目的::研究健康体检人群中眼底杯盘比增大者的眼压分布情况.方法::从本单位2019年度完成眼底检查和非接触眼压测量的健康体检人群中,将任何一眼杯盘比≥0.5的受检者纳入研究范围,并依据眼科疾病检查情况分为有相关眼病组和无相关眼病组...目的::研究健康体检人群中眼底杯盘比增大者的眼压分布情况.方法::从本单位2019年度完成眼底检查和非接触眼压测量的健康体检人群中,将任何一眼杯盘比≥0.5的受检者纳入研究范围,并依据眼科疾病检查情况分为有相关眼病组和无相关眼病组,将两组受检者的眼压情况进行分析.结果::无相关眼病组的杯盘比增大人群,眼压呈正态分布(P>0.05),右眼压的范围为最小值10 mm Hg到最大值30 mm Hg,左眼压范围为最小值9 mm Hg到最大值31 mm Hg.有相关眼病组的杯盘比增大人群,眼压分布区间窄,且双眼呈现不一致的分布态势.无相关眼病组男女性左眼眼压有统计学差异,男性左眼眼压明显高于女性(P<0.01),右眼眼压有统计学差异,男性右眼眼压较女性更高(P<0.05);有相关眼病组男女性左眼眼压和右眼眼压均没有统计学差异.无相关眼病组无论男性(P<0.001)和女性(P<0.01),左眼压均高于右眼压;而在有相关眼病人群中,无论男性(P<0.05)和女性(P<0.05),右眼压均高于左眼压.结论:相对健康人群中有很大比例(90.6%)的生理性杯盘比增大者(眼压在正常范围内,视力及视野情况无青光眼指向),进一步证实了大凹陷并非均为病理性,虽然杯盘比≥0.6被定为青光眼筛查的指标,但是在正常人与青光眼患者中有重叠现象.健康体检中进行眼底及眼压检查非常必要,可以筛查出杯盘比增大且眼压增高的青光眼待排查人群.相对健康人群中男性眼压较女性更高,左眼眼压比右眼高.展开更多
Aim:To evaluate the relative diagnostic strength of cup to disc(C/D)ratio,clinical disc damage likelihood scale(DDLS),a new clinical method of documenting glaucomatous optic disc changes,and Heidelberg retina tomograp...Aim:To evaluate the relative diagnostic strength of cup to disc(C/D)ratio,clinical disc damage likelihood scale(DDLS),a new clinical method of documenting glaucomatous optic disc changes,and Heidelberg retina tomograph(HRT-II)in patients with glaucoma,glaucoma suspects,and normal controls.Method:Consecutive observational case series.110 eyes from 110 patients categorised as glaucoma,glaucoma suspect,or normal were examined clinically to grade the DDLS score.HRT-II examination was performed by an examiner masked to the clinical examination findings.Optic disc parameters and Moorfields regression analysis findings were recorded.Stereophotographs of the optic disc were examined independently by two glaucoma specialists in masked fashion to determine the C/D ratio.Zeiss SITA Standard 24-2 visual fields were obtained within 3 months of HRT-II and clinical examination.For each patient,the eye with the worse mean deviation of the visual field test was enrolled in the study,and each field was additionally graded by the four level Hodapp-Parrish-II-Anderson staging.Specificity and sensitivity were calculated by receiver operating characteristic(ROC)curves.Results:Mean patient age was 58 years(SD 13.3)with 45 glaucoma patients,23 glaucoma suspects,and 42 normals.The mean deviation on Humphrey visual field assessment using SITA-Standard was-4.95 D(SD 5 D)Clinical examination using DDLS had the best predictive power with an area under the ROC curve value of 0.95 when glaucoma patients and suspects were separated from borderline or normals.This was followed by clinical examination of C/D ratio(0.84),and HRT-II Moorfields analysis(0.68).The order of diagnostic strength did not change when definite glaucoma was compared to borderline and normals.Conclusions:The DDLS grading performs well compared to C/D ratio and HRT-II evaluation.Attention to disc diameter and to rim width may increase the value of clinical optic disc examination.展开更多
