Preussner Paul-Rolf, Grossmann Allegra, Ngounou Faustin, Kouogan Gabriel, Tamon James
University Eye Hospital, Langenbeckstr. 1, 55101 Mainz, Germany.
Graefes Arch Clin Exp Ophthalmol. 2009 Dec;247(12):1671-5. doi: 10.1007/s00417-009-1166-7. Epub 2009 Aug 23.
To quantify glaucoma-related parameters in a rural African region.
In a population-based investigation, 635 persons in six villages underwent slit-lamp examination including investigation of the optic nerve head with a 90D lens and Goldmann applanation tonometry. The mean age of the persons was 49.4 +/- 19 years, minimum 5, maximum 90, median 52 years. The inferior, superior, nasal and temporal margin width of the optic nerve head (ONH) were estimated as fractions of the total disk diameter, thus allowing the evaluation of the horizontal and vertical cup-disk ratio (CDR), the ratio of the elliptical cup area to the total disk area (area CDR), and violations of the ISNT rule (Inferior>or=Superior>or=Nasal>or=Temporal ONH rim).
Area CDR significantly increased with age, on average from 0.1 in the youngest to 0.47 in the oldest person, corresponding to an increase of linear CDR from 0.32 to 0.68. The total fraction of eyes exceeding an area CDR of 0.5 (i.e. linear 0.7) was 13.4%. In addition, the intraocular pressure (IOP) increased on average from 14 mmHg in the youngest to 20 mmHg in the oldest persons, but nevertheless many high CDR values were found in eyes with normal to moderately elevated IOP. Violations of the ISNT rule were found in approximately 25% of the eyes. Application of a combination of glaucoma criteria as commonly used in literature resulted in a total prevalence of 18.7% of the screened persons, corresponding to a prevalence of 8.2% after age correction for the--on average--very young Cameroonian population.
Compared to Europe, glaucoma prevalence appears to be nearly an order of magnitude higher in this rural African population.
对非洲农村地区与青光眼相关的参数进行量化。
在一项基于人群的调查中，六个村庄的635人接受了裂隙灯检查，包括使用90D透镜对视神经乳头进行检查以及Goldmann压平眼压测量。这些人的平均年龄为49.4±19岁，最小5岁，最大90岁，中位数为52岁。视神经乳头（ONH）的下、上、鼻侧和颞侧边缘宽度被估计为整个视盘直径的分数，从而可以评估水平和垂直杯盘比（CDR）、椭圆形杯面积与整个视盘面积的比值（面积CDR）以及ISNT规则（下方≥上方≥鼻侧≥颞侧ONH边缘）的违反情况。
面积CDR随年龄显著增加，平均从最年轻者的0.1增加到最年长者的0.47，相应的线性CDR从0.32增加到0.68。面积CDR超过0.5（即线性0.7）的眼睛总数比例为13.4%。此外，眼压平均从最年轻者的14 mmHg增加到最年长者的20 mmHg，但在眼压正常至中度升高的眼睛中仍发现许多高CDR值。约25%的眼睛存在ISNT规则的违反情况。应用文献中常用的青光眼标准组合，筛查人群的总患病率为18.7%，对于平均非常年轻的喀麦隆人群进行年龄校正后患病率为8.2%。
与欧洲相比，该非洲农村人群的青光眼患病率似乎高出近一个数量级。
