HV Desai Eye Hospital, Pune, Maharashtra, India.
Indian J Ophthalmol. 2011 Jan-Feb;59(1):29-35. doi: 10.4103/0301-4738.73720.
The aim was to identify the presenting symptoms and social risk factors for late presentation of primary glaucoma in newly diagnosed cases.
It was a case-control study in a tertiary eye care center in Maharashtra, India. Newly diagnosed patients with primary glaucoma were classified as cases (late presenters) where there was no perception of light in one eye or severe visual field loss affecting an area within 20° of fixation or a cup-disc (C:D) ratio ≥0.8 and controls (early presenters), presenting relative scotoma within 20° of fixation or a C:D ratio <0.8, but >0.5. All patients underwent a comprehensive ocular examination including gonioscopy, perimetry, and detailed family and social history. Occupation, education, and socioeconomic status were graded. SPSS version 12.0 was used, and univariate and multivariate logistic regression analysis was performed.
Gradual progressive painless loss of vision was the commonest symptom (175, 87.5%). Primary angle closure glaucoma was more common in females (P = 0.001) and lower socioeconomic groups (P = 0.05). Patients who were less educated were more likely to have late presentation of glaucoma (P < 0.001, odds ratio = 0.07; 95% CI, 0.02-0.25). Knowledge of family history of glaucoma (P = 0.80, odds ratio = 1.16; 95% CI, 0.36-3.71) and eye clinic attendance in past 2 years still resulted in late presentation (P = 0.45, odds ratio = 1.34, 95% CI, 0.63-2.82).
Lack of education and awareness of glaucoma were major risk factors for late presentation.
旨在确定原发性青光眼初诊患者迟发的临床表现症状和社会风险因素。
这是印度马哈拉施特拉邦一家三级眼科护理中心的病例对照研究。将初诊原发性青光眼患者分为病例组（迟发组）和对照组（早发组）。病例组（迟发组）表现为一眼无光感或严重视野丧失，影响 20°固视范围内的区域，或杯盘比（C:D）≥0.8；对照组（早发组）表现为 20°固视范围内相对性暗点或 C:D<0.8，但>0.5。所有患者均接受全面眼科检查，包括房角镜检查、视野检查以及详细的家庭和社会史。职业、教育和社会经济地位分级。使用 SPSS 版本 12.0，进行单变量和多变量逻辑回归分析。
逐渐进展、无痛性视力丧失是最常见的症状（175 例，87.5%）。女性（P=0.001）和较低社会经济群体（P=0.05）中更常见原发性闭角型青光眼。受教育程度较低的患者更有可能出现青光眼迟发（P<0.001，优势比=0.07；95%CI，0.02-0.25）。青光眼家族史知识（P=0.80，优势比=1.16；95%CI，0.36-3.71）和过去 2 年的眼科就诊情况仍导致迟发（P=0.45，优势比=1.34，95%CI，0.63-2.82）。
缺乏教育和对青光眼的认识是导致迟发的主要危险因素。
