Kurtz S, Goldenfeld M, Melamed S
Sam Rothberg Glaucoma Center, Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer.
Harefuah. 2000 Feb 15;138(4):273-6, 342.
Glaucoma, the third leading cause of blindness in the western world, is characterized by painless, gradual loss of visual fields which may lead to severe visual impairment or even blindness. In 4 years of operation of a mobile glaucoma unit for screening and early diagnosis of glaucoma, 10,037 subjects aged 18-95 years were screened (4504 women, 45%); 55% were under 50 years (Graph 1). Ocular hypertension was diagnosed in 8.0%; primary open angle glaucoma (POAG) in 0.8%, with 2/3 already under treatment, the rest newly diagnosed. Pseudo-exfoliative glaucoma was diagnosed in 0.2%; only 2 cases had closed angle glaucoma; 91% of those screened were normal (Fig. 4; age stratification, Graph 3). POAG increased with age, from 0.2% in those under 40 years to 10% in those over 80; POAG was more common in men, but OHT was similar in both sexes (6.0% vs. 5.3%). There was no correlation between incidence of POAG and place of work except in the Sorek Nuclear Center (1.9% vs. 0.8%, p = 0.11). Other conditions significantly more frequent in POAG than normals were diabetes mellitus (x 2.5), systemic hypertension (x 4), myopia (x 2) and history of intraocular surgery (x 6).
青光眼是西方世界致盲的第三大主要原因,其特征是视野无痛性逐渐丧失,这可能导致严重视力损害甚至失明。在一个流动青光眼筛查和早期诊断单元运行的4年里,对10,037名年龄在18至95岁的受试者进行了筛查(4504名女性,占45%);55%的受试者年龄在50岁以下(图1)。诊断出高眼压症的比例为8.0%;原发性开角型青光眼(POAG)为0.8%,其中三分之二已经在接受治疗,其余为新诊断病例。剥脱性青光眼诊断率为0.2%;仅2例为闭角型青光眼;91%的筛查者结果正常(图4;年龄分层,图3)。POAG随年龄增长而增加,从40岁以下人群中的0.2%增至80岁以上人群中的10%;POAG在男性中更常见,但高眼压症在两性中相似(分别为6.0%和5.3%)。除了索雷克核中心外,POAG发病率与工作地点之间没有相关性(1.9%对0.8%,p = 0.11)。POAG患者中明显比正常人更常见的其他情况包括糖尿病(2.5倍)、系统性高血压(4倍)、近视(2倍)和眼内手术史(6倍)。