Liu Lance
Glaucoma Unit, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.
Clin Exp Ophthalmol. 2008 Jan-Feb;36(1):19-25. doi: 10.1111/j.1442-9071.2007.01623.x. Epub 2007 Nov 27.
To evaluate current glaucoma practices among consultant ophthalmologists in Australia and New Zealand.
A postal questionnaire of 25 questions regarding current glaucoma practices and the use of antimetabolites and steroids in trabeculectomy surgery was sent to all practising Australian and New Zealand Fellows of the Royal Australian and New Zealand College of Ophthalmologists (as of June 2005). This paper looked at glaucoma practice patterns and consisted of questions on demographic data, the definition of glaucoma, intraocular pressure measurements, central corneal thickness, gonioscopy, optic disc assessment, preferred first-line glaucoma medications and laser trabeculoplasty.
The overall response rate was 78% (627 out of 808). Ninety-one per cent stated that they managed glaucoma of which 12% considered themselves as a glaucoma subspecialist. Eighty-two per cent of ophthalmologists defined glaucoma as an optic neuropathy and 66% measured the intraocular pressure themselves. Pachymetry was routinely measured by 37%. When performing gonioscopy, 56% did this (more than 50% of the time) but only 13% repeated it. Fifty-eight per cent assessed the optic disc by objective means and 18% used this to follow glaucoma patients. Eighty-two per cent preferred a prostaglandin analogue as first-line treatment of primary open angle glaucoma and 79% did less than 10 argon laser trabeculoplasties in 2004.
This survey shows a wide range of glaucoma practice patterns among Australian and New Zealand ophthalmologists. Gonioscopy (initial and repeat) and objective assessment of the optic disc were poorly done.
评估澳大利亚和新西兰眼科顾问医生当前的青光眼诊疗实践。
向所有澳大利亚和新西兰皇家眼科医学院的在职研究员(截至2005年6月)发送了一份包含25个问题的邮政问卷,内容涉及当前青光眼诊疗实践以及小梁切除术中原代谢产物和类固醇的使用情况。本文研究了青光眼的诊疗模式,包括人口统计学数据、青光眼的定义、眼压测量、中央角膜厚度、前房角镜检查、视盘评估、首选的一线青光眼药物以及激光小梁成形术等问题。
总体回复率为78%(808人中627人回复)。91%的人表示他们诊治青光眼,其中12%认为自己是青光眼专科医生。82%的眼科医生将青光眼定义为视神经病变,66%的人亲自测量眼压。37%的人常规测量角膜厚度。进行前房角镜检查时,56%的人会这样做(超过50%的时间),但只有13%的人会重复检查。58%的人通过客观方法评估视盘,18%的人用此方法随访青光眼患者。82%的人首选前列腺素类似物作为原发性开角型青光眼的一线治疗药物,79%的人在2004年进行的氩激光小梁成形术少于10次。
本次调查显示澳大利亚和新西兰眼科医生的青光眼诊疗模式差异很大。前房角镜检查(初次和重复)以及对视盘的客观评估做得较差。