Epidemiology of Glaucoma in Asia-Pacific

Primary open angle glaucoma is the second most important cause of permanent blindness in the Asia Pacific region. Thus it is very important to identify epidemiological and other risk factore which are associated with open angle glaucoma. The risk for glaucoma optic nerve damage increases with the age and with the level of the intraocular pressure. In this paper, I will highlight our study of several risk factors for development of the open angle glaucoma like (1) elevated intraocular pressure, (2) myopi...

Epidemiology of hospitalized pediatric glaucoma patients in Beijing Tongren Hospital

Background No population-based assessment of the prevalence and incidence of pediatric glaucoma in China are available. Here we describe the spectrum of hospitalized pediatric glaucoma patients in Beijing Tongren Hospital in China.Methods We reviewed the charts of pediatric patients, from birth to 18 years old, with a discharge diagnosis of glaucoma in Beijing Tongren Hospital, from 2002 to 2008. All children were admitted for anti-glaucoma surgery, treating the sequelae of the glaucoma, or managing postoperative complications. We evaluated the demographic characteristics and the proportion of different glaucoma subtypes. Results Pediatric patients （n=1452） accounted for 12.91% of the total glaucoma in-patients from 2002 to 2008, and at last data of pediatric glaucoma were presented for 1055 children who came from 28 provinces, municipalities and autonomous regions in China. Boys were more common in all subtypes and at all ages, with a total ratio of boys to girls of 2.32：1. Congenital glaucoma was the most common subtype, accounting for 46.07% in all patients and accounting for 69.95% in children under 3 years of age. The median presenting age of congenital glaucoma patients was 2 years. Patients with traumatic glaucoma were the second most common group （n=128, 12.13%）, and presented at older age （the median presenting age was 11 years）. The majority of traumatic glaucoma occurred in children between 10 and 15 years of age （n=72, 56.25%）. Aphakic glaucoma was the third most common （9.19%） subtype. Conclusions Congenital glaucoma is the most prevalent glaucoma subtype in hospitalized pediatric patients in Beijing Tongren Hospital. The prevention and treatment of traumatic glaucoma can reduce the incidence of visual damage in developing countries. Close follow-up for glaucoma is important after pediatric cataract surgery.

Childhood glaucoma profile in Dakahelia, Egypt: a retrospective study

AIM： To analyze childhood glaucoma regarding its demographics, presentations, different causes and surgical modalities used among patients in Dakahelia and to apply the Childhood Glaucoma Research Network（CGRN） classification retrospectively to evaluate its convenience.METHODS： A retrospective study in which the medical files of all glaucoma patients 〈16 years old presented to Mansoura Ophthalmic Center, Mansoura University from 2014 to 2017, were retrieved and analyzed. Collected data included： age, gender, laterality, visual acuity（VA）, refraction, intraocular pressure（IOP）, corneal diameter, cup-disc ratio, types and number of surgeries and antiglaucomatous drugs（AGD） at the first and last visit. Prevalence of different subtypes was calculated and means of clinical features were compared.RESULTS： A total of 305 eyes of 207 patients were included classified into 6 groups： primary congenital glaucoma（PCG）, juvenile open angle glaucoma（JOAG）, glaucoma associated with systemic disease, glaucoma associated with ocular anomalies, acquired glaucoma and glaucoma following cataract surgery. PCG was the predominant type（55.1%） followed by acquired glaucoma（29.5%）. Males represented 63.8% of the whole studied patients. Glaucoma associated with ocular anomaly group showed the youngest age at diagnosis（21.9±30.0 mo）. The shortest corneal diameter was recorded in post cataract group（10.4±0.5 mm）. Highest cup-disc ratio was found in the PCG group（P〈0.0005）. Glaucoma associated with systemic disease presented with the highest baseline IOP（34.5±5.0 mm Hg）. All the cases with PCG were treated surgically with 21.8% required more than one surgery. The majority of the patients（74.2%） in the acquired group were treated medically. Combined trabeculotomy-trabeculectomy was the most frequent operation done, accounting for 34.5% of all primary surgeries. Ahmed valve implantation comprised 87% of the secondary surgeries. Acquired glaucoma group had the highest percent of eyes with good final Snellen＇s VA（69.4%）, while glaucoma associated with ocular anomaly group had poorest final VA. CONCLUSION： PCG is the most prevalent type of childhood glaucoma, followed by acquired glaucoma especially traumatic hyphema. Combined trabeculotomytrabeculectomy and Ahmed valve implantation are the most common surgical interventions. CGRN classification is found to provide a consensus skeleton and is recommended to be integrated in our routine ongoing clinical practice.

