Mitchell P, Smith W, Attebo K, Healey P R
Department of Ophthalmology, University of Sydney, Australia.
Ophthalmology. 1996 Oct;103(10):1661-9. doi: 10.1016/s0161-6420(96)30449-1.
The purpose of this study was to determine the prevalence of open-angle glaucoma and ocular hypertension in an Australian community whose residents are 49 years of age or older.
There were 3654 persons, representing 82.4% of permanent residents from an area west of Sydney, Australia, who were examined. The population was identified by a door-to-door census of all dwellings and by closely matched findings from the national census.
All participants received a detailed eye examination, including applanation tonometry, suprathreshold automated perimetry (Humphrey 76-point test), and Zeiss stereoscopic optic disc photography. Glaucoma suspects were asked to return for full threshold fields (Humphrey 30-2 test), gonioscopy, and repeat tonometry.
A 5-point hemifield difference on the 76-point test was found in 616 persons (19% of people tested). Humphrey 30-2 tests were performed on 336 glaucoma suspects (9.2% of population), of whom 125 had typical glaucomatous field defects. Two hundred three persons had enlarged or asymmetric cup-disc ratios (> or = 0.7 in 1 or both eyes or a cup-disc ratio difference of > or = 0.3). Open-angle glaucoma was diagnosed when glaucomatous defects on the 30-2 test matched the optic disc changes, without regard to the intraocular pressure level. This congruence was found in 87 participants (2.4%), whereas an additional 21 persons (0.6%) had clinical signs of open-angle glaucoma but incomplete examination findings. Open-angle glaucoma was thus found in 108 persons, a prevalence of 3.0% (95% confidence interval [CI], 2.5-3.6), of whom 49% were diagnosed previously. An exponential rise in prevalence was observed with increasing age. Ocular hypertension, defined as an intraocular pressure in either eye greater than 21 mmHg, without matching disc and field changes, was present in 3.7% of this population (95% CI, 3.1-4.3), but there was no significant age-related increase in prevalence. The prevalence of glaucoma was higher in women after adjusting for age (odds ratio, 1.5; CI, 1.0-2.2). There was no sex difference in the age-adjusted prevalence of ocular hypertension.
These data provide detailed age and sex-specific prevalence rates for open-angle glaucoma and ocular hypertension in an older Australian population.
本研究旨在确定澳大利亚一个居民年龄在49岁及以上的社区中开角型青光眼和高眼压症的患病率。
共有3654人接受了检查，他们占澳大利亚悉尼以西一个地区永久居民的82.4%。通过对所有住所进行挨家挨户的普查以及与全国人口普查结果进行紧密匹配来确定该人群。
所有参与者均接受了详细的眼部检查，包括压平眼压测量、超阈值自动视野计检查（Humphrey 76点测试）以及蔡司立体视盘摄影。青光眼疑似患者被要求回来进行全阈值视野检查（Humphrey 30 - 2测试）、房角镜检查和重复眼压测量。
在616人（占受检者的19%）的76点测试中发现了5点半视野差异。对336名青光眼疑似患者（占人群的9.2%）进行了Humphrey 30 - 2测试，其中125人有典型的青光眼性视野缺损。203人有杯盘比增大或不对称（一只或两只眼睛杯盘比≥0.7或杯盘比差值≥0.3）。当30 - 2测试中的青光眼性缺损与视盘变化相符时，无论眼压水平如何，均诊断为开角型青光眼。在87名参与者（2.4%）中发现了这种一致性，另外21人（0.6%）有开角型青光眼的临床体征但检查结果不完整。因此，共发现108例开角型青光眼患者，患病率为3.0%（95%置信区间[CI]，2.5 - 3.6），其中49%之前已被诊断。随着年龄增长，患病率呈指数上升。高眼压症定义为一只眼睛眼压大于21 mmHg且视盘和视野无相应变化，该人群中患病率为3.7%（95% CI，3.1 - 4.3），但患病率无明显的年龄相关性增加。调整年龄后，女性青光眼患病率较高（优势比，1.5；CI，1.0 - 2.2）。年龄调整后的高眼压症患病率无性别差异。
这些数据提供了澳大利亚老年人群中开角型青光眼和高眼压症按年龄和性别划分的详细患病率。
