Swanson Mark W
Department of Optometry, University of Alabama at Birmingham, Birmingham, Alabama 35294-0010, USA.
Optom Vis Sci. 2011 Jan;88(1):86-92. doi: 10.1097/OPX.0b013e3181fc3638.
The International Society of Geographical and Epidemiological Ophthalmology (ISGEO) suggests a case definition for the prevalence studies of glaucoma based on the 97.5th and 99.5th percentile of vertical optic cup distribution among the evaluated population. Although multiple studies evaluating the prevalence of glaucoma have been undertaken in the last 20 years, case definitions have varied, and data on the underlying population distribution are sparse. This study evaluates the population distribution of 97.5th and 99.5th percentile of vertical cup disc ratio (VCDR) and VCDR asymmetry (VCDRA) in the US population and its association with demographic characteristics, self-reported glaucoma, and visual field.
The National Health and Nutrition Examination Survey (NHANES) is a nationally representative sample of the US population, which during the years 2005 to 2008 collected frequency doubling technology screening fields and digital fundus photography. Accounting for the complex design of the NHANES population, estimates of the 97.5th and 99.5th percentile of VCDR and VCDRA were calculated, and national estimates of glaucoma prevalence were generated. Associations between disc characteristics, demographic variables, and self-reported glaucoma were explored.
Approximately 2.11% (95% confidence interval, 1.55 to 2.67) of the US population older than 40 years has glaucoma based on ISGEO criteria. A much larger 5.13% (95% confidence interval, 4.43 to 5.85) of the US population older than 40 years self-reports having glaucoma. Based on the estimates from NHANES, 6.89% of the population has a VCDR or VCDRA >97.5th percentile in either eye or OU. For the at-risk population with VCDR/VCDRA above the 97.5th percentile, <20% reported having glaucoma, whereas for those at the 99.5th percentile, <50% reported having glaucoma.
The prevalence of glaucoma from NHANES based on ISGEO criteria produces similar population estimated to other population-based studies. Self-reported glaucoma is ∼2.4 times more common than what the prevalence estimates suggest.
国际地理与流行病学眼科学会（ISGEO）基于所评估人群中垂直视杯分布的第97.5百分位数和第99.5百分位数，提出了青光眼患病率研究的病例定义。尽管在过去20年中已经开展了多项评估青光眼患病率的研究，但病例定义各不相同，且关于基础人群分布的数据稀少。本研究评估了美国人群中垂直杯盘比（VCDR）和VCDR不对称性（VCDRA）的第97.5百分位数和第99.5百分位数的人群分布及其与人口统计学特征、自我报告的青光眼和视野的关联。
国家健康与营养检查调查（NHANES）是美国人群具有全国代表性的样本，在2005年至2008年期间收集了频率加倍技术筛查视野和数字眼底照片。考虑到NHANES人群的复杂设计，计算了VCDR和VCDRA的第97.5百分位数和第99.5百分位数的估计值，并生成了青光眼患病率的全国估计值。探讨了视盘特征、人口统计学变量与自我报告的青光眼之间的关联。
根据ISGEO标准，40岁以上的美国人群中约2.11%（95%置信区间，1.55至2.67）患有青光眼。40岁以上的美国人群中自我报告患有青光眼的比例要高得多，为5.13%（95%置信区间，4.43至5.85）。根据NHANES的估计，6.89%的人群单眼或双眼的VCDR或VCDRA>第97.百分位数。对于VCDR/VCDRA高于第97.5百分位数的高危人群，<20%报告患有青光眼，而对于处于第99.5百分位数的人群，<50%报告患有青光眼。
基于ISGEO标准的NHANES青光眼患病率得出的人群估计值与其他基于人群的研究相似。自我报告的青光眼比患病率估计值所显示的情况普遍约2.4倍。
