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。     

中国陕西省农村原发性闭角型青光眼流行病学调查

目的：调查陕西省农村≥40岁人群原发性闭角型青光眼的患病率及影响因素。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，其中≥40岁人群3500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、Van Herick周边前房深度评估、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、暗室试验、视野检查。结果：8500人中有6815人完成了青光眼的相关检查，总受检率为80．18％，其中≥40岁人群3500人中有2835人完成了青光眼的相关检查，受检率为81．00％。VanHerick周边前房深度分级：2级、1级和0级分别占10．4名、3．0％和0．2％。≥40岁人群原发性闭角型青光眼患者有3l例，其患病率为1．09％，通过多因素logistic回归分析显示随着年龄的增长患病率显著增加（P=0．008）。虽然女性较男性多见（OR：1．77，95％CI为0．77-4．10），文盲较非文盲多见（OR：1．71，95％CI为0．76～3．87），但其差异无统计学意义（P不同性别=0．180，P不同文化程度=0．199）。事前未被诊断为青光眼的患者占67．74％（21例），在另外10例有确诊史的青光眼患者中只有6例（60％）曾作过虹膜根切术。48．39％（15例）原发性闭角型青光眼患者存在不同程度的视力损伤，其中盲目占29．03％。70．97％（22例）为慢性闭角型青光眼。结论：陕西省农村≥40岁人群的窄房角比例高于亚洲其他国家人群。原发性闭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，大部分患者无青光眼确诊史。     

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。     

原发性开角型青光眼和高眼压患者及正常人群结膜印迹细胞学检查的比较

目的：比较原发性开角型青光眼和高眼压患者及拥有健康眼球表面的正常人群的泪膜功能和印象细胞学检查的数值。
　　方法：此前瞻性研究中纳入了原发性开角型青光眼患者11例11眼(平均年龄：62.7±6.1岁),高眼压患者12例12眼(平均年龄：62.8±6.4岁)及健康人12例12眼(平均年龄：62.9±6.03岁)。这些患者均是最近被诊断出患有原发性开角型青光眼及高眼压,且之前未接受过抗青光眼方面的治疗。均行结膜印迹细胞学检查、泪膜破裂时间和基础泪液分泌试验。每组印迹细胞学检查的样本根据Nelson分级法分为0~3级。应用Kruskal-Wallis检验和Dunn多重比较检验进行统计分析。
　　结果：原发性开角型青光眼患者,高眼压患者及正常人群平均基础泪液分泌值分别为10.4±1.3,10.9±1.2和11.1±1.1 mm/5min,其差距没有统计学意义(P=0.33);三组的泪膜破裂时间分别为11.2±1.1,11.3±1.1和11.8±1.2s,其差距没有统计学意义(P=0.35)。原发性开角型青光眼患者中6眼(54.5%)为0级,5眼(45.5%)为1级。高眼压患者中6眼(50%)为0级,6眼(50%)为1级,健康人中6眼(50%)为0级,6只眼(50%)为1级(P=0.97)。
　　结论：氧化应激可能会导致青光眼,眼表疾病,泪腺功能障碍及机体杯状细胞所分泌的黏液减少。原发性开角型青光眼患者,高眼压症患者及健康人群间的印象细胞学检查数值并无显著差异。     

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。     

原发性开角型青光眼与24h眼压及眼灌注压的研究进展

原发性开角型青光眼是一类早期无明显临床症状,但随病情进展将导致不可逆的视神经损害及视野缺损的致盲性眼病。眼压是原发性开角型青光眼诊断及评定治疗效果的简单而又重要的指标。临床上,一些治疗中的原发性开角型青光眼患者白天就诊时间所测眼压已达靶眼压,但视神经损害却仍在进展,研究表明可能与夜间眼压的升高、24 h较大的眼压波动及夜间眼灌注压的降低有关。因此,我们对原发性开角型青光眼与眼压及眼灌注压波动的相关文献予以综述,以更好的理解三者之间的关系。     