To investigate the relationship between drainage angle configuration with untr eated intraocular pressure (IOP) and optic disc cupping in subjects with chronic angle-closure glaucoma (CACG). Prospective, observational...To investigate the relationship between drainage angle configuration with untr eated intraocular pressure (IOP) and optic disc cupping in subjects with chronic angle-closure glaucoma (CACG). Prospective, observational study. Two hundred s ev-enty-five Asian subjects with CACG who participated in a randomized control led trial that investigated the IOP-reduc-ing effect of latanoprost and timolo l. Chronic angle-closure glaucoma was defined as the presence of glaucomatous o ptic neuropathy (with or without a visual field defect), an anterior chamber ang le in which the pigmented trabecular meshwork was not visible for at least 180° on gonioscopy, and evidence of peripheral anterior synechiae (PAS) in associatio n with elevated IOP of 21 mmHg or more. Static and dynamic gonioscopy were perfo rmed, the angles were graded in each quadrant according to the Shaffer scheme, a nd the number of clock hours of PAS was recorded. The untreated IOP and vertical cup-to-disc ratio were correlated with mean angle width and extent of PAS. Me an angle width, clock hours of PAS, IOP, and vertical cup-to-disc ratio. Most subjects were female (75%), and the mean age was 62.9±9.4 years. The mean angl e width was 0.77±0.53 and the mean number of clock hours of PAS was 4.77±3.2 h ours. Untreated IOP correlated with angle width (r =-0.23; P < 0.001) and clock hours of PAS (r=0.22;P < 0.001). Vertical cup-to-disc ratio also correlated w ith angle width (r=-0.17; P=0.004) and PAS (r=0.28; P < 0.001). Performing a mu ltiple linear regression using baseline IOP as the outcome variable with age, ge nder, clock hours of PAS, and angle width as predictors, there was a 0.39-mmHg (95%confidence interval, 0.15-0.63) increase in baseline untreated IOP for eac h unit increase in clock hours of PAS (P=0.002). In subjects with CACG, the exte nt of PAS and a narrower width of the drainage angle were associated with higher untreated IOP and a larger vertical cup-to-disc ratio.展开更多
文摘目的::研究健康体检人群中眼底杯盘比增大者的眼压分布情况.方法::从本单位2019年度完成眼底检查和非接触眼压测量的健康体检人群中,将任何一眼杯盘比≥0.5的受检者纳入研究范围,并依据眼科疾病检查情况分为有相关眼病组和无相关眼病组,将两组受检者的眼压情况进行分析.结果::无相关眼病组的杯盘比增大人群,眼压呈正态分布(P>0.05),右眼压的范围为最小值10 mm Hg到最大值30 mm Hg,左眼压范围为最小值9 mm Hg到最大值31 mm Hg.有相关眼病组的杯盘比增大人群,眼压分布区间窄,且双眼呈现不一致的分布态势.无相关眼病组男女性左眼眼压有统计学差异,男性左眼眼压明显高于女性(P<0.01),右眼眼压有统计学差异,男性右眼眼压较女性更高(P<0.05);有相关眼病组男女性左眼眼压和右眼眼压均没有统计学差异.无相关眼病组无论男性(P<0.001)和女性(P<0.01),左眼压均高于右眼压;而在有相关眼病人群中,无论男性(P<0.05)和女性(P<0.05),右眼压均高于左眼压.结论:相对健康人群中有很大比例(90.6%)的生理性杯盘比增大者(眼压在正常范围内,视力及视野情况无青光眼指向),进一步证实了大凹陷并非均为病理性,虽然杯盘比≥0.6被定为青光眼筛查的指标,但是在正常人与青光眼患者中有重叠现象.健康体检中进行眼底及眼压检查非常必要,可以筛查出杯盘比增大且眼压增高的青光眼待排查人群.相对健康人群中男性眼压较女性更高,左眼眼压比右眼高.
