Department of Surgical Sciences, Ophthalmology, Uppsala University, Uppsala, Sweden.
Ups J Med Sci. 2024 Oct 28;129. doi: 10.48101/ujms.v129.10664. eCollection 2024.
Open-angle glaucoma (OAG) is a leading cause of irreversible blindness. There are no prospective studies on the risk of developing blindness in both eyes in individuals with definite OAG.
A total of 354 patients with newly diagnosed OAG, who had participated in four studies conducted at the Eye Department in Tierp, Sweden, from 1979 to 2006, were included in the investigation. Using the World Health Organization's criteria for blindness, medical records, glaucoma case records, and visual fields were reviewed to identify patients who developed bilateral blindness. Incidence proportions and incidence rates were estimated. To assess potential risk factors for blindness, standardised morbidity ratios (SMRs) were calculated. The effects of age and sex were also analysed using Cox proportional hazard models.
By the end of the study in August 2023, 33 cases of blindness caused by OAG had been found, corresponding to an incidence proportion of 9.3% (95% confidence interval [CI]: 6.5-12.8%). Within the first 20 years, 29 cases were detected, yielding a proportion of 8.2% (95% CI: 5.5-11.6%). The incidence rate was estimated to be 8.6 per 1,000 person-years (95% CI: 5.9-12.6 per 1,000 person-years). Glaucoma-related blindness was associated with male sex (SMR 2.33; 95% CI: 1.13-4.80). The hazard ratio was doubled for every 5 year of increasing age (2.21; 95% CI: 1.60-3.05).
In this study of blindness in newly diagnosed OAG in a Swedish population, approximately one in 10 patients progressed to bilateral blindness caused by the disease. Old age and male sex were identified as significant risk factors.
开角型青光眼（OAG）是不可逆失明的主要原因。目前尚无前瞻性研究探讨明确诊断为 OAG 的个体双眼失明的风险。
共纳入 354 例于 1979 年至 2006 年在瑞典 Tierp 眼科进行的四项研究中确诊的新发 OAG 患者。使用世界卫生组织（WHO）失明标准、病历、青光眼病例记录和视野检查来识别发生双眼失明的患者。估计发病率比例和发病率。为评估失明的潜在危险因素，计算标准化发病比（SMR）。还使用 Cox 比例风险模型分析年龄和性别效应。
截至 2023 年 8 月研究结束时，共发现 33 例由 OAG 引起的失明病例，发病率比例为 9.3%（95%置信区间[CI]：6.5-12.8%）。在前 20 年中，发现了 29 例，比例为 8.2%（95%CI：5.5-11.6%）。发病率估计为 8.6/1000 人年（95%CI：5.9-12.6/1000 人年）。与性别相关的青光眼相关失明与男性有关（SMR 2.33；95%CI：1.13-4.80）。年龄每增加 5 岁，风险比增加一倍（2.21；95%CI：1.60-3.05）。
在这项针对瑞典人群新发 OAG 失明的研究中，约每 10 名患者中就有 1 名进展为该病引起的双眼失明。年龄较大和男性是显著的危险因素。
