Prevalence of primary angle-closure disease in an urban south Indian population and comparison with a rural population - The Chennai Glaucoma Study
Prevalence of primary angle-closure disease in an urban south Indian population and comparison with a rural population - The Chennai Glaucoma Study
复制标题
DOI：
10.1016/j.ophtha.2007.05.034
复制
发表时间：
2008-04-01
期刊：
影响因子：
13.7
通讯作者：
McCarty, Catherine
中科院分区：
文献类型：
--
作者：
Vijaya, Lingam;George, Ronnie;McCarty, Catherine
目的：确定原发性闭角型青光眼（PACG）、原发性闭角型青光眼（PAC）和PAC可疑青光眼（PACS）在城市人群中的患病率，并将患病率和相关危险因素与农村人群进行比较。所有受试者都进行了完整的眼科检查，包括最小分辨角视力的对数、压平眼压测量、前房角镜检查、透镜混浊分级、散瞳眼底检查、视盘照相和视野。主要结果测量：青光眼的诊断采用国际地理和流行病学眼科学会分类。3850例（80.2%）应答; 34例受试者（17例女性，17例男性）患有PACG（0.88%; 95%置信区间[CI]，0.60-1.16）。平均眼内压（IOP）为26.0 ± 14.9 mmHg。5例受试者（14.7%）既往被诊断为青光眼，其中1例接受了青光眼手术，2例被诊断为开角型青光眼。2例受试者（5.9%）为双侧盲，3例受试者（8.8%）为单侧盲。106例受试者（2.75%; 95% CI，2.01-3.49）被诊断为PAC（62例女性，44例男性）。39例受试者（36.8%）的IOP > 24 mmHg，83例（78.3%）有外周前粘连，16例（15.1%）两者都有。278例受试者（7.24%; 95% CI，6.38-8.02）有PACS（183例女性，95例男性）。PACG和PACS的患病率在城市和农村人群中相似。原发性房角关闭的患病率在城市人群中较高（P < 0.0001）。在两个人群中，原发性房角关闭和PACG与年龄和IOP增加呈正相关，在农村女性中更常见（比值比[OR]，4.3; 95% CI，2.2-8.3）。仅在城市人群中观察到与远视相关（OR，2.0; 95%CI，1.4-2.8）。结论：PACG和PACS在农村和城市人群中的患病率相似; PAC在城市人群中更常见。两组患者均无症状。低检出率可能是由于缺乏房角镜检查作为常规眼科检查的一部分。
Objective: To determine the prevalence of primary angle-closure glaucoma (PACG), primary angle closure (PAC), and PAC suspect (PACS) in an urban population, and to compare prevalence and associated risk factors with a rural population.Design: Population-based cross-sectional study.Participants: Four thousand eight hundred subjects 40 years or older were selected from Chennai city using multistage random cluster sampling.Intervention: All subjects had a complete ophthalmic examination that included logarithm of the minimum angle of resolution visual acuity, applanation tonometry, gonioscopy, grading of lens opacities, dilated fundus examination, optic disc photography, and visual fields.Main Outcome Measures: Glaucoma was diagnosed using the International Society of Geographical and Epidemiological Ophthalmology classification.Results: Three thousand eight hundred fifty (80.2%) responded; 34 subjects (17 female, 17 male) had PACG (0.88%; 95% confidence interval [CI], 0.60-1.16). The mean intraocular pressure (IOP) was 26.0 +/- 14.9 mmHg. Five subjects (14.7%) had been previously diagnosed to have glaucoma, 1 of whom had undergone glaucoma surgery and 2 of whom had been diagnosed to have open-angle glaucoma. Two subjects (5.9%) were bilaterally and 3 subjects (8.8%) were unilaterally blind. One hundred six subjects (2.75%; 95% Cl, 2.01-3.49) were diagnosed to have PAC (62 female, 44 male). Thirty-nine subjects (36.8%) had presenting IOP > 24 mmHg, 83 (78.3%) had peripheral anterior synechiae, and 16 (15.1%) had both. Two hundred seventy-eight subjects (7.24%; 95% Cl, 6.38-8.02) had PACS (183 female, 95 male). Prevalences of PACG and PACS were similar in the urban and rural populations. Primary angle closure prevalence was higher in the urban population (P < 0.0001). Primary angle closure and PACG were positively associated with increasing age and IOP in both populations and were more common in rural women (odds ratio [OR], 4.3; 95% Cl, 2.2-8.3). Association with hyperopia was seen only in the urban population (OR, 2.0; 95% Cl, 1.4-2.8).Conclusions: Prevalences of PACG and PACS were similar in the rural and urban populations; PAC was more common in the urban population. In both groups, the disease was asymptomatic. Poor detection rates were probably due to lack of gonioscopy as a routine part of an eye examination.