文摘Aim:To evaluate the relative diagnostic strength of cup to disc(C/D)ratio,clinical disc damage likelihood scale(DDLS),a new clinical method of documenting glaucomatous optic disc changes,and Heidelberg retina tomograph(HRT-II)in patients with glaucoma,glaucoma suspects,and normal controls.Method:Consecutive observational case series.110 eyes from 110 patients categorised as glaucoma,glaucoma suspect,or normal were examined clinically to grade the DDLS score.HRT-II examination was performed by an examiner masked to the clinical examination findings.Optic disc parameters and Moorfields regression analysis findings were recorded.Stereophotographs of the optic disc were examined independently by two glaucoma specialists in masked fashion to determine the C/D ratio.Zeiss SITA Standard 24-2 visual fields were obtained within 3 months of HRT-II and clinical examination.For each patient,the eye with the worse mean deviation of the visual field test was enrolled in the study,and each field was additionally graded by the four level Hodapp-Parrish-II-Anderson staging.Specificity and sensitivity were calculated by receiver operating characteristic(ROC)curves.Results:Mean patient age was 58 years(SD 13.3)with 45 glaucoma patients,23 glaucoma suspects,and 42 normals.The mean deviation on Humphrey visual field assessment using SITA-Standard was-4.95 D(SD 5 D)Clinical examination using DDLS had the best predictive power with an area under the ROC curve value of 0.95 when glaucoma patients and suspects were separated from borderline or normals.This was followed by clinical examination of C/D ratio(0.84),and HRT-II Moorfields analysis(0.68).The order of diagnostic strength did not change when definite glaucoma was compared to borderline and normals.Conclusions:The DDLS grading performs well compared to C/D ratio and HRT-II evaluation.Attention to disc diameter and to rim width may increase the value of clinical optic disc examination.
文摘To investigate the relationship between drainage angle configuration with untr eated intraocular pressure (IOP) and optic disc cupping in subjects with chronic angle-closure glaucoma (CACG). Prospective, observational study. Two hundred s ev-enty-five Asian subjects with CACG who participated in a randomized control led trial that investigated the IOP-reduc-ing effect of latanoprost and timolo l. Chronic angle-closure glaucoma was defined as the presence of glaucomatous o ptic neuropathy (with or without a visual field defect), an anterior chamber ang le in which the pigmented trabecular meshwork was not visible for at least 180° on gonioscopy, and evidence of peripheral anterior synechiae (PAS) in associatio n with elevated IOP of 21 mmHg or more. Static and dynamic gonioscopy were perfo rmed, the angles were graded in each quadrant according to the Shaffer scheme, a nd the number of clock hours of PAS was recorded. The untreated IOP and vertical cup-to-disc ratio were correlated with mean angle width and extent of PAS. Me an angle width, clock hours of PAS, IOP, and vertical cup-to-disc ratio. Most subjects were female (75%), and the mean age was 62.9±9.4 years. The mean angl e width was 0.77±0.53 and the mean number of clock hours of PAS was 4.77±3.2 h ours. Untreated IOP correlated with angle width (r =-0.23; P < 0.001) and clock hours of PAS (r=0.22;P < 0.001). Vertical cup-to-disc ratio also correlated w ith angle width (r=-0.17; P=0.004) and PAS (r=0.28; P < 0.001). Performing a mu ltiple linear regression using baseline IOP as the outcome variable with age, ge nder, clock hours of PAS, and angle width as predictors, there was a 0.39-mmHg (95%confidence interval, 0.15-0.63) increase in baseline untreated IOP for eac h unit increase in clock hours of PAS (P=0.002). In subjects with CACG, the exte nt of PAS and a narrower width of the drainage angle were associated with higher untreated IOP and a larger vertical cup-to-disc ratio.