Profile of pediatric glaucoma patients in Shanghai Eye, Ear, Nose and Throat Hospital

Background The extent of our knowledge of the epidemiology of pediatric glaucoma in China is limited. To better characterize the epidemiology of pediatric glaucoma in eastern China, we report the clinical profile, etiologies, and treatment modalities in patients 〈18 years of age in Shanghai Eye, Ear, Nose and Throat Hospital. Methods The medical records of patients presenting glaucoma between January 2003 and December 2010 were retrospectively reviewed. The demographic characteristics, the proportion of different glaucoma subtypes and surgical precedures were collected and analyzed. Results A total of 1 142 eyes of 734 pediatric patients （500 males） were included. Congenital glaucoma was the leading subtype, accounting for 47.55% of all patients. The ratio of boys to girls was 2.5：1. Patients with congenital glaucoma affecting both eyes accounted for 72.5% of all patients examined. Patients with primary juvenile glaucoma were the second most common group （n=125, 17.03%）. Traumatic glaucoma was the third most common subtype （n=81, 11.03%）. The type of surgery was related to the subtype of glaucoma. Conclusions Congenital glaucoma, primary juvenile glaucoma, and traumatic glaucoma are the most prevalent subtypes in pediatric glaucoma patients in Shanghai Eye, Ear, Nose and Throat Hospital. The characteristics of congenital glaucoma in China are similar to those in Western countries.

Interrelationship among blood pressure, intraocular pressure, and life-style in middle-aged and older Japanese residents

To clarify the interrelationship among blood pressure (BP), intraocular pressure (IOP), and life-style related factors, a cross-sectional study was conducted. This epidemiological study analyzed health examination data obtained between 2001 and 2004 from 1113 Japanese individuals, ranging in age 28 to 79 years, who had not undergone any ocular surgery or medical treatment for hypertension, ocular hypertension, and glaucoma. The association of systolic and diastolic BP (SBP and DBP), and life-style related factors such as body mass index (BMI), drinking, smoking, and exercise habits with IOP were evaluated by multiple regression analyses and analyses of covariance. The results of this study showed that SBP, DBP, and BMI had a significantly positive association with IOP in both sexes. In men, the number of cigarette smoking per day was also positively related to IOP

539例住院青光眼患者的调查及致盲率分析

目的 了解最近 5年住院青光眼患者的病型构成、年龄、性别、职业分布及致盲率 ,分析致盲原因 ,探讨防治措施。方法 对 1997～ 2 0 0 1年入院的青光眼患者 5 39例病历资料进行调查、统计、分析。结果 5 39例住院青光眼患者中原发性青光眼 4 2 0例 ,占 77 92 % ;继发性青光眼 87例 ,占 16 14 % ;先天性青光眼 32例 ,占 5 94 %。原发性青光眼中 ,急性闭角型青光眼 2 6 0例 ,慢性闭角型青光眼 139例 ,开角型青光眼 2 1例 ,分别占原发性青光眼 6 1 90 %、33 10 %、5 0 0 %。 5 39例患者中男 2 36例 ,女 30 3例。其中急性闭角型青光眼中女性最多 ,占急性闭角型青光眼6 5 0 0 % (16 9/ 2 6 0 )。年龄分布 :急性闭角型青光眼平均年龄 6 1 4± 10 0岁 ,慢性闭角型青光眼 5 7 3± 9 4岁 ,开角型青光眼 4 6 9± 12 4岁 ,先天性青光眼 2 1± 0 5岁。职业分布 :工人、农民 379例 ,占 74 4 6 %。致盲率 (双眼盲 )16 2 7% ,单眼盲 38 92 %。结论 近 5年青光眼患者主要是原发性闭角型青光眼 ,多为老年 ,女性偏多 ,工人、农民占70 %以上 ,视功能损伤严重 ,致盲率高。必须加强青光眼防治知识的宣传和普及 ,做到早期诊断。

