Wan-Ezatul-Arisha Wan Masri, Diana-Toh Shi Jin, Huwaina Abdul Satar, Najib Majdi Yaakob, Azhany Yaakub, Norsa'adah Bachok, Liza-Sharmini Ahmad Tajudin
Unit of Biostatistics and Research Methodology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150, Kota Bharu, Kelantan, Malaysia.
Department of Ophthalmology and Visual Science, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150, Kota Bharu, Kelantan, Malaysia.
Graefes Arch Clin Exp Ophthalmol. 2022 Jun;260(6):2003-2012. doi: 10.1007/s00417-021-05466-9. Epub 2021 Nov 1.
This study aims to determine the 5-year visual field progression and identify the prognostic factors for progression in Malay patients with primary glaucoma.
A retrospective cohort record review study was conducted among 222 patients (222 eyes) with primary glaucoma who were selected from a glaucoma research database of a tertiary center in Malaysia. The patients were Malays and diagnosed with primary open-angle glaucoma (POAG) or primary angle-closure glaucoma (PACG). Patients who were followed up regularly for at least 6 months between 1 January 2009 and 31 December 2014 and completed another 1-year follow-up after recruitment (between 1 January 2015 and 31 December 2015) were selected. Multiple prognostic factors that influence visual field progression were identified. Progression of visual field loss was based on the Advanced Glaucoma Intervention Study and Hodapp-Parrish-Anderson scores. Kaplan-Meier survival and Cox proportional hazard regression analyses were performed.
Sixty-three patients (28.4%) developed visual field progression after a mean (SD) follow-up of 6.9 (3.3) years. Those with POAG progressed faster (mean time, 10.6 years; 95% confidence interval [CI], 9.3, 11.9) than those with PACG (17.3 years; 95% CI, 14.8, 19.9) but not statistically significant. Disc hemorrhage and history of eye pain increased the risk of progression by 2.8-folds (95% CI, 1.6, 4.8) and 2.5-folds (1.4, 4.4), respectively.
The 5-year survival of the Malay primary glaucoma patients with visual field progression was similar with that of other Asian populations. However, aggressive management is required for those with disc hemorrhages and eye pain related to increased intraocular pressure.
本研究旨在确定马来西亚原发性青光眼患者5年视野进展情况，并识别进展的预后因素。
对从马来西亚一家三级中心的青光眼研究数据库中选取的222例原发性青光眼患者（222只眼）进行回顾性队列记录审查研究。患者均为马来人，诊断为原发性开角型青光眼（POAG）或原发性闭角型青光眼（PACG）。选取在2009年1月1日至2014年12月31日期间至少定期随访6个月并在招募后（2015年1月1日至2015年12月31日）完成另外1年随访的患者。识别影响视野进展的多个预后因素。视野丧失进展基于高级青光眼干预研究和霍达普-帕里什-安德森评分。进行了Kaplan-Meier生存分析和Cox比例风险回归分析。
平均（标准差）随访6.9（3.3）年后，63例患者（28.4%）出现视野进展。POAG患者进展更快（平均时间为10.6年；95%置信区间[CI]，9.3，11.9），快于PACG患者（17.3年；95%CI，14.8，19.9），但差异无统计学意义。视盘出血和眼痛病史分别使进展风险增加2.8倍（95%CI，1.6，4.8）和2.5倍（1.4，4.4）。
视野进展的马来西亚原发性青光眼患者的5年生存率与其他亚洲人群相似。然而，对于有视盘出血和与眼压升高相关眼痛的患者，需要积极治疗。
