Vijaya Lingam, George Ronnie, Arvind Hemamalini, Baskaran M, Ve Ramesh S, Raju Prema, Kumaramanickavel Govindasamy, McCarty Catherine
Glaucoma Project, Vision Research Foundation, Sankara Nethralaya, Chennai, India.
Ophthalmology. 2008 Apr;115(4):655-660.e1. doi: 10.1016/j.ophtha.2007.05.034. Epub 2007 Sep 17.
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.
Population-based cross-sectional study.
Four thousand eight hundred subjects 40 years or older were selected from Chennai city using multistage random cluster sampling.
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.
Glaucoma was diagnosed using the International Society of Geographical and Epidemiological Ophthalmology classification.
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% CI, 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% CI, 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% CI, 2.2-8.3). Association with hyperopia was seen only in the urban population (OR, 2.0; 95% CI, 1.4-2.8).
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.
确定城市人群中原发性闭角型青光眼（PACG）、原发性房角关闭（PAC）和房角关闭可疑（PACS）的患病率，并与农村人群的患病率及相关危险因素进行比较。
基于人群的横断面研究。
采用多阶段随机整群抽样从金奈市选取4800名40岁及以上的受试者。
所有受试者均接受了全面的眼科检查，包括最小分辨角对数视力、压平眼压测量、前房角镜检查、晶状体混浊分级、散瞳眼底检查、视盘照相和视野检查。
采用国际地理和流行病学眼科学会的分类方法诊断青光眼。
3850名（80.2%）受试者做出回应；34名受试者（17名女性，17名男性）患有PACG（0.88%；95%置信区间[CI]，0.60 - 1.16）。平均眼压（IOP）为26.0±14.9 mmHg。5名受试者（14.7%）之前被诊断患有青光眼，其中1人接受了青光眼手术，2人被诊断为开角型青光眼。2名受试者（5.9%）双眼失明，3名受试者（8.8%）单眼失明。106名受试者（2.75%；95% CI，2.01 - 3.49）被诊断患有PAC（62名女性，44名男性）。39名受试者（36.8%）就诊时眼压>24 mmHg，83名（78.3%）有周边前粘连，16名（15.1%）两者均有。278名受试者（7.24%；95% CI，6.38 - 8.02）患有PACS（183名女性，95名男性）。城市和农村人群中PACG和PACS的患病率相似。原发性房角关闭在城市人群中的患病率更高（P<0.0001）。在两个人群中，原发性房角关闭和PACG均与年龄增长和眼压升高呈正相关，且在农村女性中更为常见（优势比[OR]，4.3；95% CI，2.2 - 8.3）。仅在城市人群中发现与远视有关联（OR，2.0；95% CI，1.4 - 2.8）。
农村和城市人群中PACG和PACS的患病率相似；PAC在城市人群中更为常见。在两组中，该病均无症状。检出率低可能是由于缺乏将前房角镜检查作为眼科检查常规项目所致。
