中国陕西省农村原发性开角型青光眼流行病学调查

目的：调查陕西省农村人群原发性开角型青光眼的患病率及相关影响因素。方法：2003—07／12，采用按比例随机整群抽样的方法在陕南、陕北及关中3个地区农村调查8500人，所有受检人员均进行标准问卷调查，包括询问青光眼确诊史、家族史、发作史及手术史，并进行了相关的眼科检查，包括视力、外眼、眼前节、眼底检查。≥50岁人群及怀疑有高眼压者对其应用压平式眼压计测量眼压。对可疑青光眼者进行进一步检查，包括复查眼压、前房角镜检查、视野检查。结果：8500人中共有6815人完成了青光眼的相关检查，受检率为80．18％。原发性开角型青光眼患者共有9例，年龄为38-80（平均62．0）岁，患病率为0．13％，≥30岁、≥40岁和≥50岁人群患病率分别为0．23％、0．28％和0．39％。可疑原发性开角型青光眼患者有12例（0．18％），年龄为35-77（平均54.7）岁，比原发性开角型青光眼患者平均年龄约小7岁。多因素logistic回归分析显示患病率随着年龄的增长而增加（P=0．023）。除年龄外，高度近视也是该人群开角型青光眼发生的危险因素。有青光眼确诊史的患者占22．22％，其中无1例接受过药物或手术治疗。66．67％（6例）原发性开角型青光眼患者存在不同程度的视力损伤，其中盲目占33．33％。结论：原发性开角型青光眼的患病率与国内其他报道相近，且随着年龄的增长而增加。绝大部分患者无青光眼确诊史，并且从未接受过任何相关治疗。     

陕西省农村人群青光眼的流行病学调查

目的:调查陕西省农村≥50岁人群中青光眼的患病情况。方法:2003-07/12,采用按比例随机整群抽样的方法在陕南、陕北及关中3个地区农村调查8500人,其中≥50岁人群有2125人。所有受检人员均进行标准问卷调查,包括询问青光眼确诊史、家族史、发作史及手术史,并进行了相关的眼科检查,包括视力、外眼、前房深度及眼底检查。≥50岁人群应用压平式眼压计测量眼压,对可疑青光眼者进行进一步检查,包括复查眼压、前房角镜检查、激发试验、视野检查。结果:≥50岁人群中有1775人完成了青光眼的相关检查,受检率为83.53%。青光眼的患病率为2.14%,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1.63%、0.39%、0.11%。55.26%青光眼患者存在不同程度的视力损伤,其中单眼低视力、双眼低视力、单眼盲及双眼盲所占比例依次为18.42%、5.26%、18.42%和13.16%。事前未被诊断为青光眼的患者占71.05%(27例),在另外28.95%(11例)有确诊史的青光眼患者中只有6例(54.55%)曾接受过治疗。正常眼的眼压平均值为13.9±2.2mmHg(1mmHg=0.133kPa),随着年龄的增加眼压有增加的趋势(P<0.05)。结论:陕西省农村人群青光眼的患病率为2.14%,但原发性闭角型青光眼和原发性开角型青光眼在原发性青光眼中的比例为4.18:1。无确诊史的青光眼患者占大多数。     

天津市蓟县桑梓村40岁及以上人群中青光眼患病率调查

目的 调查天津蓟县桑梓村40岁及以上人群中青光眼的患病率。方法 2003年1～3月，对天津蓟县桑梓村1987人进行青光眼的普查，每一位受检者接受了问卷调查、视力、色觉、眼前节检查、前房深度、眼压测量及眼底检查，部分接受了倍频视野仪、Goldmann前房角镜及中心视野检查。结果 1701人完成了检查，受检率为85.61％。青光眼患病率为1．59％，原发性闭角型青光眼为1．12％，原发性开角型青光眼为0．35％，继发性青光眼为0.12％；高龄、有青光眼家族史者原发性青光眼患病率较高。所检出的27例青光眼患者中，有19例视功能有一定程度的损伤，其中6例双眼盲，5例单眼盲，4例双眼低视力，4例单眼低视力；19例视力损伤中13例患者年龄≥70岁。结论 青光眼引起的视功能损伤是十分严重的，高龄伴有青光眼家族史的人群应定期随访。     

