Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Capital Medical University, Beijing, China
Department of Ophthalmology, 1st Hospital of Shijiazhuang, Shijiazhuang, China.
Br J Ophthalmol. 2021 Apr;105(4):502-506. doi: 10.1136/bjophthalmol-2020-316259. Epub 2020 Aug 7.
To study the risk factors associated with blindness after treatment of acute primary angle closure (APAC), and to identify the critical time window to decrease rate of blindness.
In this multicentre retrospective case series, 1030 consecutive subjects (1164 eyes) with APAC in China were recruited. The rates of blindness were analysed up to 3 months after treatment of APAC. A logistic regression was used to identify the risk factors associated with blindness, including age, gender, distance to hospital, rural or urban settings, treatment method, education level, time from symptom to treatment (TST, hours) and presenting intraocular pressure (IOP). The critical time window associated with a blindness rate of ≤1% was calculated based on a cubic function by fitting TST to the rate of blindness at each time point.
The rate of blindness after APAC was 12.54% after treatment. In multivariate regression, education level, TST and presenting IOP were risk factors for blindness (p=0.022, 0.004 and 0.001, respectively). The critical time window associated with a blindness rate of ≤1% was 4.6 hours.
Education level, TST and presenting IOP were risk factors for blindness after APAC. Timely medical treatment is key in reducing blindness after APAC.
研究急性原发性闭角型青光眼（APAC）治疗后失明的相关危险因素，并确定降低失明率的关键时间窗。
本多中心回顾性病例系列研究纳入了中国 1030 例（1164 只眼）APAC 连续患者。分析了 APAC 治疗后 3 个月内的失明率。采用逻辑回归分析与失明相关的危险因素，包括年龄、性别、距医院的距离、城乡环境、治疗方法、教育水平、症状至治疗时间（TST，小时）和就诊时眼压（IOP）。根据 TST 与各时间点失明率的三次函数拟合，计算失明率≤1%的关键时间窗。
APAC 治疗后失明率为 12.54%。多变量回归分析显示，教育水平、TST 和就诊时 IOP 是失明的危险因素（p=0.022、0.004 和 0.001）。失明率≤1%的关键时间窗为 4.6 小时。
教育水平、TST 和就诊时 IOP 是 APAC 后失明的危险因素。及时的医疗干预是降低 APAC 后失明的关键。