斗门县农村中老年人群原发闭角性青光眼流行病学调查

【目的】调查 5 0岁以上的中老年人群中的原发闭角性青光眼患病率。【方法】 1997年在广东省斗门县以村为单位 ,通过重组随机整群抽样确定检查对象 ,用ETDRS视力表检查裸眼视力、常戴镜视力和针孔视力 ,Schiotz计测定眼压 ,直接电眼底镜作视神经垂直C/D比的估计 ,手电筒侧照法和vanHerrick法测定前房深度 ,并结合急性发作史、前房角镜和视野检查作出诊断。【结果】在 5 34 2名实检对象 (受检率 92 7% )中 ,青光眼是第 5位致盲眼病。原发闭角性青光眼的患病率为1 0 % ,男性和女性中分别为 0 8%和 1 2 % ,在 5 0～ 5 9、6 0～ 6 9和 70～ 98岁年龄组中分别为 0 4%、0 8%和 1 6 % ,浅前房人群中为 5 9% ,经logistic回归校正混杂作用后 ,年龄和前房深度为独立的危险因素 ,以 5 0岁年龄组和深前房者为基准 ,70～ 98岁年龄组和浅前房者的调整比数比分别为 3 3和 11 3。【结论】原发闭角性青光眼是人群中重要的致盲眼病 ,老年和浅前房者是危险人群。

我国中老年人群青光眼诊治状况调查

青光眼是不可逆性视功能损害及致盲的重要原因,特别在中老年人群,国内流行病学调查揭示了我国青光眼的发病状况,我们结合这些调查结果,对原发性青光眼的类型变化、患病率、盲眼率、视功能损害、未诊断率、治疗、高危人群、危险因素、筛查方法等进行综述。

城乡特定区域人群眼压分布特征研究

目的 探讨人群中眼压的分布特征以及眼压与年龄、近视、糖尿病性视网膜病变、核性白内障、青光眼等因素的关系。方法 选择 40岁以上居民 44 5 1例 ,进行视力、屈光、倍频视野、裂隙灯眼前节数码照相、散瞳眼底照相等检查。采用非接触眼压计测量眼压。每例受试者随机选一眼用于数据统计与分析。结果 双眼眼压资料完整者 44 2 9例。 70岁以上组的平均眼压显著低于 70岁以下各组 (P <0 0 5 )。正常人眼压呈轻微偏向右侧的近似正态性分布 (偏度系数0 2 71) ,平均眼压 ( 15 90± 2 82 )mmHg ,95 %可信限区间 (CI) 10 3 7～ 2 1 43mmHg。近视、糖尿病性视网膜病变、青光眼者的眼压均高于无上述疾患者 (P <0 0 5 )。白内障手术后与无白内障手术史者眼压无统计学差异。年龄、核性白内障与眼压呈一定程度的负相关 ,而近视、糖尿病性视网膜病变、青光眼与眼压呈一定程度的正相关 (P <0 0 5 )。结论 在人群中非接触眼压计测得的眼压正常值范围与Goldmann压平眼压计正常值 10～ 2 1mmHg非常近似。 70岁后眼压有下降的趋势。