中国陕西省农村人群血压、眼压和原发性开角型青光眼流行病学调查

目的：调查中国陕西省农村≥50岁人群原发性开角型青光眼、眼内压与全身血压的联系。 方法：2003-07／12，采用整体随机分层抽样法在陕西省洋县、靖边县及富平县调查8500人，其中≥50岁人群2125人，所有受检人员均进行标准问卷调查及详细的眼科检查，包括视力检查、裂隙灯检查、测量眼压及散瞳后直接检眼镜检查眼底。受检者于坐位测量血压。若有可疑青光眼性视盘损害或眼压高于22mmHg者则应进行视野检查。 结果：≥50岁人群中有1775人完成了青光眼的相关检查，受检率为83．53％。通过相关分析，发现此人群中眼压与全身性血压有显著相关性；眼压与收缩压均随年龄的增长而显著升高。通过多因素logistic回归分析，显示原发性开角型青光眼与低舒张期灌注压有显著联系，但未发现原发性开角型青光眼与高血压的显著联系。 结论：中国陕西省农村≥50岁人群中原发性开角型青光眼的患病率与中国其他报道相近。证实较低的舒张期灌注压是原发性开角型青光眼的一个重要危险因素。     

北京市西长安街社区50岁以上人群青光眼调查

目的调查北京市城市社区50岁以上人群中青光眼患病状况及其视功能损害情况。设计横断面调查。研究对象北京市西城区西长安街社区≥50岁居民。方法共检查2410人,应答率88．06％。检查包括视力、裂隙灯显微镜、检眼镜检查,询问青光眼家族史。采用非接触眼压计测量眼压,裂隙灯显微镜测量周边前房深度,观察视盘有无青光眼性视神经改变。对已确诊为青光眼者,记录其青光眼发作史、手术史等。对高危人群及可疑青光眼患者Goldman眼压计测量眼压、前房角镜检查、激发试验、视野检查等。主要指标青光眼患病率,盲与低视力比例。结果西城区西长安街社区50岁及50岁以上人群青光眼患病率为2．49％,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1．66％、0．62％、0．08％。57．89％的青光眼患者视功能有损伤,青光眼患者中双眼盲比例为7．02％,均为≥66岁的患者。单眼盲、双眼低视力和单眼低视力的比例分别为24．56％、5．26％和21．05％。结论社区居民青光眼患者中以原发性青光眼为主。原发性开角型青光眼的构成比较既往有增加的趋势。防治青光眼是今后社区防盲工作的重点之一。     

超声乳化人工晶状体植入治疗原发性闭角型青光眼

目的：探讨晶状体超声乳化吸出联合后房人工晶状体植入术，治疗原发性闭角型青光眼的疗效。 方法：2001-10／2004-10收治原发性闭角型青光眼32例，术前控制眼压，经视力检查、前房角镜和裂隙灯等检查后，均单独采用晶状体超声乳化吸出联合后房人工晶状体植入。 结果：术后随访3-12mo。视力均较术前提高，视力≥0．3者23例占72％；术后眼压〈21mmHg（1mmHg=0．133kPa）者29例占91％。 结论：超声乳化人工晶状体植入可有效地治疗原发性闭角型青光眼。     

吉林省长春市双阳区齐家乡原发性闭角青光眼的患病率调查及其影响因素

目的研究吉林省长春市农村人口原发性闭角型青光眼（PACG）的患病率及其相关影响因素。方法2004年9月至2005年2月,对长春市双阳区齐家乡两个自然村的40岁及以上人群共1139人进行青光眼调查。现场检查项目包括常规视力、裂隙灯显微镜、周边前房深度、眼压及眼底检查。对可疑青光眼患者进一步详细检查眼压、前房角镜、眼底及视野。结果实际检查人数为1139人,受检率为74．5％;确诊为PACG者29例,青光眼患病率为2．5％,随年龄增加其患病率增高。其中男性青光眼患病率为1．5％,女性为3．5％;女性青光眼患病率明显高于男性。周边前房深度检查发现女性人群浅前房的比例明显高于男性,且随年龄的增加浅前房的比例明显增大。有青光眼家族史的人群中,PACG的患病率高于无青光眼家族史的人群。结论长春市双阳区PACG的患病率较高,其患病率与患者性别、年龄、家族史及周边前房深度等因素有关.     