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。     

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。     

在非青光眼人群中血压与视盘结构的关系

血压水平是原发性开角型青光眼发病的非眼压性危险因素之一,高血压病、血管痉挛和急性低血压被认为是潜在的危险因素。但人群为基础的流行病学研究结论并不一致。为研究非青光眼人群中血压水平与视盘结构的关系,作者对希腊北部Thessa-loniki地区60岁以上人群随机样本2554人进行     

24小时血压参数与原发性开角型青光眼视神经损害的相关性

目的：研究24 h血压参数与原发性开角型青光眼（POAG）视神经损害之间的相关性。方法：病例对照研究。选择2013年6月至2016年12月期间成都市第一人民医院确诊的60例POAG患者作为POAG组,55 例正常人群作为对照组。2 组均进行24 h眼压和血压的同步监测,比较2 组受检者24 h血压参数、眼灌注压及眼压的差异,并分析POAG组患者24 h血压参数、眼灌注压及眼压与相关视功能之间的关系。采用独立样本t检验和多重线性回归等进行统计学分析。结果：①POAG组的24 h平均眼压、眼压差、眼灌注压差及脉压差显著高于对照组,2 组差异均有统计学意义（t =3.22、6.57、2.29、2.39,P ＜0.05）。②POAG组平均收缩压显著高于对照组（t =3.02,P =0.003）,其收缩压最高值、收缩压波动值、夜间平均收缩压、夜间最高收缩压及其波动值均显著高于对照组（t =4.38、5.27、4.13、4.13、 4.14,P ＜0.001）。③POAG组24 h平均舒张压、舒张压最高值、夜间平均舒张压、夜间舒张压最高值也显著高于对照组（t =2.22、2.50、2.29、2.10,P ＜0.05）。④POAG组患者的24 h血压相关参数与视神经损害相关性：平均眼压是POAG视野的平均缺损值（MD）的影响因素,二者呈负相关（b =-0.44,P =0.004）;盘周平均视网膜神经纤维层（RNFL）厚度与平均眼压（b =-0.956,P =0.001）、眼压差（b =-1.125,P =0.003）呈负相关;夜间平均舒张压（b =0.395,P ＜0.001）和夜间平均动脉压（b =0.046,P =0.001）分别与AP100和AP50值呈正相关。结论：①24 h血压相关参数与POAG的视神经损害之间存在相关性;②夜间眼灌注压、夜间舒张压和夜间动脉压可能是POAG视神经损害的影响因素;③在POAG的治疗中,稳定的血压和靶眼压有利于保持有效的稳定的眼灌注压,提示在关注降眼压治疗POAG的同时应该关注血压的变化。     

Intraocular pressure and ocular hemodynamics in patients with primary open‐angle glaucoma treated with the combination of morning dosing of bimatoprost and dorzolamide hydrochloride

Acta Ophthalmol. 2011: 89: e57–e63

Abstract.

Aims: This prospective, multicenter, single‐masked study evaluated the additive effect of dorzolamide hydrochloride 2% on the diurnal intraocular pressure (IOP) curve and retinal and retrobulbar hemodynamics in patients with primary open‐angle glaucoma (POAG) treated with morning‐dosed bimatoprost 0.03%. Methods: Eighty‐nine patients (aged, 60.7 ± 11.8 years, range 33–80; 68 women) with POAG received bimatoprost dosed once in the morning for 1 month, after which dorzolamide was added twice daily for 2 months. IOP (Goldmann) and arterial blood pressure (BP) and diurnal ocular perfusion pressures (OPP) were measured every 2 hr for 24 hr. Heidelberg retina flowmetry of the retinal microcirculation was recorded four times daily in 64 patients and colour Doppler imaging of the ophthalmic and central retinal arteries was recorded five times daily in 25 patients. All measurements were taken after the two phases of treatment and compared using anova analysis with Bonferroni adjustment. Results: Mean baseline IOP was 16.5 ± 3.4 mmHg. Mean diurnal IOP with dorzolamide adjunctive therapy (12.9 ± 2.1 mmHg) was significantly lower compared to mean IOP with bimatoprost monotherapy (13.6 ± 2.2 mmHg) (p = 0.03). Adjunctive dorzolamide therapy significantly decreased vascular resistance in the ophthalmic artery (p = 0.02). Mean diastolic BP and OPP were significantly lower after adjunctive therapy. There were no changes in retinal microcirculation between the two phases of treatment. Conclusions: Adjunctive dorzolamide therapy to morning‐dosed bimatoprost 0.03% reduced diurnal IOP and vascular resistance in the ophthalmic artery but did not alter retinal circulation in this group of patients with POAG.     

