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中国人眼前房角宽度的决定因素及两年变化。

Determinants and two-year change in anterior chamber angle width in a Chinese population.

机构信息

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China.

出版信息

Ophthalmology. 2012 Dec;119(12):2500-6. doi: 10.1016/j.ophtha.2012.06.051. Epub 2012 Sep 8.

Abstract

OBJECTIVE

To study the population distribution and longitudinal changes in anterior chamber angle width and its determinants among Chinese adults.

DESIGN

Prospective cohort, population-based study.

PARTICIPANTS

Persons aged 35 years or more residing in Guangzhou, China, who had not previously undergone incisional or laser eye surgery.

METHODS

In December 2008 and December 2010, all subjects underwent automated keratometry, and a random 50% sample had anterior segment optical coherence tomography with measurement of angle-opening distance at 500 μm (AOD500), angle recess area (ARA), iris thickness at 750 μm (IT750), iris curvature, pupil diameter, corneal thickness, anterior chamber width (ACW), lens vault (LV), and lens thickness (LT) and measurement of axial length (AL) and anterior chamber depth (ACD) by partial coherence laser interferometry.

MAIN OUTCOME MEASURES

Baseline and 2-year change in AOD500 and ARA in the right eye.

RESULTS

A total of 745 subjects were present for full biometric testing in both 2008 and 2010 (mean age at baseline, 52.2 years; standard deviation [SD], 11.5 years; 53.7% were female). Test completion rates in 2010 varied from 77.3% (AOD500: 576/745) to 100% (AL). Mean AOD500 decreased from 0.25 mm (SD, 0.13 mm) in 2008 to 0.21 mm (SD, 13 mm) in 2010 (difference, -0.04; 95% confidence interval [CI], -0.05 to -0.03). The ARA decreased from 21.5 ± 3.73 10(-2) mm(2) to 21.0 ± 3.64 10(-2) mm(2) (difference, -0.46; 95% CI, -0.52 to -0.41). The decrease in both was most pronounced among younger subjects and those with baseline AOD500 in the widest quartile at baseline. The following baseline variables were significantly associated with a greater 2-year decrease in both AOD500 and ARA: deeper ACD, steeper iris curvature, smaller LV, greater ARA, and greater AOD500. By using simple regression models, we could explain 52% to 58% and 93% of variation in baseline AOD500 and ARA, respectively, but only 27% and 16% of variation in 2-year change in AOD500 and ARA, respectively.

CONCLUSIONS

Younger persons and those with the least crowded anterior chambers at baseline have the largest 2-year decreases in AOD500 and ARA. The ability to predict change in angle width based on demographic and biometric factors is relatively poor, which may have implications for screening.

FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

摘要

目的

研究中国成年人前房角宽度的人群分布和纵向变化及其决定因素。

设计

前瞻性队列,基于人群的研究。

参与者

年龄在 35 岁及以上、居住在中国广州、既往未行切口或激光眼科手术的人群。

方法

在 2008 年 12 月和 2010 年 12 月,所有受试者均接受自动角膜曲率计检查,随机抽取 50%的样本行眼前节光学相干断层扫描,测量 500μm 处房角开放距离(AOD500)、房角隐窝面积(ARA)、750μm 处虹膜厚度(IT750)、虹膜曲率、瞳孔直径、角膜厚度、前房宽度(ACW)、晶状体悬韧带(LV)和晶状体厚度(LT),并通过部分相干激光干涉仪测量眼轴长度(AL)和前房深度(ACD)。

主要观察指标

右眼 AOD500 和 ARA 的基线和 2 年变化。

结果

共有 745 名受试者在 2008 年和 2010 年均接受了完整的生物测量检查(基线时平均年龄为 52.2 岁,标准差为 11.5 岁;53.7%为女性)。2010 年的检测完成率在 77.3%(AOD500:576/745)至 100%(AL)之间。AOD500 平均值从 2008 年的 0.25mm(标准差为 0.13mm)下降到 2010 年的 0.21mm(标准差为 13mm)(差值为-0.04;95%置信区间为-0.05 至-0.03)。ARA 从 21.5±3.73×10(-2)mm(2)下降到 21.0±3.64×10(-2)mm(2)(差值为-0.46;95%置信区间为-0.52 至-0.41)。这种下降在年龄较小的受试者和基线时 AOD500 处于最宽四分位数的受试者中最为明显。以下基线变量与 AOD500 和 ARA 均有较大的 2 年下降显著相关:较深的 ACD、较陡的虹膜曲率、较小的 LV、较大的 ARA 和较大的 AOD500。使用简单回归模型,我们可以分别解释基线 AOD500 和 ARA 52%至 58%和 93%的变异,但只能分别解释 AOD500 和 ARA 2 年变化的 27%和 16%的变异。

结论

较年轻的人群和基线前房角最不拥挤的人群,AOD500 和 ARA 的 2 年降幅最大。基于人口统计学和生物测量学因素预测角度宽度变化的能力相对较差,这可能对筛查有影响。

金融披露

作者没有与本文讨论的任何材料有关的专有或商业利益。

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