State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Br J Ophthalmol. 2019 Mar;103(3):355-360. doi: 10.1136/bjophthalmol-2017-311808. Epub 2018 May 18.
To determine the 10-year incidence of all forms of primary angle closure (PAC) in phakic eyes and its risk factors in an urban Chinese population aged 50 years and older.
Survivors of 1405 baseline participants were invited to attend the 10-year follow-up visit in the Liwan Eye Study. Participants with established baseline angle closure, including primary angle closure suspects (PACS), PAC and primary angle closure glaucoma (PACG), or those who underwent bilateral cataract surgery during the 10-year period, as well as those who did not tolerate gonioscopic examinations, were excluded from this analysis. Incident PAC was present when those with open angles at baseline developed angle closure in any form in either eye during the 10-year period.
Among 791 participants who returned during the 10-year follow-up visit, 620 (78.4%) provided data on PAC incidence. The 10-year cumulative incidence of any forms of PAC was 20.5% (127/620, 95% CI 17.4% to 24.9%), including 16.9%, 2.4% and 1.1% with incident PACS, PAC and PACG in either eye, respectively. In multiple logistic regression, significant risk factors for incident angle closure were greater baseline lens thickness (OR=1.82 per mm, p=0.003), shallower anterior chamber depth (OR=3.18 per mm decreased, p=0.010) and narrower angle width (OR=1.63 per decreased angle width, p<0.0001).
Approximately one in five people aged 50 years and older developed some form of angle closure over a 10-year period. Small ocular dimensions and hyperopia at baseline were associated with the development of angle closure.
在 50 岁及以上的中国城市人群中，确定原发性闭角型青光眼（PAC）各类型的 10 年发病率及其危险因素。
邀请了 1405 名基线参与者的幸存者参加荔湾眼病研究的 10 年随访。该研究排除了具有基线前房角关闭（包括原发性闭角型青光眼疑似患者、PAC、PACG）或在 10 年内接受双眼白内障手术、无法进行房角镜检查的患者，也排除了基线时具有正常房角但在 10 年内任何一眼发生任何类型房角关闭的患者。
在 10 年随访期间，791 名参与者中有 620 名（78.4%）提供了 PAC 发病率的数据。10 年任何形式 PAC 的累积发病率为 20.5%（127/620，95%CI 17.4%~24.9%），其中分别有 16.9%、2.4%和 1.1%的患者在任何一眼发生了原发性闭角型青光眼疑似患者、PAC 和 PACG。多因素逻辑回归分析显示，发生房角关闭的显著危险因素包括基线晶状体厚度更大（每增加 1mm，OR=1.82，p=0.003）、前房深度较浅（每减少 1mm，OR=3.18，p=0.010）和房角宽度较窄（每减少 1 个角度宽度，OR=1.63，p<0.0001）。
在 50 岁及以上的人群中，约五分之一的人在 10 年内发生了某种形式的房角关闭。基线时的小眼球尺寸和远视与房角关闭的发生有关。