Vascular risk factors for primary open angle glaucoma: the Egna-Neumarkt Study

OBJECTIVE: To assess the impact of vascular risk factors on the prevalence of primary open angle glaucoma. DESIGN: Population-based cross-sectional study. PARTICIPANTS: Four thousand two hundred ninety-seven patients more than 40 years of age underwent a complete ocular examination in the context of the Egna-Neumarkt Glaucoma Study. INTERVENTION: Ocular examinations were performed by trained, quality-controlled ophthalmologists according to a predefined standardized protocol including medical interview, blood pressure reading, applanation tonometry, computerized perimetry, and optic nerve head examination. MAIN OUTCOME MEASURES: Prevalences of ocular hypertension, primary open-angle glaucoma, normal-tension glaucoma, and other types of glaucoma were determined. Correlation coefficients were calculated for the association between systemic blood pressure and age-adjusted intraocular pressure (IOP) and between age and both intraocular and systemic blood pressures. Odds ratios were computed to assess the risk of primary open-angle glaucoma and normal-tension glaucoma in relation to systemic hypertension or antihypertensive medication, blood pressure levels, diastolic perfusion pressure, and a number of other cardiovascular risk factors. RESULTS: A positive correlation was found between systemic blood pressure and IOP, and an association was found between diagnosis of primary open-angle glaucoma and systemic hypertension. Lower diastolic perfusion pressure is associated with a marked, progressive increase in the frequency of hypertensive glaucoma. No relationship was found between systemic diseases of vascular origin and glaucoma. CONCLUSIONS: Our data are in line with those reported in other recent epidemiologic studies and show that reduced diastolic perfusion pressure is an important risk factor for primary open-angle glaucoma.     

Intraocular pressure and systemic blood pressure: longitudinal perspective: the Beaver Dam Eye Study

AIM: To investigate the relation between change in systemic blood pressures and change in intraocular pressure. METHODS: This was a population based study of people 43-86 years old living in Beaver Dam, Wisconsin. Measurements at baseline (1988-90) and 5 year follow up of systemic blood pressures, intraocular pressures, and history of use of blood pressure medications. RESULTS: Intraocular pressures were significantly correlated with systolic and diastolic blood pressures at both baseline and follow up. There were significant direct correlations between changes in systemic blood pressures and changes in intraocular pressure. There was a 0.21 (95% CI: 0.16 to 0.27) mm Hg increase in IOP for a 10 mm Hg increase in systolic and 0.43 (0.35 to 0.52) mm Hg increase in IOP for a 10 mm Hg increase in diastolic blood pressure. Further adjustment for diabetes and medication use did not alter these associations. Decreased systolic or diastolic blood pressures of more than 10 mm Hg over 5 years were significantly associated with decreased IOP. CONCLUSIONS: Reduced systemic blood pressure is associated with reduced intraocular pressure. This finding should be evaluated in other studies, especially with respect to the possibility of resultant decreased risk of open angle glaucoma.     

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.     

Ocular pulse amplitude, intraocular pressure and beta blocker/carbonic anhydrase inhibition in combined therapy of primary open-angle glaucoma

BACKGROUND: Beyond intraocular pressure (IOP, German abbreviation: IOD) ocular perfusion is increasingly discussed in the pathogenesis of the glaucomas. The present study was designed to investigate for ocular pulse amplitude (OPA) in primary open angle glaucoma patients with elevated intraocular pressure (POAG, German abbreviation: POWG) following application of timolol, a beta-blocker and dorzolamide a topical carbonic anhydrase inhibitor. METHODS: OPA (Ocular Blood Flow System, OBF Labs U.K.) IOP, heart rate, systolic and diastolic brachial artery pressures were measured before and 4 weeks following application of timolol and additional 4 weeks following application of a timolol/dorzolamide combination in 14 POAG patients. RESULTS: Following administration of timolol, IOP was highly significantly reduced in drug treated POAG eyes; this effect was additively enhanced by dorzolamide. Timolol did not affect OPA, whereas dorzolamide significantly increased OPA in drug treated POAG eyes. Systemic perfusion parameters were unchanged. CONCLUSION: Timolol and dorzolamide drastically reduced IOP, in addition dorzolamide increased OPA in POAG, an ocular microcirculatory effect which may further help to improve prognosis of POAG.     

