L.V Prasad Eye Institute, Kallam Anji Reddy campus, L.V Prasad Marg, Banjara Hills, Hyderabad, India.
Ophthalmology. 2010 Sep;117(9):1729-35. doi: 10.1016/j.ophtha.2010.01.021. Epub 2010 May 13.
To estimate the prevalence and associated risk factors for primary angle-closure glaucoma (PACG), primary angle closure (PAC), and primary angle-closure suspects (PACS) in the Indian state of Andhra Pradesh.
A population-based, cross-sectional study using a stratified, random, cluster, and systematic sampling strategy.
Between 1996 and 2000, participants aged > or =40 years from 94 clusters in 1 urban and 3 rural areas were included.
Trained professionals performed a detailed eye examination, including visual acuity, refraction, slit-lamp biomicroscopy, applanation tonometry, gonioscopy, and dilated fundus evaluation after ruling out risk of angle closure. Humphrey threshold 24-2 visual fields (VFs) were performed when indicated by disc criteria or if intraocular pressure (IOP) was > or =22 mmHg.
Angle closure was diagnosed and categorized using International Society of Geographical and Epidemiological Ophthalmology criteria.
Primary angle-closure glaucoma was present in 35 of 3724 subjects aged > or =40 years, an age- and gender-adjusted prevalence of 0.94% (95% confidence interval [CI], 0.63-1.24). Primary angle closure was present in 12 subjects (0.3%; 95% CI, 0.1-0.5), and PACS was present in 71 subjects (2%; 95% CI, 1.5-2.3). The prevalence of angle-closure disease (ACD=PACG+PAC) was 1.26% (95% CI, 0.90-1.62). Forty-one of 47 subjects (87.2%) with ACD were unaware of their disease. The prevalence of PACG increased from 0.56% (0.17-0.94) in the fourth decade to 2.5% (0.87-4.12) in the seventh decade. Seven (20%) of the 35 subjects with PACG were blind (visual acuity <3/60). Intraocular pressure increase (odds ratio [OR] 1.16; 95% CI, 1.11-1.22; P<0.001), diabetes mellitus (OR 3.18l; 95% CI, 1.34-7.58; P=0.001), and female gender (OR 2.07; 95% CI, 1.09-3.93; P=0.025) were significantly associated with angle-closure disease. No significant association was found with systemic hypertension (P=0.24) and hyperopia (P=0.05).
The prevalence of PACG in this population was 0.94%. Increasing age, increasing IOP, diabetes mellitus, and female gender were significantly associated with angle-closure disease. Blindness due to PACG was 20%.
评估印度安得拉邦原发性闭角型青光眼（PACG）、原发性房角关闭（PAC）和原发性房角关闭可疑（PACS）的流行率及相关危险因素。
采用分层、随机、聚类和系统抽样策略的基于人群的横断面研究。
1996 年至 2000 年间，纳入了来自 1 个城市和 3 个农村地区的 94 个聚类中年龄≥40 岁的参与者。
经培训的专业人员进行了详细的眼部检查，包括视力、屈光、裂隙灯生物显微镜检查、压平眼压计、房角镜检查和排除了房角关闭风险后的眼底散瞳评估。如果眼底标准表明存在或眼内压（IOP）>22mmHg，则进行 Humphrey 阈值 24-2 视野（VF）检查。
采用国际地理和流行病学眼科协会标准诊断和分类房角关闭。
在 3724 名年龄≥40 岁的受试者中，有 35 名患有原发性闭角型青光眼，年龄和性别调整后的患病率为 0.94%（95%置信区间[CI]，0.63-1.24）。有 12 名受试者（0.3%；95%CI，0.1-0.5）患有原发性房角关闭，71 名受试者（2%；95%CI，1.5-2.3）患有原发性房角关闭可疑。角型闭角型疾病（ACD=PACG+PAC）的患病率为 1.26%（95%CI，0.90-1.62）。47 名 ACD 患者中有 41 名（87.2%）不知道自己患有该病。PACG 的患病率从 40 岁组的 0.56%（0.17-0.94）增加到 70 岁组的 2.5%（0.87-4.12）。35 名 PACG 患者中有 7 名（20%）失明（视力<3/60）。眼压升高（比值比[OR]1.16；95%CI，1.11-1.22；P<0.001）、糖尿病（OR 3.18；95%CI，1.34-7.58；P=0.001）和女性（OR 2.07；95%CI，1.09-3.93；P=0.025）与角型闭角型疾病显著相关。未发现与系统性高血压（P=0.24）和远视（P=0.05）有显著相关性。
该人群的 PACG 患病率为 0.94%。年龄增长、眼压升高、糖尿病和女性与闭角型疾病显著相关。PACG 导致的失明占 20%。
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