邯郸地区眼健康筛查人群日间眼压值分布及参考区间建立

Distribution and reference intervals of daytime intraocular pressure in the eye health screening population of Handan

目的探讨邯郸地区眼健康筛查人群日间眼压值分布情况,并建立日间眼压值参考区间。方法横断面研究。2021年5月至2022年6月对邯郸市第一医院体检中心18~90岁体检者行全身和眼病筛查,检查项目包括视力、眼压(使用Goldmann眼压计)、眼前节情况(裂隙灯显微镜检查)、眼后节情况(眼底照相),并行眼前节及后节相干光层析成像术检查。排除具有可引起眼压明显改变因素、影响眼压测量准确性因素和无法行眼压测量者。采用单纯随机法抽样选取受试者及其单眼,分为2个性别和6个年龄段(18~<30、30~<40、40~<50、50~<60、60~<70、≥70岁)分别记录中央角膜厚度(CCT)、8:00至11:00眼压值。采用独立样本t检验和单因素方差分析进行统计学分析,以x¯±1.96s确定日间眼压值参考区间。结果在9310名测量眼压的体检者中,健康参考个体7886人,随机抽样3491名受试者(3491只眼),年龄为(47.74±14.47)岁,范围为18~90岁,其中男性1694人,女性1797人。全体受试者CCT为(525.56±49.39)μm。全体受试者日间眼压值为(15.40±2.54)mmHg(1 mmHg=0.133 kPa),参考区间为10.42~20.39 mmHg;其中日间眼压值男性为(15.49±2.58)mmHg,女性为(15.29±2.49)mmHg,两者比较的差异有统计学意义(P<0.05);日间眼压值参考区间男性为10.43~20.54 mmHg,女性为10.41~20.18 mmHg;6个年龄段日间眼压值[(15.13±2.58)、(15.33±2.53)、(15.49±2.50)、(15.53±2.55)、(15.39±2.62)、(15.28±2.52)mmHg]比较,差异有统计学意义(P<0.05)。结论邯郸地区不同性别、不同年龄段眼健康筛查人群日间眼压值分布情况及以此建立的日间眼压值参考区间与国际通用正常眼压值参考区间(10~21 mmHg)大致相同。建议参考不同性别和年龄段的日间眼压值参考区间进行临床决策。

Objective To describe the distribution and establish reference intervals(RI)of daytime intraocular pressure(IOP)in the eye health screening population of Handan.Methods This cross-sectional study included subjects who participated in eye health screening at the Physical Examination Center of Handan First Hospital from May 2021 to June 2022.A complete general and ocular examination was performed,including measurements of visual acuity and IOP(using Goldmann tonometry),slit lamp microscopy,fundus photography,and anterior and posterior segment optical coherence tomography.Subjects with factors that could cause significant changes in IOP or affect the accuracy of IOP measurement,or with an inability to measure IOP were excluded.Simple random sampling was used to select participants,who were grouped by gender and age(18 to<30,30 to<40,40 to<50,50 to<60,60 to<70,and≥70 years).Central corneal thickness and IOP at 8 to 11 o′clock in one eye of each participant were recorded.The independent sample t test and ANOVA were used for statistical analysis,and the RI of IOP values was calculated by x¯±1.96s.Results A total of 9310 subjects had their IOP measured,and 3491 participants(3491 eyes)were randomly selected from 7886 healthy subjects.The age of the participants was(47.74±14.47)years old,ranging from 18 to 90 years old.There were 1694 males and 1797 females.The central corneal thickness of all participants was(525.56±49.39)μm.The daytime IOP of all participants was(15.40±2.54)mmHg(1 mmHg=0.133 kPa),and the RI was 10.42 to 20.39 mmHg.The IOP was(15.49±2.58)mmHg for males and(15.29±2.49)mmHg for females,and the gender difference was statistically significant(P<0.05).The RI of daytime IOP values was 10.43 to 20.54 mmHg for males and 10.41 to 20.18 mmHg for females.There were significant differences in daytime IOP[(15.13±2.58),(15.33±2.53),(15.49±2.50),(15.53±2.55),(15.39±2.62),and(15.28±2.52)mmHg]among 6 age groups(P<0.05).Conclusions The distribution of daytime IOP in different gender and age groups in the eye health screening population of Handan and the RIs derived from the distribution were roughly the same as the international normal IOP RI(10 to 21 mmHg).It is recommended to refer to the RI of daytime IOP values of different genders and ages for clinical decision.