青光眼临床诊疗若干问题问卷调查（2016年）

The questionnaire survey on glaucoma diagnosis and treatment in China （2016）

目的初步了解PACG及POAG在我国的诊疗现状以及眼科医师对于相关进展的认识情况。方法横断面非随机抽样调查。采用问卷调查的形式，研究对象为2016年11月11至12日参加第11届全国青光眼学术会议的眼科医师。调查内容包括被调查者基本信息、青光眼诊断、青光眼治疗认识情况3个部分内容。将有效问卷数据转入SAS9．4软件进行统计分析。结果共发放问卷450份，收回有效问卷372份，有效应答率是82．7％（372／450）。58．9％（219／372）的人选择国际地域性和眼科流行病学组（ISGEO）关于闭角型青光眼的分类体系用于青光眼诊断。而48．1％（179/372）的人认为“以前房角关闭机制为基础的闭角型青光眼分类体系”对于青光眼治疗更具有指导性，高于ISGEO分类体系（42．2％，157／372）。72．3％（269／372）的人了解3min暗室俯卧试验，但仅27．7％（103／372）的人使用该技术。83．4％（310／372）的眼科医师知道偏低颅内压是POAG的危险因素。对于青光眼治疗，71．8％（267／372）的眼科医师所在单位已经应用复合式小梁切除术巩膜瓣可调节缝线技术，76．9％（286／372）的人认为该技术的应用降低了小梁切除术的并发症。结论在目前的PACG诊疗实践中，ISGEO和以前房角关闭机制进行分类的两种分类方式并存。偏低颅压作为POAG新的危险因素知晓率高，受到国内眼科医师的关注。3min暗室俯卧试验以及复合式小梁切除术巩膜瓣可调节缝线技术还有待进一步推广。

Objective To investigate the present situation of diagnosis and treatment for primary angle-closure glaucoma （PACG） and primary open-angle glaucoma （POAG） and awareness of the relevant progress among Chinese ophthalmologists. Methods This study was a cross-sectional, non-randomized sampling survey. Participants were ophthalmologists who attended the 11st Chinese Glaucoma Society Congress during November 11 to 12, 2016. They were invited to fill out a questionnaire. The questionnaire included participants＇ basic information and their knowledge about glaucoma diagnosis and treatment. The data collected through questionnaire were analyzed with SAS9.4. Results A total of 450 questionnaires were distributed and 372 valid questionnaires were retrieved, with a response rate of 82. 7%（372/450）. ISGEO classification system was adopted by 58.9% （219/372） of the participants as the diagnostic criteria for PACG. Of the respondents, 48.1% （179/372） of the participants believed that ＂anterior chamber angle closure mechanism-based PACG classification system＂ was more instructive for treatment, the percentage was higher than ISGEO classification system （42.2%, 157/372）. Most （72.3%, 269/372） of the participants knew the 3-minute dark room prone test, but only 27.7%（103/372） of them applied it in clinical practice. A total of 83.4%（310/372） of the participants believed that low cerebrospinal fluid pressure is a risk factor for POAG. In all, 71.8% （267/372） of the participants reported that their institutes had applied compound trabeculectomy with adjustable suture, with 76.9% （286/372） of the participants agreeing that the adjustable suture reduced the rate of complications after trabeculectomy. Conclusions Currently, both ISGEO classification system and anterior chamber angle closure mechanism-based PACG classification system were adopted in the diagnosis and treatment of glaucoma. Low cerebrospinal fluid pressure as new risk factors for POAG has been widely acknowledged and given attentions by Chinese ophthalmologists. The 3-minute darkroom prone test and compound trabeculectomy with adjustable suture still need to be promoted.