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。     

北京市顺义县50岁及以上人群中青光眼患病率和正常眼眼压的调查

目的　调查北京市顺义县≥ 5 0岁人群中青光眼的患病率和正常眼的眼压。方法　 1996年 9～ 11月 ,采用整群随机抽样法在顺义县调查了 5 5 5 5人 ,除进行视力和一般眼部检查外 ,还进行了有关青光眼的检查 ,如询问青光眼家族史和发作史 ,测量前房深度和眼压 ,眼底检查时观察视乳头有无青光眼性改变。结果　 4 880人完成了有关青光眼的检查 ,受检率为 87 85 %。青光眼的患病率为2 0 7% ,其中原发性闭角型青光眼患病率为 1 6 6 % ,原发性开角型青光眼患病率为 0 2 9% ,继发性青光眼患病率为 0 12 %。各种类型的青光眼患病率均随年龄增长而增加。 6 4 0 0 %的青光眼患者视功能有一定程度或严重损伤。双眼盲比例为 16 0 0 % ,均为≥ 6 0岁的患者。单眼盲、双眼低视力和单眼低视力的比例分别为 17 0 0 %、2 3 0 0 %和 8 0 0 %。正常眼的眼压均值为 (13 5 3± 2 2 0 )mmHg(1mmHg =0 133kPa) ,随着年龄增长 ,眼压有下降趋势。结论　就青光眼的患病率和青光眼患者的视功能而言 ,青光眼是严重的致盲眼病。≥ 5 0岁人群中 ,正常眼的眼压均值比预想值低。在这些人群中筛查青光眼时 ,应将正常眼压上限值降低至 18mmHg。     

激光周边虹膜成形术的临床观察

通过对３６例５６只原发性急、慢性闭角型青光眼施行倍频Ｎｄ：ＹＡＧ激光周边虹膜成形术后的临床观察，随访１—６月（平均４．２月），结果显示：８０—８３％眼的眼压得到控制，７３．６％眼减少了抗青光眼药物的用量，８３％眼房角增宽，６２．５％眼周边前房深度加深，３７％眼房角粘连范围减轻或重新开放。提示：激光周边虹膜成形术对治疗原发性急性闭角型青光眼发作期的患眼、周边虹膜切除术后眼压控制不理想者、慢性闭角型青光眼早期或房角粘连范围不大者有较大的实用价值。     

Prevalence of glaucoma in rural Myanmar: the Meiktila Eye Study

AIM: To determine the prevalence of glaucoma in the Meiktila district of central, rural Myanmar. METHODS: A cross-sectional, population-based survey of inhabitants > or =40 years of age from villages in Meiktila district, Myanmar, was performed; 2481 eligible participants were identified and 2076 participated in the study. The ophthalmic examination included Snellen visual acuity, slit-lamp examination, tonometry, gonioscopy, dilated stereoscopic fundus examination and full-threshold perimetry. Glaucoma was classified into clinical subtypes and categorised into three levels according to diagnostic evidence. RESULTS: Glaucoma was diagnosed in 1997 (80.5%) participants. The prevalence of glaucoma of any category in at least one eye was 4.9% (95% CI 4.1 to 5.7; n = 101). The overall prevalence of primary angle-closure glaucoma (PACG) was 2.5% (95% CI 1.5 to 3.5) and of primary open-angle glaucoma (POAG) was 2.0% (95% CI 0.9 to 3.1). PACG accounted for 84% of all blindness due to glaucoma, with the majority due to acute angle-closure glaucoma (AACG). CONCLUSION: The prevalence of glaucoma in the population aged > or =40 years in rural, central Myanmar was 4.9%. The ratio of PACG to POAG was approximately 1.25:1. PACG has a high visual morbidity and AACG is visually devastating in this community. Screening programmes should be directed at PACG, and further study of the underlying mechanisms of PACG is needed in this population.     

陕西农村50岁以上人群眼压不对称性与无确诊史青光眼相关研究

目的:通过对陕西省农村50岁以上人群眼压(IOP)不对称性的分布情况及其与无确诊史的调查,分析眼压不对称性与原发性青光眼之间的关系。方法:采用分层整群抽样法于2003-07/12在陕西省洋县、靖边县及富平县对50岁以上人口进行问卷调查,包括询问青光眼确诊史、家族史、发作史和手术史,并进行相关眼科检查,包括视力、眼压、外眼、眼前节、前房深度、眼底等,可疑青光眼者进行进一步检查,包括复查眼压、检查前房角、进行激发试验、检查视野等。双眼眼压之差≥3mmHg定义为眼压不对称性。服用抗青光眼药物者、有诊断史的青光眼患者、接受过白内障手术者及有不可信眼压的受检者不做为调查对象。结果:共调查50岁以上观察对象2125例,其中有1775例完成了青光眼的相关检查,受检率为83.53%。在排除了83例服用抗青光眼药物或有青光眼诊断史、或曾接受过白内障手术及眼压不可信的受检者后,共有1692例符合研究对象纳入标准。调查发现共有23例无青光眼确诊史的患者,患病率为1.36%(95%CI,0.88,2.07)。眼压不对称性共有124例,患病率为7.3%(95%CI,6.2,8.7)。通过Mantel-Haenszel分层分析,显示眼压不对称性的患病率随年龄的增长而显著增加(P=0.012)。双眼中最高眼压>21mmHg的受检者眼压不对称性的患病率(35.7%)明显高于最高眼压≤21mmHg的受检者(7.1%)。应用多因素非条件logistic回归分析显示眼压不对称性与无确诊史的原发性青光眼有显著性关联(OR为3.68;95%CI,1.37,9.86),此联系在双眼中的最高眼压≤21mmHg的受检者中依旧保持(OR为4.74;95%CI,1.16,19.35)。结论:对于那些没有出现高眼压并且还未诊断为青光眼的患者,眼压不对称性与原发性青光眼关联有统计学意义,提示临床上诊断原发性青光眼时,眼压不对称性可作为一个有价值的诊断参考指征。     

