东非人群的青光眼特征：肯尼亚纳库鲁老年人的一项为期 6 年的队列研究。
Glaucoma Features in an East African Population: A 6-Year Cohort Study of Older Adults in Nakuru, Kenya.
机构信息
Clinical Research Department, International Centre for Eye Health, London School of Hygiene & Tropical Medicine.
Rwanda International Institute of Ophthalmology and Dr Agarwal's Eye Hospital, Kigali, Rwanda.
出版信息
J Glaucoma. 2018 May;27(5):455-463. doi: 10.1097/IJG.0000000000000941.
PURPOSE
Glaucoma is a leading cause of blindness in people of African descent. Minimal data is available from African population-based cohort studies. The primary aims of this study were to describe the normative distribution of glaucoma features to enable glaucoma classification and to assess risk factors for those with glaucoma at follow-up among people aged 50 years and above in Kenya.
MATERIALS AND METHODS
Random cluster sampling with probability proportionate to size was used to select a representative cross-sectional sample of adults aged 50 years and above in 2007 to 2008 in Nakuru District, Kenya. A 6-year follow-up was undertaken in 2013 to 2014. Comprehensive ophthalmic examination included visual acuity, digital retinal photography, visual fields, intraocular pressure, optical coherence tomography, and independent grading of optic nerve images. We report glaucoma features, prevalence and predictors for glaucoma based on the International Society for Geographical & Epidemiological Ophthalmology (ISGEO) criteria. Measures were estimated using a Poisson regression model and including inverse-probability weighting for loss to follow-up.
RESULTS
At baseline, 4414 participants aged 50 years and above underwent examination. Anterior chamber optical coherence tomography findings: mean anterior chamber angle of 36.6 degrees, mean central corneal thickness of 508.1 μm and a mean anterior chamber depth of 2.67 mm. A total of 2171 participants were examined at follow-up. The vertical cup to disc ratio distribution was 0.7 and 0.8 at the 97.5th and 99.5th percentiles, respectively. A total of 88 (4.3%, 95% confidence interval, 3.5%-5.9%) of participants at follow-up had glaucoma consistent with ISGEO criteria. A relative afferent pupillary defect and raised intraocular pressure were associated with the diagnosis.
CONCLUSIONS
Glaucoma is a public health challenge in low-resource settings. Research into testing and treatment modalities in Africa is needed.
目的
青光眼是导致非洲裔人群失明的主要原因。目前来自非洲人群的基于队列的研究数据很少。本研究的主要目的是描述青光眼特征的正常分布，以便进行青光眼分类，并评估肯尼亚 50 岁及以上人群在随访中患有青光眼的危险因素。
材料和方法
采用概率比例规模随机聚类抽样方法，于 2007 年至 2008 年在肯尼亚纳库鲁区选择了一个具有代表性的 50 岁及以上成年人的横断面样本。在 2013 年至 2014 年进行了 6 年的随访。全面眼科检查包括视力、数字眼底照相、视野、眼压、光学相干断层扫描和独立的视神经图像分级。我们根据国际地理和流行病学眼科学会（ISGEO）标准报告青光眼特征、患病率和青光眼预测因素。采用泊松回归模型进行估计，并对失访进行逆概率加权。
结果
基线时，4414 名 50 岁及以上的参与者接受了检查。前房光学相干断层扫描结果：平均前房角 36.6 度，平均中央角膜厚度 508.1μm，平均前房深度 2.67mm。共有 2171 名参与者在随访时接受了检查。垂直杯盘比分布在第 97.5 和 99.5 百分位数分别为 0.7 和 0.8。共有 88 名（4.3%，95%置信区间，3.5%-5.9%）在随访时有符合 ISGEO 标准的青光眼。相对传入瞳孔缺陷和眼压升高与诊断相关。
结论
在资源匮乏的环境中，青光眼是一个公共卫生挑战。需要在非洲进行关于检测和治疗方法的研究。
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