Bourne R R A, Sukudom P, Foster P J, Tantisevi V, Jitapunkul S, Lee P S, Johnson G J, Rojanapongpun P
Department of Epidemiology and International Eye Health, Institute of Ophthalmology, University College London, London, UK.
Br J Ophthalmol. 2003 Sep;87(9):1069-74. doi: 10.1136/bjo.87.9.1069.
To determine prevalence, demography, mechanism, and visual morbidity of glaucoma in urban Thai people.
790 subjects aged 50 years or older from Rom Klao district, Bangkok, Thailand, were enumerated in a population based cross sectional study. Each subject underwent the following investigations: visual acuity, visual field testing, slit lamp examination, applanation tonometry, gonioscopy, and an optic disc examination after mydriasis. Main outcome measures included visual acuity (logMAR), visual fields, intraocular pressure (IOP), gonioscopic characteristics, vertical cup/disc ratio (VCDR), prevalence of types of glaucoma. Glaucoma was diagnosed on the basis of optic disc appearance and visual field defects. In eyes in which the optic disc could not be examined, glaucoma was diagnosed when visual acuity was <3/60 and either IOP >99.5th percentile or there was evidence of previous glaucoma surgery.
701 subjects were examined (response rate 88.7%). In eyes with "normal" suprathreshold visual fields, the mean IOP was 13.3 mm Hg (97.5th percentile = 20 mm Hg). The 97.5th and 99.5th percentiles of VCDR were 0.72 and 0.86 respectively. Of the 701 subjects examined in the clinic, 27 had glaucoma (3.8%, 95% CI: 2.5 to 5.6), 16 had primary open angle glaucoma (POAG, prevalence 2.3%, 95% CI: 1.3 to 3.7), six were primary angle closure glaucoma (PACG, prevalence 0.9%, 95% CI: 0.3 to 1.9), and five were secondary glaucoma (SecG, prevalence 0.7%, 95% CI: 0.2 to 1.7). Among the 43 unilaterally blind subjects, glaucoma was the cause in five subjects (12%). One subject was bilaterally blind due to glaucoma (prevalence 11%, 95% CI: 0.3 to 61.9). 28 people (4%) were glaucoma suspects on the basis of optic disc appearance and six on the basis of visual fields only. 98 subjects (14%) had "occludable angles" in either eye, 22 of whom had primary angle closure (PAC, prevalence 3.1%, 95% CI: 1.9 to 4.7); 14 had peripheral anterior synechiae in either eye and eight had ocular hypertension (OHT).
POAG accounted for 67% of all glaucoma, PACG 21%, and secondary glaucomas 12%. Glaucoma was the second most common cause of severe unilateral visual loss.
确定泰国城市人群中青光眼的患病率、人口统计学特征、发病机制及视觉损害情况。
在泰国曼谷挽叻县进行了一项基于人群的横断面研究，纳入790名年龄在50岁及以上的受试者。每位受试者均接受了以下检查：视力、视野检测、裂隙灯检查、压平眼压测量、前房角镜检查以及散瞳后的视盘检查。主要观察指标包括视力（对数最小分辨角对数视力表）、视野、眼压（IOP）、前房角镜特征、垂直杯盘比（VCDR）、青光眼类型的患病率。青光眼根据视盘外观和视野缺损进行诊断。对于无法检查视盘的眼睛，当视力<3/60且眼压>IOP第99.5百分位数或有既往青光眼手术证据时，诊断为青光眼。
701名受试者接受了检查（应答率88.7%）。在视野“正常”且阈值以上的眼睛中，平均眼压为13.3 mmHg（第97.5百分位数 = 20 mmHg）。VCDR的第97.5和第99.5百分位数分别为0.72和0.86。在诊所检查的701名受试者中，27人患有青光眼（3.8%，95%可信区间：2.5至5.6），16人患有原发性开角型青光眼（POAG，患病率2.3%，95%可信区间：1.3至3.7），6人患有原发性闭角型青光眼（PACG，患病率0.9%，95%可信区间：0.3至1.9），5人患有继发性青光眼（SecG，患病率0.7%，95%可信区间：0.2至1.7）。在43名单侧失明的受试者中，5人（12%）是由青光眼导致的。1名受试者因青光眼双侧失明（患病率11%，95%可信区间：0.3至61.9）。28人（4%）根据视盘外观被怀疑患有青光眼，6人仅根据视野被怀疑患有青光眼。98名受试者（14%）一只或两只眼睛存在“可闭角”，其中22人患有原发性房角关闭（PAC，患病率3.1%，95%可信区间：1.9至4.7）；14人一只或两只眼睛存在周边前粘连，8人患有高眼压症（OHT）。
POAG占所有青光眼的67%，PACG占21%，继发性青光眼占12%。青光眼是严重单侧视力丧失的第二大常见原因。