Prevalence of glaucoma in a rural East African population

PURPOSE: To determine the prevalence of glaucoma in an adult population in rural central Tanzania. METHODS: Six villages were randomly selected from eligible villages in the Kongwa district, and all residents more than 40 years of age were enumerated and invited to a comprehensive eye examination including presenting visual acuity, refraction, automated 40-point Dicon (San Diego, CA) suprathreshold screening field test, Tono-Pen (Bio-Rad, Inc., Boston, MA) intraocular pressure (IOP) measurement, and standardized examination by an ophthalmologist of anterior segment, optic nerve head, and retina after pupil dilation. Gonioscopy and Glaucoma-Scope (Ophthalmic Imaging Systems, Sacramento, CA) optic disc imaging were performed on those with IOP higher than 23 mm Hg and cup-to-disc ratio (c/d) more than 0.6 and on a 20% random sample of participants. RESULTS: Of 3641 eligible persons, 3268 (90%) underwent ophthalmic examination. The prevalence of glaucoma of all types was 4.16% (95% confidence interval [CI] = 3.5, 4.9%). Primary open-angle glaucoma (OAG) was diagnosed in 3.1% (95% CI = 2.5, 3.8%), primary angle-closure glaucoma (ACG) in 0.59% (95% CI = 0.35, 0.91%), and other forms of glaucoma in 0.49%. The prevalence of glaucoma was found to be sensitive to changes in the diagnostic criteria. CONCLUSIONS: The high prevalence of OAG in this group was similar to that of African-derived persons in the United States but less than in African-Caribbean populations. ACG was more prevalent in east Africans than suggested by anecdotal reports.     

Glaucoma in a rural population of southern India: the Aravind comprehensive eye survey

PURPOSE: To determine the prevalence of glaucoma and risk factors for primary open-angle glaucoma in a rural population of southern India. DESIGN: A population-based cross-sectional study. PARTICIPANTS: A total of 5150 subjects aged 40 years and older from 50 clusters representative of three southern districts of Tamil Nadu in southern India. METHODS: All participants had a comprehensive eye examination at the base hospital, including visual acuity using logarithm of the minimum angle of resolution illiterate E charts and refraction, slit-lamp biomicroscopy, gonioscopy, applanation tonometry, dilated fundus examinations, and automated central 24-2 full-threshold perimetry. MAIN OUTCOME MEASURES: Definite primary open-angle glaucoma (POAG) was defined as angles open on gonioscopy and glaucomatous optic disc changes with matching visual field defects, whereas ocular hypertension was defined as intraocular pressure (IOP) greater than 21 mmHg without glaucomatous optic disc damage and visual field defects in the presence of an open angle. Manifest primary angle-closure glaucoma (PACG) was defined as glaucomatous optic disc damage or glaucomatous visual field defects with the anterior chamber angle partly or totally closed, appositional angle closure or synechiae in the angle, and absence of signs of secondary angle closure. Secondary glaucoma was defined as glaucomatous optic nerve damage and/or visual field abnormalities suggestive of glaucoma with ocular disorders that contribute to a secondary elevation in IOP. RESULTS: The prevalence (95% confidence interval) of any glaucoma was 2.6% (2.2, 3.0), of POAG it was 1.7% (1.3, 2.1), and if PACG it was 0.5% (0.3, 0.7), and secondary glaucoma excluding pseudoexfoliation was 0.3% (0.2,0.5). On multivariate analysis, increasing age, male gender, myopia greater than 1 diopter, and pseudoexfoliation were significantly associated with POAG. After best correction, 18 persons (20.9%) with POAG were blind in either eye because of glaucoma, including 6 who were bilaterally blind and an additional 12 persons with unilateral blindness because of glaucomatous optic neuropathy in that eye. Of those identified with POAG, 93.0% had not been previously diagnosed with POAG. CONCLUSIONS: The prevalence of glaucoma in this population is not lower than that reported for white populations elsewhere. A large proportion of those with POAG had not been previously diagnosed. One fifth of those with POAG had blindness in one or both eyes from glaucoma. Early detection of glaucoma in this population will reduce the burden of blindness in India.     

