[色素性青光眼的青光眼家族史及危险因素。一项新的临床研究]

[Family history of glaucoma and risk factors in pigmentary glaucoma. A new clinical study].

作者信息

Gramer E, Thiele H, Ritch R

机构信息

Universitäts-Augenklinik Würzburg.

出版信息

Klin Monbl Augenheilkd. 1998 Jun;212(6):454-64. doi: 10.1055/s-2008-1034930.

DOI:10.1055/s-2008-1034930

PMID:9715466

Abstract

BACKGROUND

Whether a family history of glaucoma (FHG) in patients with pigmentary glaucoma (PG) is a prognostical indicator, is unknown. Therefore the aim of this study was to evaluate the influence of FHG on the severity of the disease in PG and pigment dispersion syndrome (PDS). Furthermore risk factors in PG and PDS were evaluated.

METHODS

The findings of 207 patients with PG and PDS, who were able to give information about FHG, were evaluated (149 PG, 43 PDS with ocular hypertension (OH), 15 PDS without OH).

RESULTS

Significance of FHG: FHG was found in 39.1%, and in one third of the patients more than one relative had the disease. FHG was found in PG not more frequent than in PDS. Pigmentary glaucomas in advanced stages of the disease did not have a higher incidence of FHG than patients in beginning stages. Out of 207 patients with PG and PDS 71% were male and 29% female (p < 0.001). In patients with FHG the share of men was 64.2% and not significantly different to the group without FHG with 75.4%. The sex distribution in parents and grandparents having a glaucomatous disease was 1:1.

RISK FACTORS

The pf1p4nts with and without FHG in PDS with and without OH, PG, and within the different stages of visual field loss, showed no significant differences in risk factors, for example in maximum intraocular pressure, refraction and cup-disc ratio. Myopia: Patients with PG had a significantly higher myopia than patients with PDS (p < 0.01). The higher the myopia, the earlier the disease was diagnosed (p = 0.008). Krukenberg spindle: During miotic therapy the Krukenberg spindle decreased in the upper half of the cornea. Time of diagnosis: PG was diagnosed at a higher age compared to PDS.

CONCLUSION

FHG does not influence the severity of the disease in PG. Family history of glaucoma is a risk factor in patients with PG, but no prognostical indicator. Patients with FHG do not have primarily larger cup-disc ratios than patients without FHG. Myopia is a risk factor.

摘要

背景

色素性青光眼（PG）患者的青光眼家族史（FHG）是否为预后指标尚不清楚。因此，本研究的目的是评估FHG对PG和色素播散综合征（PDS）疾病严重程度的影响。此外，还评估了PG和PDS的危险因素。

方法

对207例能够提供FHG信息的PG和PDS患者的检查结果进行评估（149例PG，43例伴有高眼压（OH）的PDS，15例不伴有OH的PDS）。

结果

FHG的意义：39.1%的患者存在FHG，三分之一的患者有不止一位亲属患有该病。PG患者中FHG的发现频率并不高于PDS患者。疾病晚期的色素性青光眼患者中FHG的发生率并不高于疾病早期的患者。207例PG和PDS患者中，71%为男性，29%为女性（p < 0.001）。有FHG的患者中男性比例为64.2%，与无FHG患者组的75.4%无显著差异。患有青光眼疾病的父母和祖父母的性别分布为1:1。

危险因素

在伴有和不伴有OH的PDS、PG以及视野缺损不同阶段中，有和无FHG的患者在危险因素方面无显著差异，例如最高眼压、屈光和杯盘比。近视：PG患者的近视程度显著高于PDS患者（p < 0.01）。近视程度越高，疾病诊断越早（p = 0.008）。Krukenberg梭：在缩瞳治疗期间，角膜上半部分的Krukenberg梭减少。诊断时间：PG的诊断年龄高于PDS。