Wu Johnny, Hewitt Alex W, Green Catherine M, Ring Maree A, McCartney Paul J, Craig Jamie E, Mackey David A
Department of Ophthalmology, Royal Hobart Hospital, University of Tasmania, Hobart, Tasmania, Australia.
Arch Ophthalmol. 2006 Jul;124(7):950-4. doi: 10.1001/archopht.124.7.950.
To determine whether there is a difference in disease severity between familial and sporadic primary open-angle glaucoma (POAG).
A cross-sectional study design compared the distribution of Glaucoma Inheritance Study in Tasmania (GIST) severity scores of patients with genealogically confirmed familial POAG and those with sporadic POAG. The GIST severity scores provide a combined weighting of glaucoma severity based on findings from visual field defects and optic disc analysis, with and without intraocular pressure. A Poisson regression analysis, t test, and chi(2) tests were performed.
One thousand twelve (59.5%) of 1700 subjects had familial glaucoma. The mean +/- SD age at examination was greater in the sporadic POAG group compared with the familial group (72.6 +/- 10.3 years vs 70.6 +/- 12.6 years; P = .001). The family group was significantly younger at diagnosis than the sporadic group (mean +/- SD, 61.4 +/- 13.0 years vs 64.0 +/- 12.6 years; P<.001). The GIST severity scores were significantly skewed toward greater disease severity in the familial group compared with the sporadic group (P<.001).
Identifying individuals at risk of severe POAG will be more successful if screening programs are developed with appropriate weighting toward those with a positive family history of the disease.
确定家族性和散发性原发性开角型青光眼(POAG)在疾病严重程度上是否存在差异。
采用横断面研究设计,比较经谱系确认的家族性POAG患者和散发性POAG患者的塔斯马尼亚青光眼遗传研究(GIST)严重程度评分分布情况。GIST严重程度评分基于视野缺损和视盘分析结果(无论有无眼压)对青光眼严重程度进行综合加权。进行了泊松回归分析、t检验和卡方检验。
1700名受试者中有1012名(59.5%)患有家族性青光眼。散发性POAG组的平均检查年龄(±标准差)高于家族性组(72.6±10.3岁对70.6±12.6岁;P = 0.001)。家族性组的诊断年龄显著低于散发性组(平均±标准差,61.4±13.0岁对64.0±12.6岁;P<0.001)。与散发性组相比,家族性组的GIST严重程度评分明显偏向于更严重的疾病严重程度(P<0.001)。
如果在制定筛查计划时对有该疾病家族史阳性的个体给予适当加权,那么识别严重POAG风险个体将会更成功。