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色素性播散综合征和色素性青光眼:概述及种族差异。

Pigment dispersion syndrome and pigmentary glaucoma: overview and racial disparities.

机构信息

Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

Levy Mwanawasa University Teaching Hospital, Levy Mwanawasa Medical University, Lusaka, Zambia.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2023 Mar;261(3):601-614. doi: 10.1007/s00417-022-05817-0. Epub 2022 Sep 10.

Abstract

Pigment dispersion syndrome (PDS) and pigmentary glaucoma (PG) are two stages within the same ophthalmic disease spectrum, which are known to be affected by race. The prevalence of PDS is underestimated, largely due to its minor clinical symptoms. Although the prevalence of PG is low, the visual impairment associated with PG is extremely severe. The prevalence of PDS-PG is four or more times higher in Caucasians than in Blacks or Asians, and the "classic" PDS in Caucasians has long been used as a benchmark diagnostic criterion. Following extensive research focused on African Americans and Asians, the standard for diagnosing PDS-PG was refined. At the same time, the pathogenesis of PDS is not the same in different races. Hence, the effectiveness of preventive treatment and the need for treatment may not be equivalent in different races. The rate of conversion of PDS to PG is nearly 1/3 in Caucasians and higher in blacks and Asians, requiring more aggressive treatment and monitoring. We systematically searched a PubMed database from inception to March 2022 to provide an overview of research progress in various aspects of PDS-PG. Specifically, this paper considers the effects of race on disease prevalence, clinical manifestation, diagnostic criteria, disease mechanism, hereditary traits, treatment, and prevention to provide an accurate and comprehensive guide for the diagnosis and treatment of PDS-PG in various races.

摘要

色素播散综合征(PDS)和色素性青光眼(PG)是同一眼科疾病谱中的两个阶段,已知它们受种族影响。PDS 的患病率被低估了,主要是因为其临床症状较轻。虽然 PG 的患病率较低,但与 PG 相关的视力损害极其严重。白种人 PDS-PG 的患病率比黑人和亚洲人高 4 倍以上,白种人的“经典”PDS 长期以来一直被用作诊断标准。在对非裔美国人和亚洲人进行广泛研究后,对 PDS-PG 的诊断标准进行了细化。同时,PDS 的发病机制在不同种族之间并不相同。因此,不同种族的预防性治疗效果和治疗需求可能并不相同。PDS 向 PG 转化的速度在白种人中接近 1/3,在黑人和亚洲人中更高,需要更积极的治疗和监测。我们系统地检索了 PubMed 数据库,从建库到 2022 年 3 月,以提供 PDS-PG 各个方面研究进展的概述。具体来说,本文考虑了种族对疾病流行率、临床表现、诊断标准、发病机制、遗传特征、治疗和预防的影响,为不同种族 PDS-PG 的诊断和治疗提供了准确和全面的指导。

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