加纳城市人群中青光眼进展的发生率和视野恶化的速率。
Incidence of Glaucoma Progression and Rate of Visual Field Deterioration in a Cohort of Urban Ghanaians.
机构信息
Department of Ophthalmology, University of North Carolina at Chapel Hill.
Department of Ophthalmology, Duke University, Durham, NC.
出版信息
J Glaucoma. 2022 Jul 1;31(7):503-510. doi: 10.1097/IJG.0000000000001984. Epub 2022 Jan 12.
PRCIS
The annual incidence of glaucoma progression (9.7%) and rates of visual field mean deviation (MD) change in progressors (-1.02±0.06 dB/y) are high in a small cohort of urban Ghanaians.
PURPOSE
To report the incidence of glaucoma progression and the rate of visual field deterioration in a small cohort of Ghanaians.
METHODS
One hundred ten subjects (204 eyes) diagnosed with glaucoma at a baseline population-based screening examination were re-examined a mean of 8.3±0.8 years later. Eyes were classified as having progressed if the optic disc alone, visual field alone or both showed significant glaucomatous changes on follow-up. Visual field MD was used to calculate the rate of visual field progression.
RESULTS
Progression was observed in 89 (80.9%, 9.7%/year) subjects (130 eyes). Progression occurred in 32 (31.7%, 3.8%/year) subjects by optic disc alone (46 eyes), 38 (44.7%, 5.4%/year) subjects by visual field alone (58 eyes), and 19 (25.0%, 3.0%/year) subjects by both modalities (26 eyes). The average rate of change in MD differed significantly between progressors (-1.02±1.06 dB/y) and nonprogressors (+0.089±0.49 dB/y), P =0.001. The rate of visual field worsening was greater among those who were classified as having progressed by both structure and function (-1.29±0.68 dB/y) and by function alone (-1.21±1.20 dB/y) than by structure alone (-0.55±0.76 dB/y). Progression was significantly associated with older age [odds ratio (OR), 1.42; P <0.001] and higher baseline intraocular pressure (OR, 1.18; P =0.002). Factors associated with rate of MD change were baseline older age (OR, 1.66; P =0.003), higher intraocular pressure (OR, 2.81; P =0.007), better visual field MD (OR, 1.41; P =0.004), and systemic hypertension (OR, 1.15; P =0.029).
CONCLUSION
The incidence and rate of visual field progression are high in this longitudinal study of Ghanaian subjects with glaucoma. The findings may have important clinical and public health policy ramifications.
PRCIS
在一个小型加纳城市人群中，青光眼进展的年发生率（9.7%）和进展者的视野平均偏差（MD）变化率（-1.02±0.06 dB/y）很高。
目的
报告加纳小型人群中青光眼进展的发生率和视野恶化的速度。
方法
对基线人群筛查检查中诊断为青光眼的 110 名受试者（204 只眼）进行了平均 8.3±0.8 年的后续检查。如果视神经盘单独、视野单独或两者都在随访中显示出明显的青光眼变化，则将眼睛分类为进展。使用视野 MD 计算视野进展的速度。
结果
89 名（80.9%，9.7%/年）受试者（130 只眼）观察到进展。32 名（31.7%，3.8%/年）受试者通过视神经盘单独进展（46 只眼），38 名（44.7%，5.4%/年）受试者通过视野单独进展（58 只眼），19 名（25.0%，3.0%/年）受试者通过两种方式进展（26 只眼）。进展者的 MD 平均变化率与非进展者有显著差异（-1.02±1.06 dB/y，P =0.001）。在结构和功能均进展（-1.29±0.68 dB/y）和仅功能进展（-1.21±1.20 dB/y）的患者中，视野恶化的速度大于仅结构进展（-0.55±0.76 dB/y）的患者。进展与年龄较大（比值比 [OR]，1.42；P <0.001）和较高的基线眼内压（OR，1.18；P =0.002）显著相关。与 MD 变化率相关的因素包括基线年龄较大（OR，1.66；P =0.003）、较高的眼内压（OR，2.81；P =0.007）、较好的视野 MD（OR，1.41；P =0.004）和高血压（OR，1.15；P =0.029）。
结论
在这项对加纳青光眼患者的纵向研究中，青光眼的发生率和视野进展速度均较高。研究结果可能具有重要的临床和公共卫生政策意义。
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