Hendrickx K H, van den Enden A, Rasker M T, Hoyng P F
Department of Experimental Ophthalmology, The Netherlands Ophthalmic Research Institute, Amsterdam.
Ophthalmology. 1994 Jul;101(7):1165-72. doi: 10.1016/s0161-6420(94)31192-4.
In this longitudinal study, the cumulative incidence of patients with glaucoma and disc hemorrhages was investigated. A possible effect of glaucoma therapy on the incidence rate of disc hemorrhages was evaluated.
A group consisting of 68 patients with primary open-angle glaucoma (POAG), 34 with normal-pressure glaucoma, and 125 with suspected glaucoma (mean follow-up, 7.3 +/- 2.5 years; range 3-13 years) was observed closely with quarterly examinations.
In normal-pressure glaucoma, the cumulative incidence of patients with disc hemorrhages was 35.3%, which was significantly higher than for those with POAG (10.3%; P < 0.01) and for those with suspected glaucoma (10.4%; P < 0.001). The mean follow-up period before a first disc hemorrhage was detected was 2.5 +/- 2.8 years. In the bleeders, recurrent disc hemorrhages were observed in 67% of the patients with normal-pressure glaucoma, 29% of those with POAG, and 54% of glaucoma suspects. In normal-pressure glaucoma, therapy had no effect on the incidence rate of disc hemorrhages. In glaucoma suspects, a significant reduction of the incidence rate of disc hemorrhages per year (0.11 +/- 0.04) was observed during episodes with therapy compared with episodes without (0.43 +/- 0.15; P < 0.05). A concept of two populations (i.e., one with disc hemorrhages and the other never having them) seems to be valid for normal-pressure glaucoma, but not for POAG and suspected glaucoma.
The cumulative incidence of initial disc hemorrhages increases with time in POAG and suspected glaucoma, but reaches a limit in normal-pressure glaucoma. Glaucoma therapy may reduce the incidence rate of all, initial and recurrent, disc hemorrhages in patients with high pressures, but not in patients with normal-pressure glaucoma.
在这项纵向研究中，调查了青光眼和视盘出血患者的累积发病率。评估了青光眼治疗对视盘出血发病率的可能影响。
对一组由68例原发性开角型青光眼（POAG）患者、34例正常眼压性青光眼患者和125例疑似青光眼患者组成的队列（平均随访时间为7.3±2.5年；范围为3 - 13年）进行每季度一次的密切检查。
在正常眼压性青光眼中，视盘出血患者的累积发病率为35.3%，显著高于POAG患者（10.3%；P < 0.01）和疑似青光眼患者（10.4%；P < 0.001）。首次检测到视盘出血前的平均随访期为2.5±2.8年。在出血患者中，67%的正常眼压性青光眼患者、29%的POAG患者和54%的疑似青光眼患者出现了复发性视盘出血。在正常眼压性青光眼中，治疗对视盘出血发病率没有影响。在疑似青光眼中，与未治疗期相比，治疗期每年视盘出血发病率显著降低（0.11±0.04）（未治疗期为0.43±0.15；P < 0.05）。对于正常眼压性青光眼，两个群体（即一个有视盘出血，另一个从未有过视盘出血）的概念似乎是成立的，但对于POAG和疑似青光眼则不然。
在POAG和疑似青光眼中，初始视盘出血的累积发病率随时间增加，但在正常眼压性青光眼中达到一个极限。青光眼治疗可能会降低高眼压患者所有（初始和复发性）视盘出血的发病率，但对正常眼压性青光眼患者无效。
