我国青光眼临床诊断方式基于微信的问卷调查

The questionnaire survey based on Wechat on glaucoma diagnotic methods in China

目的了解我国青光眼诊断方式及相关设备使用的现状。设计横断面研究。研究对象可以网络联系的中国大陆地区眼科医生。方法根据研究目的自行设计问卷,使用"问卷星"设计问卷链接,通过微信直接发送或二次转发到全国或省市地区的微信群。调查对象直接在手机填写问卷,一个手机号码只能提交一次问卷。使用SAS 9.4软件进行统计分析,关联分析采用卡方检验。主要指标Goldmann眼压计使用率、前房角、眼底、视野的不同评估方法的使用比率、不同房角镜分类方法的使用比率。结果共收到除了港澳台西藏以外的全国28个省级行政区的1111份问卷。48.48%所在医院有青光眼专业组,青光眼专家和专科医生占20.62%。常规使用Goldmann眼压计的占25.29%,42.94%因医院无Glodmann眼压计而无法常规使用。最常用的房角检查法是房角镜(69.49%)和UBM(17.55%)。使用房角镜频率75%~100%的被调查者仅为35.64%,29.26%的被调查者房角镜使用频率低于25%。最常用的房角分级法是Scheie法(74.17%)。最常用的眼底检查仪器是直接检眼镜(39.97%),其次是前置镜(29.16%),眼底照相仅占11.61%。25.74%的被调查者用眼底照相的频率低于25%。最常用的视野检查为Humphrey视野计(45.00%)。青光眼专家及专科医生使用房角镜、眼底照相及Humphrey视野计的频率显著高于其他医生。结论我国青光眼诊断实践中,未能广泛采用Goldmann眼压测量,房角镜检查和眼底照相技术使用率比较低。我国青光眼诊断规范化与国际存在差距,需进一步加强培训、推广规范化流程,以减少我国与国际诊疗水平间的差异。

Objective To obtain the national real situation of glaucoma dignosis and related instrument usage in China. Design Cross-sectional survey. Participants Ophthalmologists who were internet available thoughout the mainland. Method The questionnaire and link were designed and sent by WeChat directly. The respondents filled out the questiormaire directly on the mobile phone, and a mobile phone number can only be submitted once. The data analysis was conducted by SAS 9.4, the association analysis used chi square test. Main Outcome nearsures Utilization rate of Goldmann tonometer. The ratio of different instruments used to assess the angle of anterior chamber, fundus, and visual field. The utilization rate of different methods for angle classification. Results A total of 1111 questionnaires were received from 28 provincial administrative regions, among which 20.62% were glaucoma specialists and at- tending doctors, and 48.48% had glaucoma department in their hospitals. Only 25.29% of them used Goldmann applanation tonometer （GAT） as the routine IOP measurement, and 42.94% didn＇t regularely use GAT because of the lack of the device. The most favorite methods in checking chamber angle was gonioscopy （69.49%） , followed by UBM （17.55%）. Only 35.64% of the respondents whose fre- quency of utilization of gonioscopy was between 75%-100%, and 29.26% of the respondents whose frequency of utilization of go- nioscopy was less than 25%. Scheie classification was the main （74.17%） grading system for gonioscopy. Direct ophthalmoscope was the most common fundus examination instruments （39.97%）, followed by indirect slit-lamp lens （29.16%）, and the fundus camera was only 11.61%. 25.74% of those being surveyed had a frequency of utilization of fundus camera less than 25%. In visual field test, Humphrey perimetry （45.00%） was most commonly applied. Glaucoma specialists and attending doctors used gonioscope, fundus cameras and Humphrey perimetry significantly more often than others. Conclusion In the current practice of glaucoma diagnosis in China, GAT measurement has not been widely used. The fYequency of utilization oi gonioscope and lundus camera was low. lhere is a gap between real clinical situation and international standards, and the process of training and promotion standalization needs to be strengthened to reduce the difference between China and the international level in glaucoma diagnosis guidelines.