亚洲人群的开角型和闭角型青光眼对视功能的影响。

Singapore Eye Research Institute, Singapore National Eye Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

J Glaucoma. 2013 Apr-May;22(4):330-5. doi: 10.1097/IJG.0b013e3182408593.

PURPOSE

To evaluate the impact of bilateral primary glaucoma on glaucoma-specific functioning in Asians.

METHODS

Patients with bilateral primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG) aged 40 years or above of Chinese ethnicity in Singapore were recruited. All underwent a comprehensive clinical assessment of glaucoma. Glaucoma was diagnosed with a standard criteria including optic disc abnormality and visual field defect. The Glaucoma Quality of Life-15, a glaucoma-specific questionnaire, was used to evaluate the impact of glaucoma, and Rasch analysis was used to validate the Glaucoma Quality of Life-15.

RESULTS

A total of 192 patients (mean±SD age, 65.73±17.6 y and 65.1% male) were recruited, of which 56.2% (n=108) and 43.8% (n=84) had POAG and PACG, respectively. Fifty-four (28.1%), 85 (44.3%), and 53 (27.6%) had bilateral mild glaucoma, mild glaucoma in 1 eye and moderate/severe glaucoma in the other, and bilateral moderate/severe glaucoma, respectively. In multivariate analyses, compared with patients with mild glaucoma in both eyes, those with (a) mild glaucoma in 1 eye and moderate/severe in other; and (b) moderate/severe glaucoma in both eyes, reported significantly poorer functioning (β-coefficient=-8.20; confidence interval, -14.36 to -2.04; P<0.05) and (β=-21.05; confidence interval, -28.06 to -14.04; P<0.05), respectively. A similar independent association was found for POAG and PACG. These associations were also considered to be clinically significant while comparing bilateral mild glaucoma with bilateral moderate/severe glaucoma. We however, found no significant difference for functioning and severity of glaucoma between PACG and POAG patients (P<0.05).

CONCLUSIONS

Bilateral glaucoma is worse than the mild form in any eye and is significantly associated with poor glaucoma-specific functioning in this Singaporean Chinese sample. These data emphasize the need for strategies to identify patients early and prevent deterioration beyond the mild form of the condition.

目的

评估亚洲人双侧原发性青光眼对青光眼特定功能的影响。

方法

在新加坡招募了年龄在 40 岁及以上的双侧原发性开角型青光眼（POAG）和原发性闭角型青光眼（PACG）的中国裔患者。所有患者均接受了全面的青光眼临床评估。青光眼的诊断采用包括视盘异常和视野缺损在内的标准标准。使用青光眼特定问卷-15 评估青光眼的影响，使用 Rasch 分析验证青光眼生活质量-15。

结果

共招募了 192 名患者（平均年龄±标准差，65.73±17.6 岁，65.1%为男性），其中 56.2%（n=108）和 43.8%（n=84）分别患有 POAG 和 PACG。54 例（28.1%）、85 例（44.3%）和 53 例（27.6%）患有双侧轻度青光眼、一眼轻度青光眼和另一眼中度/重度青光眼以及双侧中度/重度青光眼。多变量分析显示，与双眼轻度青光眼患者相比，一眼轻度青光眼和另一眼中度/重度青光眼患者（a）和双眼中度/重度青光眼患者（b）的功能明显更差（β系数=-8.20；置信区间，-14.36 至-2.04；P<0.05）和（β=-21.05；置信区间，-28.06 至-14.04；P<0.05）。POAG 和 PACG 也存在类似的独立关联。在将双侧轻度青光眼与双侧中度/重度青光眼进行比较时，这些关联也被认为具有临床意义。然而，我们发现 PACG 和 POAG 患者的青光眼严重程度和功能之间没有显著差异（P<0.05）。