新疆乌鲁木齐市体检人群青光眼患病情况及相关因素分析

目的:探讨青光眼在限定人群患病情况、性别、年龄分布特点,为青光眼防治提供流行病资料。方法:2008-03/2008-08,对50岁及以上眼科体检人群,总计1743人进行青光眼调查。检查项目包括常规视力、裂隙灯显微镜、周边前房深度、眼压及直接眼底镜检查。对可疑青光眼患者进一步详细检查眼压、前房角镜、视野检查及眼底检查。结果:体检人群中确诊为青光眼者36人,患病率为2.06%,其中原发性闭角型青光眼、原发性开角型青光眼、继发性青光眼患病率分别为:1.55%、0.40%和0.11%,男性青光眼患者的患病率为1.51%,女性为2.53%,女性青光眼患者明显高于男性,原发性闭角型青光眼明显高于原发性开角型青光眼,且各型青光眼患病率随年龄增长而增高。结论:50岁及以上体检人群青光眼患病率与既往青光眼流行病调查的患病率接近,且原发性闭角型青光眼患病率高于原发性开角型青光眼患病率,女性原发性闭角型青光眼患病率高于男性,与青光眼的流行病学调查结果亦接近。

白内障住院患者984例病因构成及其相关因素分析

目的:探讨白内障住院患者的病因构成、性别、年龄、民族分布、经济水平及其变化特点,为白内障的防治研究提供一些新的流行病学资料。方法:将2003-01/2007-12在新疆医科大学第一附属医院眼科住院的984例白内障患者,按出院诊断分为七类,统计其年龄、性别、民族、地理与经济水平的构成,分析其变化特点。结果:在5a中老年性白内障为主要白内障类型。2003年老年性白内障占白内障总数的82.10%,2007年下降为53.76%;2003年并发性白内障占白内障总数的3.08%,2007年上升为27.07%,其构成比变化有统计学意义。2003/2007年各年的构成比增加缓慢,但与2003年(16.46%)相比较,2007年(27.03%)较前增加了1.64倍,具有统计学意义。984例白内障患者中男性患者多于女性患者,男553例,平均年龄60.09岁,女431例,平均年龄62.22岁,其中最大年龄93岁,最小年龄7月龄。5a中白内障住院患者以汉族、维吾尔族为主,其中汉族患者多于维吾尔族患者,以南北疆划分,北疆患者明显多于南疆患者,城市患者明显多于农村患者。结论:我院眼科白内障患者构成与其他研究结果不完全一致;老年性白内障也是我院白内障的主要类型。

江苏省初治结核病复发流行病学特征及影响因素

目的研究初治肺结核患者治疗成功后复发的流行病学特征及其影响因素,为制定和完善干预措施,减少结核病复发提供科学依据。方法采用回顾性队列研究方法,从结核病管理信息系统中导出江苏省重大传染病防治科技重大专项试点城市张家港、丹阳、泰兴三地2009-2018年患者病案信息,采用Kaplan-Meier法估计结核病复发风险,各组复发率之间比较采用Log-rank法检验,采用Cox比例风险模型研究肺结核复发的危险因素。结果纳入研究对象的8 704例成功治疗本地初治结核病患者中,截至观察终点共有410例(占4.71%)患者复发,复发率为1.02/100人年,其中77.32%的患者3年内复发,5年内累积复发占93.41%。单因素分析结果显示,男性(HR=1.385,95%CI:1.10~1.75,P=0.007)、40~岁组(HR=2.12,95%CI:1.117~4.032,P=0.022)和≥60岁组(HR=2.726,95%CI:1.446~5.140,P=0.002)、农民(HR=4.225,95%CI:1.884~9.476,P<0.001)、被动发现(HR=4.551,95%CI:2.261~9.164,P<0.001)、病原学阳性(HR=2.460,95%CI:2.007~3.015,P<0.001)、合并糖尿病(HR=3.028,95%CI:1.986~4.617,P<0.001)、单耐药(HR=3.456,95%CI:1.868~6.394,P<0.001)和诊断时长超过30天(HR=1.579,95%CI:1.205~2.069,P=0.001)患者复发率较高。多因素分析发现,合并糖尿病(aHR=2.698,95%CI:1.32~5.53,P=0.007)和耐药(aHR=3.496,95%CI:1.88~6.51,P<0.001)是结核病复发的独立危险因素。结论应加强结核病患者治疗成功后的随访和管理,以早期发现结核病复发并纳入规范化治疗,同时对结核病复发高危人群开展针对性干预措施。

