Rai Bhim B, Sarac Ozge, van Kleef Joshua P, Maddess Ted
John Curtin School of Medical Research, Australian National University, Canberra, ACT, Australia.
Department of Ophthalmology, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan.
Clin Ophthalmol. 2023 Jan 6;17:107-114. doi: 10.2147/OPTH.S396879. eCollection 2023.
To inform national health policy, we quantified the pattern of neuro-ophthalmological disorders (NODs) presenting to the national vitreoretinal clinics in Bhutan.
Retrospective cross-sectional study.
We reviewed all new NODs patients over three years. Demographic data, presenting complaints, treatment history, systemic diseases, diagnostic procedures, and diagnoses were quantified. Logistic regression examined the odds of factors linked to more common NODs.
Of 226 patients, the majority were males (54.0%), farmers (60.2%), and urbanites (55.8%). Loss of vision was the most common presenting complaint (57.9%), followed by head or orbital trauma (19.5%). The best corrected visual acuity (BCVA) of 216 eyes (47.8%) was ≤6/60. Hypertension was the most common systemic disease (16.4%), followed by diabetes (3.5%), and intracranial space-occupying lesions (3.5%). Neuroimaging (37.6%) was the most common diagnostic test performed, followed by visual field testings (VFTs) (22.9%). With a NOD incidence of 7.8% p.a. (226/2913), optic atrophy (OA) was diagnosed in 134 patients (59.3%). Other common NODs were optic neuritis (15.5%), papilloedema (9.3%), and traumatic optic neuropathy (8.4%). Female gender increased the odds for glaucomatous OA by 2.65× (p = 0.044), and age by 1.09× per year (p < 0.001). Being female increased the odds of optic neuritis by 2.57× (p = 0.03).
Over half of the NODs were OA, which could be curable with timely treatment. Improved treatment of glaucoma and non-communicable diseases would reduce the risk of NODs-induced visual loss in Bhutan. The need for improved neuro-ophthalmological assessment and a coordinated multidisciplinary approach to NODs are the highest priorities.
为为国家卫生政策提供信息，我们对不丹全国玻璃体视网膜诊所的神经眼科疾病（NODs）模式进行了量化。
回顾性横断面研究。
我们回顾了三年来所有新的NODs患者。对人口统计学数据、就诊主诉、治疗史、全身性疾病、诊断程序和诊断进行了量化。逻辑回归分析了与更常见NODs相关因素的几率。
在226例患者中，大多数为男性（54.0%）、农民（60.2%）和城市居民（55.8%）。视力丧失是最常见的就诊主诉（57.9%），其次是头部或眼眶外伤（19.5%）。216只眼（47.8%）的最佳矫正视力（BCVA）≤6/60。高血压是最常见的全身性疾病（16.4%），其次是糖尿病（3.5%）和颅内占位性病变（3.5%）。神经影像学检查（37.6%）是最常用的诊断检查，其次是视野检查（VFTs）（22.9%）。NODs的年发病率为7.8%（226/2913），134例患者（59.3%）被诊断为视神经萎缩（OA）。其他常见的NODs包括视神经炎（15.5%）、视乳头水肿（9.3%）和外伤性视神经病变（8.4%）。女性患青光眼性OA的几率增加2.65倍（p = 0.044），年龄每增加一岁几率增加1.09倍（p < 0.001）。女性患视神经炎的几率增加2.57倍（p = 0.03）。
超过一半的NODs为OA，及时治疗可能治愈。改善青光眼和非传染性疾病的治疗将降低不丹因NODs导致视力丧失的风险。改善神经眼科评估以及采用协调的多学科方法治疗NODs是最优先事项。
