Department of Ophthalmology, University of Washington, Seattle, WA, USA.
Department of General Internal Medicine, University of Washington, Seattle, WA, USA.
Eye (Lond). 2021 Mar;35(3):952-958. doi: 10.1038/s41433-020-1003-0. Epub 2020 Jun 3.
BACKGROUND/OBJECTIVES: To determine the predictors of narrow angle detection in a United States population-based cohort.
This was a retrospective cohort study using the Massachusetts All-Payer Claims Database. Demographic information of all patients and eye care provider information during the years 2011-2015 were extracted from Massachusetts All Payers Claims Data. All payers who received eye care during 1/1/2012-12/31/2015 without any previous eye visit during 2011 were included in the analyses. Laser peripheral iridotomy was identified by Current Procedural Terminology code 66761. Narrow angle detection was defined as the diagnosis of narrow angles by diagnosis code followed by a laser peripheral iridotomy procedure. Different predictors of narrow angle detection were evaluated using Kaplan-Meier curves with the log rank and Cox regression modeling.
A total of 1,082,144 patients were included. The hazard ratio of narrow angle detection increased with age compared to the reference group of 0-10 years: 21-30 years of age (hazard ratio = 4.5), 31-40 (10.5), 41-50 (27.9), 51-60 (46.1), 61-70 (68.4), 71-80 (56.8) (all p < 0.0002), was 1.47 times higher in women and 1.85 times higher if evaluated by ophthalmologists compared to optometrists, after controlling for provider × time interaction.
Older age and female sex are associated with narrow angles. The rate of narrow angle detection was significantly higher if patients are seen by ophthalmologists compared to optometrists only. Evaluation with an ophthalmologist may be important for patients at high risks for developing primary angle closure glaucoma.
背景/目的：在美国人群队列中确定窄角检测的预测因素。
这是一项使用马萨诸塞州所有支付者索赔数据库的回顾性队列研究。从马萨诸塞州所有支付者索赔数据中提取了所有患者的人口统计学信息和 2011-2015 年期间的眼科护理提供者信息。在 2012 年 1 月 1 日至 2015 年 12 月 31 日期间接受过眼部护理且在 2011 年期间没有任何先前眼部就诊的所有支付者均纳入分析。激光周边虹膜切开术通过当前程序术语代码 66761 确定。窄角检测的定义是通过诊断代码诊断出窄角，然后进行激光周边虹膜切开术。使用 Kaplan-Meier 曲线和对数秩检验和 Cox 回归模型评估窄角检测的不同预测因素。
共纳入 1082144 例患者。与 0-10 岁的参考组相比，窄角检测的风险比随着年龄的增长而增加：21-30 岁（风险比=4.5），31-40 岁（10.5），41-50 岁（27.9），51-60 岁（46.1），61-70 岁（68.4），71-80 岁（56.8）（均<0.0002），女性风险比增加 1.47 倍，与视光师相比，如果由眼科医生评估，风险比增加 1.85 倍，控制了提供者×时间交互作用。
年龄较大和女性与窄角有关。与仅由视光师就诊相比，如果由眼科医生就诊，窄角检测率显著更高。对于有发生原发性闭角型青光眼风险的患者，眼科评估可能很重要。
