Ophthalmology, BIRDEM, Dhaka, Bangladesh.
Harun Eye Hospital, Dhaka, Bangladesh.
BMJ Open Ophthalmol. 2024 Mar 27;9(1):e001609. doi: 10.1136/bmjophth-2023-001609.
To delineate the epidemiological landscape of glaucoma using a population-based sample representative of Bangladesh.
Using multistage stratified cluster random sampling, households were selected to identify individuals ≥35 years across all 8 divisions of Bangladesh. Sampling frames were derived from the 2011 national census. Fifty-eight study examination sites were set up for comprehensive eye evaluations, including intraocular pressure, gonioscopy and visual field testing when indicated. International Society for Geographic and Epidemiological Ophthalmology definitions were used to define glaucoma and glaucoma suspect cases.
One hundred forty clusters (89 rural and 51 urban) were randomly selected, and 13 791 residential households were visited. We invited 17 002 individuals ≥35 years for on-site examination, of which 12 000 (71%) complied, with a male-to-female ratio of 1:1. The prevalence of glaucoma was 3.2% (95% CI 2.79% to 3.64%), and glaucoma suspect was 10.1% (95% CI 9.05% to 11.12%). The majority (78%) had primary open-angle glaucoma (POAG), while angle closure was seen in 16%. Of the POAG, 83% (n=251) were normal-tension glaucoma. Multivariable logistic regression showed increasing age (OR=1.01 for every 5-year increment, 95% CI 1 to 1.01) and male gender (OR=1.43, 95% CI 1.15 to 1.77) to be associated with an increased risk of glaucoma.
The prevalence of glaucoma in Bangladesh is 3.2% in ≥35-year-old individuals with older men most at risk. Extrapolating the results, we estimate about 2 million patients with glaucoma. Though normal-tension variety was the most common type, caution should be exercised in generalising these results to other populations.
利用代表孟加拉国的基于人群的样本描绘青光眼的流行病学情况。
使用多阶段分层聚类随机抽样，在孟加拉国的所有 8 个地区选择家庭以识别≥35 岁的个体。抽样框架源自 2011 年全国人口普查。在 58 个研究检查点建立了全面的眼部评估，包括在有指征时进行眼压、房角镜检查和视野检查。使用国际眼科地理和流行病学学会的定义来定义青光眼和青光眼疑似病例。
随机选择了 140 个（89 个农村和 51 个城市）聚类，访问了 13791 个居民家庭。我们邀请了 17002 名≥35 岁的个体进行现场检查，其中 12000 名（71%）符合要求，男女比例为 1:1。青光眼的患病率为 3.2%（95%可信区间 2.79%至 3.64%），青光眼疑似为 10.1%（95%可信区间 9.05%至 11.12%）。大多数（78%）患有原发性开角型青光眼（POAG），而 16%为闭角型青光眼。在 POAG 中，83%（n=251）为正常眼压性青光眼。多变量逻辑回归显示，年龄每增加 5 岁（OR=1.01，95%可信区间 1 至 1.01）和男性（OR=1.43，95%可信区间 1.15 至 1.77）与青光眼风险增加相关。
在≥35 岁的人群中，孟加拉国的青光眼患病率为 3.2%，年龄较大的男性风险最高。推断结果，我们估计有大约 200 万名青光眼患者。虽然正常眼压性青光眼是最常见的类型，但在将这些结果推广到其他人群时应谨慎。