青光眼住院病人的构成比变化特点

目的:了解住院青光眼病人的内部构成比变化,为青光眼的防治研究提供新的流行病学资料。方法:青光眼病区1990年7月～1996年6月住院患者3156人,按出院诊断、性别及年龄分组,分析其内部构成及变化趋势,并与1977年7月～1982年7月的资料比较。结果:闭角型青光眼占青光眼总数的55.86％,40岁以上女性患者居多,原发性开角型青光眼和糖皮质激素诱发开角型青光眼的比重增大,分别为19.25％和4.35％,患病对象集中在年轻男性。结论:我国原发性开角型青光眼的患病率并不低,在作好闭角型青光眼防治工作的同时,必须加强原发性开角型青光眼和糖皮质激素诱发开角型青光眼的防治,重点对象为年轻的男性患者。眼科学报1997;13:96～99。

亚洲年龄相关性眼病流行病学调查概览

近年来,在亚洲进行的多项群体调查为年龄相关眼病的流行病学情况提供了新的信息。亚洲人群屈光不正和青光眼的流行病学特征已经比较明确,但对糖尿病视网膜病变和年龄相关性黄斑变性等重要致盲原因的研究尚有欠缺。本文主要对近年来在亚洲开展的年龄相关性眼病流行病学研究及结果进行综述。

华西医院青光眼住院患者构成及其变化

目的:比较近年青光眼患者在青光眼类型、发病年龄和性别分布的差异,并与以往的资料作比较,以了解青光眼内部构成的变化趋势,为青光眼的防治研究提供新的流行病学资料。方法:收集华西医院眼科2009-01/12所有青光眼住院患者病历共577例,根据出院诊断分为原发性闭角型青光眼(PACG),原发性开角型青光眼(POAG),先天性青光眼,继发性青光眼,并将其与1978-01/1981-12,以及2001-01/2002-12青光眼住院患者971例进行比较。结果:2009年间,原发性青光眼占当年青光眼住院患者总数的60.2%所占比例下降;POAG占原发性青光眼的27.4%,在原发性青光眼中的构成比有所上升;PACG中位数年龄为62.8,总体有所增大,POAG中位数年龄为48,无明显变化;POAG中女性患者比例增加;2009年继发性青光眼占当年青光眼住院患者总数的33.4%,比例显著较往年增加。结论:POAG在原发性青光眼中的构成比有所上升,继发性青光眼患者显著增加。

深圳地区综合医院体检人群青光眼认知度影响因素分析

目的:调查1091例深圳地区综合医院体检人群青光眼认知度的影响因素并分析不同因素对青光眼认知度的影响程度。方法:采用自行设计的青光眼认知度调查问卷,选取北京大学深圳医院体检科检查的普通人群1091例作为研究对象,以χ2检验及Logistic回归分析其对青光眼认知度及影响因素和影响程度进行研究分析。结果:影响被调查人群青光眼认知情况的因素包括教育程度、月收入、是否有医保、医疗行业从业史及近视史(P<0.05);而年龄、性别及全身疾病史对青光眼认知度影响无显著性差异(P>0.05);用二元Logistic回归分析得出对青光眼认知度有显著影响的因素为医疗行业从业史和教育程度。结论:医疗行业从业者、教育程度较高、有医保、近视者及月收入相对较高者的青光眼认知情况较好。应加强医务人员对一般人群的青光眼知识宣教,尤其是应加强对教育程度较低、月收入较低、患有全身疾病者、无医保及有青光眼个人史及家族史人群的宣传教育。