POAG患者习惯性体位眼压及眼灌注压昼夜波动趋势的研究

目的：探讨初诊未行治疗的原发性开角型青光眼( prilary open angle glaucola,POAG)患者习惯性体位眼压及眼灌注压(ocular perfusion pressure,OPP)波动趋势,并验证由日间平均坐位及卧位眼压推导夜间峰值眼压的可行性。
　　方法：选取POAG患者19例19眼及正常对照组18例18眼,分别于10：00,14：00,18：00及22：00时行坐位眼压及血压监测,为验证由日间卧位眼压推导夜间峰值眼压的可行性,另对POAG组于卧位5 lin后再行监测。2：00,5：00及7：00行卧位监测,计算出OPP并行数据分析。由已知公式通过日间眼压计算夜间峰值眼压,并与实际值对比。
　　结果：24h习惯性体位下,POAG患者平均眼压及眼压波动均高于正常对照组(P<0.05),POAG组平均眼压峰值出现于凌晨5：00,对照组则为7：00。两组夜间眼压均值均大于日间,差异有统计学意义(P<0.05)。两组内习惯性体位平均眼灌注压( MOPP )均表现为夜间低于日间( P<0.05),而两组间 MOPP 无明显统计学差异( P>0.05)。POAG患者MOPP波动较对照组大,差异有统计学意义( P<0.05)。由两公式推导所得夜间眼压峰值均与所测值无明显统计学差异(P>0.05)。
　　结论：习惯性体位下POAG组及正常人的眼压峰值多出现在凌晨至上午,POAG患者的习惯性体位平均眼压及眼压波动均高于对照组。两组内夜间灌注压均较日间低,且POAG患者有更大的MOPP波动。由日间眼压推导夜间峰值眼压具有一定的可行性。     

Vascular risk factors in glaucoma: the results of a national survey

Background The role of vascular risk factors in glaucoma is still being debated. To assess the importance of vascular risk factors in patients with primary open-angle glaucoma (POAG), data from the medical history of 2,879 POAG patients and 973 age-matched controls were collected and analyzed. Methods Design: observational survey. Setting: 35 Italian academic centers. Study population: POAG patients and age-matched controls. In order to reduce bias consecutive patients were included. Observation procedures: data concerning vascular risk factors were collected for all patients with a detailed questionnaire. A complete ophthalmological examination with assessment of intraocular pressure (IOP), visual field, optic disc, and systemic blood pressure was performed. Main outcome measures: the ESH-ESC (European Society of Hypertension-European Society of Cardiology) guidelines were used to calculate the level of cardiovascular risk. Crude and adjusted estimates of the odds ratios (OR) were calculated for all cardiovascular risk factors in POAG and controls. Results The study included 2,879 POAG patients and 973 controls. POAG cases had a significantly higher systolic and diastolic blood pressure (p = 0.001) and systolic perfusion pressure (p = 0.02) as compared with controls. Also mean IOP was significantly higher in the POAG group (p = 0.01), while diastolic perfusion pressure was not significantly different in the two groups. Myopia was more prevalent in the POAG group (23 vs 18%, p = 0.005) as well as a positive family history for glaucoma (26 vs 12%, p = 0.004). POAG patients tended to have a higher cardiovascular risk than controls: 63% of glaucoma cases vs 55% of controls (OR: 1.38, p = 0.005) had a “high” or “very high” cardiovascular risk. Conclusions The level of cardiovascular risk was significantly higher in glaucoma patients than in controls. The study was supported by an unrestricted grant from MSD. No proprietary interest.