1st and 3rd University Departments of Ophthalmology, Aristotle University, Thessaloniki, Greece.
Eye Department, University of Oslo, Norway.
J Glaucoma. 2018 Jul;27 Suppl 1:S4-S11. doi: 10.1097/IJG.0000000000000908.
From a historical standpoint the epidemiology of exfoliation syndrome (XFS) is one of the most controversial subjects in ophthalmic literature. Current literature abounds with studies on the prevalence of XFS in various ethnic populations and clearly XFS is a common condition, but its true prevalence is difficult to ascertain. Overall, XFS is considered to be the most common identifiable cause of glaucoma worldwide.
This review critically examines the published literature documenting the epidemiological features of XFS and attempts to provide a unified concept concerning existing controversy.
A critical review of selected literature pertaining to the epidemiology of XFS.
It is well established that XFS and the ensuing exfoliative glaucoma have a worldwide prevalence and a progressively increasing age-related incidence. The prevalence of the condition is significantly underestimated. Many past studies have proposed clear geographic variations within and between ethnic groups. In contrast, there has also been some epidemiological evidence suggesting that the prevalence of XFS is similar within various ethnic groups. Published literature fails to address the potential role and impact of suspected exfoliation cases in the reported prevalence figures of the condition. Incidence figures for the condition are limited and vary extensively. Cumulative data have indicated that several, as yet partly understood genetic, ethnic, and environmental factors contribute to the varied prevalence of this condition.
Further understanding on XFS epidemiology is needed. Only a future large prospective study conducted by the same investigators, using similar methodologies for different ethnic populations will prove beyond doubt the hypothesis that significant geographic variations exist. Since patients with exfoliative glaucoma are at significant risk of losing vision it is vital to elucidate the causes and the risk of developing XFS. To reach this goal, it is important to better delineate the early changes of XFS and to focus research efforts on modifiable factors for XFS development.
从历史角度来看，剥脱综合征（XFS）的流行病学是眼科文献中最具争议的主题之一。目前的文献中充斥着关于 XFS 在不同种族人群中的流行率的研究，显然 XFS 是一种常见的疾病，但它的真实流行率很难确定。总的来说，XFS 被认为是全球最常见的可识别的青光眼病因。
本文批判性地回顾了已发表的文献，记录了 XFS 的流行病学特征，并试图提供一个关于现有争议的统一概念。
对与 XFS 流行病学相关的选定文献进行批判性回顾。
XFS 和随之而来的剥脱性青光眼在全球范围内具有流行率，且发病率随年龄呈递增趋势，这一点已得到充分证实。该疾病的流行率被严重低估。许多过去的研究提出了在种族群体内部和之间存在明显的地理差异。相比之下，也有一些流行病学证据表明，XFS 在不同种族群体中的流行率相似。发表的文献未能解决疑似剥脱病例在该疾病报告流行率中的潜在作用和影响。该疾病的发病率数据有限且差异很大。累积数据表明，一些尚未完全理解的遗传、种族和环境因素共同导致了该疾病的不同流行率。
需要进一步了解 XFS 的流行病学。只有由同一研究人员进行的未来的大型前瞻性研究，使用类似的方法对不同的种族群体进行研究，才能毫无疑问地证明存在显著的地理差异的假设。由于患有剥脱性青光眼的患者有显著的视力丧失风险，因此阐明 XFS 的病因和发病风险至关重要。为了达到这个目标，重要的是要更好地描绘 XFS 的早期变化，并将研究重点放在 XFS 发展的可改变因素上。
