Hirooka Kazuyuki, Higashide Tomomi, Sakaguchi Kimikazu, Udagawa Sachiko, Sugiyama Kazuhisa, Oki Kenji, Kometani Mitsuhiro, Yoneda Takashi, Fukunaga Kensaku, Akita Tomoyuki, Baba Taro, Kiuchi Yoshiaki
From the Department of Ophthalmology and Visual Science, (K.H., T.B., Y.K.), Hiroshima University, Hiroshima, Japan.
Department of Ophthalmology (T.H., K.S., S.U., K.S.), Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
Am J Ophthalmol. 2025 Jan;269:339-345. doi: 10.1016/j.ajo.2024.09.014. Epub 2024 Sep 14.
To investigate patients with primary aldosteronism (PA) and the prevalence of normal-tension glaucoma (NTG).
Cross-sectional study.
Newly diagnosed PA patients were evaluated in this cross-sectional study, with ophthalmic examinations such as intraocular pressure measurements by a Goldmann applanation tonometer, central corneal thickness, slit-lamp biomicroscopic examination, gonioscopy, ophthalmoscopy, fundus photography, visual field test with a Humphrey Field Analyzer 24-2 SITA Standard program, and optical coherence tomography of the peripapillary retinal nerve fiber layer, performed in each of the subjects. Optic disc appearance, perimetric results, optical coherence tomography results, and other ocular findings were all used for determining the glaucoma diagnosis. The primary outcome was shown the prevalence of NTG in patients with PA.
NTG prevalence in the 212 PA patients was 11.8% (95% confidence interval [CI], 4.7%-20.7%). As compared to the hypertensive patients without PA, the hypertensive patients with PA exhibited a significantly increased NTG prevalence (odds ratio; 4.019, 95% CI, 1.223-13.205; P = .022). Increased NTG prevalence was associated with age, ranging from 8.8% (95% CI, 2.1%-15.6%) for those aged 40 to 49 years, to 37.5% (95% CI, 13.8%-61.2%) for those aged 70 years and older. In 72 hypertensive patients without PA, who were used as the controls, NTG prevalence was 5.2%, with a 95% CI ranging from 0.5% to 14.4%.
There was an 11.8% prevalence of NTG in PA patients, with these patients at an elevated risk of NTG, which was not mediated by blood pressure.
研究原发性醛固酮增多症（PA）患者及正常眼压性青光眼（NTG）的患病率。
横断面研究。
在这项横断面研究中，对新诊断的PA患者进行评估，对每位受试者进行眼科检查，如使用Goldmann压平眼压计测量眼压、测量中央角膜厚度、裂隙灯生物显微镜检查、前房角镜检查、检眼镜检查、眼底照相、使用Humphrey视野分析仪24-2 SITA标准程序进行视野测试以及对视乳头周围视网膜神经纤维层进行光学相干断层扫描。视盘外观、视野检查结果、光学相干断层扫描结果及其他眼部检查结果均用于确定青光眼诊断。主要结果为PA患者中NTG的患病率。
212例PA患者中NTG患病率为11.8%（95%置信区间[CI]，4.7%-20.7%）。与无PA的高血压患者相比，有PA的高血压患者NTG患病率显著升高（优势比；4.019，95% CI，1.223 - 13.205；P = 0.022）。NTG患病率增加与年龄相关，40至49岁人群中为8.8%（95% CI，2.1%-15.6%），70岁及以上人群中为37.5%（95% CI，13.8%-61.2%）。在72例无PA的高血压患者作为对照中，NTG患病率为5.2%，95% CI为0.5%至14.4%。
PA患者中NTG患病率为11.8%，这些患者患NTG的风险升高，且不受血压介导。
