Doheny Eye Institute and the Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Ophthalmology. 2012 Nov;119(11):2245-53. doi: 10.1016/j.ophtha.2012.05.030. Epub 2012 Jul 12.
To determine which baseline sociodemographic, lifestyle, anthropometric, clinical, and ocular risk factors predict the development of open-angle glaucoma (OAG) in an adult population.
A population-based, prospective cohort study.
A total of 3772 self-identified Latinos aged ≥40 years from Los Angeles, California, who were free of OAG at baseline.
Participants from the Los Angeles Latino Eye Study had standardized study visits at baseline and 4-year follow-up with structured interviews and a comprehensive ophthalmologic examination. We defined OAG as the presence of an open angle and a glaucomatous visual field abnormality and/or evidence of glaucomatous optic nerve damage in ≥1 eye. Multivariate logistic regression with stepwise selection was performed to determine which potential baseline risk factors independently predict the development of OAG.
Odds ratios for various risk factors.
Over the 4-year follow-up, 87 participants developed OAG. The baseline risk factors that predict the development of OAG include older age (odds ratio [OR] per decade, 2.19; 95% confidence interval [CI], 1.74-2.75; P<0.001), higher intraocular pressure (IOP; OR per mmHg, 1.18; 95% CI, 1.10-1.26; P<0.001), longer axial length (OR per mm, 1.48; 95% CI, 1.22-1.80; P<0.001), thinner central cornea (OR per 40 μm thinner, 1.30; 95% CI, 1.00-1.70; P = 0.050), higher waist-to-hip ratio (OR per 0.05 higher, 1.21; 95% CI, 1.05-1.39; P = 0.007) and lack of vision insurance (OR, 2.08; 95% CI, 1.26-3.41; P = 0.004).
Despite a mean baseline IOP of 14 mmHg in Latinos, higher IOP is an important risk factor for developing OAG. Biometric measures suggestive of less structural support such as longer axial length and thin central corneal thickness were identified as important risk factors. Lack of health insurance reduces access to eye care and increases the burden of OAG by reducing the likelihood of early detection and treatment of OAG.
FINANCIAL DISCLOSURE(S): The authors have no proprietary or commercial interest in any of the materials discussed in this article.
确定哪些基线社会人口学、生活方式、人体测量学、临床和眼部危险因素可预测成年人原发性开角型青光眼（OAG）的发生。
基于人群的前瞻性队列研究。
加利福尼亚州洛杉矶的 3772 名自认为是拉丁裔且年龄≥40 岁的成年人，他们在基线时均无 OAG。
来自洛杉矶拉丁裔眼病研究的参与者在基线和 4 年随访时接受了标准化的研究访问，包括结构化访谈和全面的眼科检查。我们将 OAG 定义为至少一只眼存在开放角和青光眼视野异常和/或青光眼视神经损伤的证据。采用逐步选择的多变量逻辑回归来确定哪些潜在的基线危险因素可独立预测 OAG 的发生。
各种危险因素的比值比。
在 4 年的随访期间，有 87 名参与者患上了 OAG。可预测 OAG 发生的基线危险因素包括年龄较大（每十年的比值比，2.19；95%置信区间，1.74-2.75；P<0.001）、眼内压（IOP）较高（每 mmHg 的比值比，1.18；95%置信区间，1.10-1.26；P<0.001）、眼轴较长（每毫米的比值比，1.48；95%置信区间，1.22-1.80；P<0.001）、中央角膜较薄（每 40 μm 变薄的比值比，1.30；95%置信区间，1.00-1.70；P = 0.050）、腰围-臀围比较高（每增加 0.05 的比值比，1.21；95%置信区间，1.05-1.39；P = 0.007）和缺乏视力保险（比值比，2.08；95%置信区间，1.26-3.41；P = 0.004）。
尽管拉丁裔人群的平均基线 IOP 为 14mmHg，但较高的 IOP 仍是发生 OAG 的重要危险因素。眼轴较长和中央角膜较薄等提示结构支撑不足的生物测量指标被确定为重要的危险因素。缺乏健康保险会减少获得眼部护理的机会，并通过降低早期发现和治疗 OAG 的可能性，增加 OAG 的负担。
作者与本文讨论的任何材料均无所有权或商业利益。
