Tajimi Iwase Eye Clinic, Gifu, Tajimi, Japan.
Department of Ophthalmology, University of the Ryukyus, Graduate School of Medicine, Okinawa, Japan.
Ophthalmol Glaucoma. 2022 Mar-Apr;5(2):160-169. doi: 10.1016/j.ogla.2021.07.010. Epub 2021 Jul 30.
To study and compare factors contributing to the differentiation between diagnosed and undiagnosed primary angle-closure glaucoma (PACG) and primary open-angle glaucoma (POAG) in the same population.
Population-based survey.
All residents 40 years of age and older in Kumejima, Japan.
Primary angle-closure glaucoma and POAG were diagnosed according to the criteria of the International Society of Geographical and Epidemiological Ophthalmology. Factors contributing significantly to the differentiation between diagnosed and undiagnosed PACG and POAG were selected from various systemic, ocular, visual function, and fundus planimetric parameters using multivariate logistic regression analysis and were compared between the two diseases.
Factors contributing significantly to the differentiation between diagnosed and undiagnosed PACG and POAG.
The prevalence rates of PACG and POAG were 2.2% and 4.0%, respectively. A greater proportion of patients with PACG (34.1%) received a diagnosis previously compared with patients with POAG (17.2%; P = 0.004). Worse mean deviation on visual field (VF) testing (odds ratio, 0.869; 95% confidence interval, 0.788-0.959; P = 0.006) and the presence of signs suggestive of previous acute angle closure (odds ratio, 4.35; range, 1.66-11.36; P = 0.003) contributed to a established diagnosis of PACG at the time of screening. A greater vertical cup-to-disc ratio (3.74; range, 1.38-10.17; P = 0.012) contributed with marginal significance to an established diagnosis of POAG at the time of screening.
Primary angle-closure glaucoma was more likely to have been diagnosed previously than POAG during a screening examination. Examination of the anterior segment and VF may contribute more to the detection of PACG, and disc examination may contribute more to the detection of POAG.
研究和比较同一人群中已确诊和未确诊原发性闭角型青光眼（PACG）和原发性开角型青光眼（POAG）之间的鉴别因素。
基于人群的调查。
日本久米岛所有 40 岁及以上的居民。
根据国际眼科地理和流行病学学会的标准诊断原发性闭角型青光眼和 POAG。使用多元逻辑回归分析从各种全身、眼部、视觉功能和眼底平面参数中选择对已确诊和未确诊 PACG 和 POAG 之间的鉴别有显著贡献的因素，并在两种疾病之间进行比较。
对已确诊和未确诊 PACG 和 POAG 的鉴别有显著贡献的因素。
PACG 和 POAG 的患病率分别为 2.2%和 4.0%。PACG 患者（34.1%）之前接受诊断的比例明显高于 POAG 患者（17.2%；P=0.004）。视野（VF）检测的平均缺损值更差（优势比，0.869；95%置信区间，0.788-0.959；P=0.006）和存在提示先前急性闭角的迹象（优势比，4.35；范围，1.66-11.36；P=0.003）有助于在筛查时确定 PACG 的诊断。更大的垂直杯盘比（3.74；范围，1.38-10.17；P=0.012）有助于在筛查时确定 POAG 的诊断。
在筛查检查中，PACG 比 POAG 更有可能之前被诊断。眼前节和 VF 的检查可能对 PACG 的检测更有帮助，而视盘检查可能对 POAG 的检测更有帮助。
