Glaucoma Blindness at a Tertiary Eye Care Center.
Glaucoma Blindness at a Tertiary Eye Care Center.
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DOI：
10.18043/ncm.76.4.211
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发表时间：
2015-09
影响因子：
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通讯作者：
Rosdahl JA
中科院分区：
文献类型：
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作者：
Stone JS;Muir KW;Stinnett SS;Rosdahl JA
青光眼是导致不可逆性失明的重要原因。这项研究描述了一个大的，不同的青光眼患者群体的特点，并评估人口统计学和临床特征和失明之间的关联。通过对2007年7月至2010年7月期间在杜克眼科中心接受青光眼服务提供者治疗的患者（N = 1，454）进行回顾性病历审查收集数据。视力和视野标准用于确定患者是否符合法律的失明标准。对非盲青光眼患者（n = 1，258）和盲青光眼患者（n = 196）进行了描述性和比较性统计分析。还对原发性开角型青光眼患者进行了亚组分析。在该三级护理人群中，13%（n = 196）的青光眼患者符合法律的失明标准，其中近一半（n = 94）因青光眼失明，另外三分之一（n = 69）因青光眼相关失明。在所有视力水平最常见的青光眼诊断是原发性开角型青光眼。与白色患者相比，更大比例的黑人患者表现出视力丧失;与白色患者相比，黑人患者失明的比值比（OR）为2.25（95% CI，1.6-3.2）。与非盲患者相比，盲患者中全身性抗高血压药物的使用率更高（OR = 2.1; 95% CI，1.4-3.1）。一项仅包括原发性开角型青光眼患者的亚组分析显示，黑人和使用全身性抗高血压药物的结果相似。黑人患者和白色患者使用全身性抗高血压药物与失明之间的关系无差异（相互作用P = 0.268）。数据基于图表审查，相关性可能会受到不可测量因素的混淆。经治疗的全身性高血压可能与失明有关，其原因不能仅用种族来解释。此外，该研究表明，黑人患者和白色患者之间因青光眼失明的情况仍然存在差异。
Glaucoma is an important cause of irreversible blindness. This study describes the characteristics of a large, diverse group of glaucoma patients and evaluates associations between demographic and clinical characteristics and blindness. Data were gathered via retrospective chart review of patients (N = 1,454) who were seen between July 2007 and July 2010 by glaucoma service providers at Duke Eye Center. Visual acuity and visual field criteria were used to determine whether patients met the criteria for legal blindness. Descriptive and comparative statistical analyses were performed on the glaucoma patients who were not blind (n = 1,258) and those who were blind (n = 196). A subgroup analysis of only those patients with primary open-angle glaucoma was also performed. In this tertiary care population, 13% (n = 196) of glaucoma patients met criteria for legal blindness, nearly one-half of whom (n = 94) were blind from glaucoma, and another one-third of whom (n = 69) had glaucoma-related blindness. The most common glaucoma diagnosis at all levels of vision was primary open-angle glaucoma. A larger proportion of black patients compared with white patients demonstrated vision loss; the odds ratio (OR) for blindness was 2.25 (95% CI, 1.6–3.2) for black patients compared with white patients. The use of systemic antihypertensive medications was higher among patients who were blind compared with patients who were not blind (OR = 2.1; 95% CI, 1.4–3.1). A subgroup analysis including only patients with primary open-angle glaucoma showed similar results for both black race and use of systemic antihypertensive medications. The relationship between use of systemic antihypertensive medications and blindness was not different between black patients and white patients (interaction P = .268). Data were based on chart review, and associations may be confounded by unmeasured factors. Treated systemic hypertension may be correlated with blindness, and the cause cannot be explained solely by race. In addition, this study demonstrated that there is continued disparity between black patients and white patients with regards to blindness from glaucoma.