新疆昌吉地区青光眼住院患者流行病学分析

目的了解原发性青光眼住院病人的病型构成、性别、年龄、民族分布以及手术情况,为制定青光眼防治的新策略提供依据。方法对我院眼科1998年1月至1999年12月以及2008年1月至2009年12月所有原发性青光眼住院病人进行统计分析。结果原发性开角型青光眼(Primary open angle glaucoma,POAG)在原发性青光眼的比例于1998年1月至1999年12月为28.24%,2008年1月至2009年12月为48.53%。经检验POAG构成比增大有统计学意义。原发性闭角型青光眼(Primary angle closure glaucoma,PACG)中位数年龄在1998年1月至1999年12月为60岁,在2008年1月至2009年12月为65岁;POAG则分别为43及47.5岁。女性患者在PACG与POAG分别占61.41%与44.09%。少数民族患青光眼比率在1998年1月至1999年12月为11.35%,2008年1月至2009年12月为18.38%,闭角型青光眼手术率在1998年1月至1999年12月为46.15%,2008年1月至2009年12月为31.11%。结论在青光眼住院病人中PACG仍占主要部分,但POAG的构成有增多的趋势,而闭角型青光眼手术比率下降,少数民族患闭角型青光眼比例增加,分析可能有诊断、屈光不正、全身情况、检查治疗手段增多增加以及社会因素等方面的原因。

青光眼住院手术患者的构成及变化趋势分析

目的分析青光眼住院手术患者的内部构成比及其性别、年龄分布,为青光眼的防治研究提供流行病学参考。方法回顾分析浙江大学医学院附属第二医院眼科2001年1月至2008年12月期间青光眼住院手术患者资料,统计住院手术患者的年龄、性别分布及各种类型青光眼的构成比,分析其内部构成比及变化趋势。结果原发性青光眼、继发性青光眼和先天性青光眼患者数各占青光眼总数的61.82%、31.01%和7.16%。住院手术患者中,原发性闭角型青光眼(PACG)患者男:女=1:2.05;原发性开角型青光眼(POAG)患者男:女=2.41:1;继发性青光眼(SG)患者男:女=1.94:1;先天性青光眼(CG)患者男:女=1.45:1。40岁以下原发性青光眼手术患者以POAG患者多于PACG,而40岁以上则相反。结论 PACG是青光眼住院手术患者的主要类型。40岁以上人群中,PACG可能是青光眼防治的重点,而40岁以下人群的防治重点则可能是POAG。

我国原发性青光眼流行病学研究进展

青光眼是不可逆盲的主要病因。随着社会、经济、环境的变化以及诊疗手段的进步,青光眼的流行病学特点也在不断的变化。由于不同的青光眼诊断标准和分类系统可以导致不同的流行病学调查结果,而流行病学的特征又指导着临床的干预措施。因此青光眼流行病学状况对青光眼的防治有着重要的意义。本文就我国原发性青光眼流行病学相关研究进展作一综述。

外伤性青光眼221例的临床分析

目的:回顾性分析221例233眼外伤性青光眼的原发病因及治疗情况,为这类青光眼的防治提供流行病学资料。方法:对我院2004-06/2009-05住院的外伤性青光眼221例233眼进行分析。结果:外伤性青光眼221例中按病因分为前房岀血95例98眼(43.0%),晶状体脱位50例53眼(22.6%),房角后退39例43眼(17.6%),晶状体皮质释放20例20眼(9.1%),角膜穿孔伤8例8眼(3.6%),球内异物6例6眼(2.7%),化学烧伤3例5眼(1.4%)。外伤性青光眼以眼球钝挫伤致前房出血居多。结论:外伤性青光眼的发病机制与病因复杂,视功能损伤严重,预防与合理治疗外伤性青光眼是挽救患者视力的重要环节。