Factors associated with lifetime risk of open-angle glaucoma blindness
Factors associated with lifetime risk of open-angle glaucoma blindness
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DOI：
10.1111/aos.12203
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发表时间：
2014-08-01
影响因子：
3.4
通讯作者：
Heijl, Anders
中科院分区：
文献类型：
--
作者：
Peters, Dorothea;Bengtsson, Boel;Heijl, Anders
目的：探讨双眼青光眼致盲的相关因素，尤其是诊断时可用的因素。方法：对2006年1月至2010年6月在瑞典马尔莫斯坎大学医院眼科或低视力中心死亡的所有原发性开角型青光眼(POAG)或假性剥脱性青光眼(PEXG)患者进行回顾性分析。诊断时的疾病分期由Mills的青光眼分期系统的简化版本定义，该系统使用周长平均偏差(MD)来定义六个严重程度阶段。根据世界卫生组织的标准定义失明。结果：共纳入423例青光眼患者，其中开角型青光眼占60%，青光眼占40%。64名患者(15%)因青光眼而失明。盲人患者确诊疾病的平均持续时间显著长于未失明的患者(14.8年+/-5.8年对10.6年+/-6.5年，p<；0.001)。眼压越高(OR1.08，95%可信区间1.03~1.13)，诊断时视野消失越严重(OR1.80，95%可信区间1.34~2.41)，失明风险就越高。死亡年龄越大，失明风险越高(OR1.09，95%可信区间1.03-1.14)，而确诊年龄并不重要。PEXG不是致盲的独立危险因素。结论：基线时眼压较高、视野状况较差以及死亡年龄较大是重要的危险因素。
Purpose: To investigate factors associated with bilateral glaucoma blindness, particularly factors available at the time of diagnosis.Methods: Retrospective chart review of all patients with primary open-angle glaucoma (POAG) or pseudoexfoliative glaucoma (PEXG) followed at the Department of Ophthalmology or Low Vision Center of Skane University Hospital, Malmo, Sweden, who died between January 2006 and June 2010. Disease stage at diagnosis was defined by a simplified version of Mills' glaucoma staging system using perimetric mean deviation (MD) to define six stages of severity. Blindness was defined according to WHO criteria. We used logistic regression analysis to examine the association between risk factors and glaucoma blindness.Results: Four hundred and 23 patients were included; 60% POAG and 40% PEXG. Sixty-four patients (15%) became blind from glaucoma. Blind patients had significantly longer mean duration with diagnosed disease than patients who did not go blind (14.8 years +/- 5.8 versus 10.6 years +/- 6.5, p < 0.001). The risk of blindness increased with higher intraocular pressure (IOP) (OR 1.08, 95% CI 1.03-1.13) and with each stage of more advanced field loss at time of diagnosis (OR 1.80 95% CI 1.34-2.41). Older age at death was also associated with an increased risk of blindness (OR 1.09 95% CI 1.03-1.14), while age at diagnosis was unimportant. PEXG was not an independent risk factor for blindness.Conclusions: Higher IOP and worse visual field status at baseline were important risk factors, as was older age at death.