或更低。当考虑到141名疑似/可能发生OAG的患者时，总发病率为9.4%（8.4%-10.6%），平均约1%/年，也随年龄增长而增加，男性明显高于女性结论：这些新的数据提供了一个衡量非洲裔人群OAG长期风险的指标，该指标明显高于欧洲血统人群。结果证实，随着年龄的增长和男性的风险增加。发病率数据填补了我们对OAG风险理解的空白，并对公共卫生政策和规划产生影响;它们还将允许研究与OAG发展风险相关的因素。
Purpose: To determine the 9-year incidence of open-angle glaucoma (OAG) in African-descent participants of the Barbados Eye Studies.Design: Nine-year cohort study with 81% to 85% participation.Participants: Three thousand two hundred twenty-two persons without definite OAG at baseline, at risk of developing OAG at follow-up.Methods: The standardized protocol included automated perimetry and various ophthalmic measurements, with a comprehensive ophthalmologic examination for those referred. Fundus photographs were evaluated independently by masked graders. Incidence was estimated by the product-limit approach. Relative risk (RR) ratios with 95% confidence intervals (Cls) were based on Cox regression models with discrete time.Main Outcome Measure: Nine-year incidence of definite OAG, based on the development of visual field defects and glaucomatous optic neuropathy, with ophthalmologic confirmation.Results: The 9-year incidence of definite OAG was 4.4% (95% CI, 3.7%-5.2%), or an average of 0.5%/year, based on 125 new cases. Incidence increased greatly with age, from 2.2% at ages 40 to 49 years to 7.9% at ages 70 years or older, and tended to be higher in men than women (4.9% vs. 4.1 %; RR, 1.3; 95% CI, 0.9-1.8). More than half (53%) of new cases were undetected, and of these, one third had intraocular pressure of 21 mmHg or less. When 141 persons developing suspected/probable OAG were considered, the total incidence was 9.4% (8.4%-10.6%), averaging approximately 1 %/year, also increasing with age, and significantly higher in men than women (10.7% vs. 8.6%; RR, 1.31; 95% CI, 1.02-1.67).Conclusions: These new data provide a measure of the long-term risk of OAG in an African-descent population, which is markedly higher than in persons of European ancestry. Results confirm the increased risk with age and in men. The incidence data fill a gap in our understanding of OAG risk and have implications for public health policy and planning; they also will allow the study of factors related to the risk of OAG development.