安徽省桐城县青光眼流行病学调查

报告１９８７年４月安徽省桐城县青光眼流行病学的调查结果：原发性青光眼的患病率为０．３８％，其中原发性闭角型和开角型青光眼患病率分别为０．３１％和０．０７％，４０岁以上人群中，原发性青光眼患病率为０．７１％，在原发性青光眼中，盲与低视力的发病率分别为１４．２８％和２１．４２％。     

Epideｍiologyof priｍaryopen angle glaucoｍa in a rural population in shaanxi provinceof china

to assessthe Prevalence and related risk factorsof PrimaryoPen angle glaucoma (POAG) in a rural PoPulation in Shaanxi Province. ·METHODS: By using a stratified, cluster-based, random samPlingtechnique, 8 500 Personsof all ages were selected randomly, fromthe North,the South andthe Middleof Shaanxi Province from Julyto December in 2006. All ParticiPants had an interview with a standard questionnaire andthose questions relatedto glaucomaof Previous diagnosis andtreatment, family history andoutbreak history.then a detailed and relative eye examination was Performed, including logarithmofthe minimum angleof resolution visual acuity, external eye examination with slit-lamP biomicroscoPy and fundus examination.the intraocular Pressure(IOP) was measured with Perkins aPPlanationtonometrytothose Persons aged 50 yearsoldor more andthose with susPected increased IOP. A further examination was Performedtothose Persons with susPicious glaucoma, including rePeatedtonometric examination, gonioscoPy, dark roomtest, automated visual fieldtesting, et al . ·RESULTS: Atotalof 6 815 amongthe eligible 8 500 Personsof all ages were interviewed and examined from Julyto December in 2006, a resPonse rateof 80.18%. Nine ParticiPants were foundto have POAG, withthe Prevalenceof 0.13%, age ranging from 38to 80 years (mean year: 62.0). Inthose aged 30 yearsoldor more,the Prevalenceofthe disease was 0.23%, 0.28% and 0.39% forthose morethan 40 and 50 yearsold, resPectively.the rateof susPicious POAG was 0.18% (12 cases) with age ranging from 35to 77 years (mean year: 54.7). With multiPle logistic analyses,the Prevalence increased significantly with age (P =0.023).Otherthan increasing age, myoPia was also a strong risk factor for POAG.of 9 ParticiPants with POAG,only 2 cases (22.22%) had been Previously diagnosed. Noone with POAG was received anytreatment Previously. 66.67%(6 cases) ParticiPants with POAG suffered from visual imPairment in various degrees secondaryto POAG.the Percentageof blindness in either eye was 33.33%. ·CONCLUSION:the Prevalenceof POAG is closetothat fromother Chinese PoPulations, increasing with age. A majorityof glaucoma was undiagnosed and untreated Previously.     

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。     

Gonioscopy findings and prevalence of occludable angles in a Burmese population: the Meiktila Eye Study

AIM: To determine the prevalence of preglaucomatous angle-closure disease in central Myanmar. METHODS: A population-based survey of inhabitants >or=40 years in the Meiktila District was carried out; 2481 subjects were identified, 2076 participated and 2060 underwent gonioscopy of at least one eye. Eyes with angles traditionally described as "occludable" were recorded as primary angle-closure suspects (PACS); eyes with PACS and peripheral anterior synechiae (PAS), or an increased intraocular pressure but without primary angle-closure glaucoma, were recorded as primary angle closure (PAC). RESULTS: The prevalence of PACS in at least one eye was 5.7% (95% CI 4.72 to 6.62); prevalence increased with age and was more common in women (p<0.001). The prevalence of PAC in at least one eye was 1.50% (95% CI 1.47 to 1.53). All participants with PAS had at least 90 degrees of closure (range 90-360 degrees). CONCLUSION: The prevalence of preglaucomatous angle-closure disease (PACS and PAC) in this population was 5.7% and 1.5%, respectively. PACS was more common in women, and its prevalence increased with age.