普通人群青光眼认知度的研究进展

青光眼是常见的不可逆的致盲性眼病,由于其发病隐匿,易被忽视,致盲率高。了解并提高普通人群对青光眼的认知度是早期发现、早期诊断、及时治疗、挽救青光眼患者残余视功能的有效途径。笔者就近年来关于普通人群青光眼认知度的相关研究进行综述。国内对青光眼认知度调查的资料较少,且多局限于眼科就诊患者。发达国家或地区普通人群对青光眼的认知度较好(72%～79%),但对青光眼症状、发病机制和治疗手段的认识仍有限。     

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。     

哈萨克族牧民青光眼门诊病例分析

1临床资料我院2005-03/2006-02共接诊哈萨克族牧民青光眼患者共67例,男16例,女51例;年龄43～78岁;患者单眼视力下降伴有眼胀头痛史者至失明达0.5a以上25例;眼痛眼胀双眼先后失明2m o～2a者9例;间歇性眼胀头痛视物障碍或急性青光眼症状1～3wk以内到医院检查者33例(其中2例为双眼     

眼科门诊医护人员对于新型冠状病毒肺炎的防护对策 △

目的 探讨在新型冠状病毒肺炎(COVID-19)疫情期间,眼科门诊医护人员的防控对策。方法 采用调查问卷的方法收集2020年1月1~24日、1月27日~2月2日、2月25日~3月25日眼科门诊就诊患者及医护人员的情况,包括患者的体温、流行病学史、疫区或外来人员接触史、目前症状(发热、咳嗽、乏力、眼红、分泌物等)以及近期接触人员的接触史等。同时制订COVID-19防控应急预案,进行医护人员眼部及全身防护,眼科器械清洁消毒制度。结果 COVID-19疫情初发期间(1月1~24日)我院眼科门诊接诊6 564例患者,每天共16名医护人员接诊患者;疫情高峰期间(1月27日~2月2日)共接诊262例患者,每天共8名医护人员参与接诊;疫情后期(2月25日~3月25日)共接诊4 503例患者,每天共16名医护人员参与接诊。通过进行医护人员眼部及全身防护、眼科器械清洁消毒等措施,截止目前眼科门诊未发现患者及医护人员感染病例。结论 COVID-19疫情期间,加大筛查力度,完善眼科门诊检查仪器设施消毒制度,保障了医护人员的安全。     

督导式教学门诊在眼科住院医师规范化培训中的实践

目的：探讨督导式教学门诊在眼科住院医师规范化培训中的具体实践和教学效果。方法：通过合理排班、限制号源等措施设立每周固定的督导式教学门诊时间，安排老师和学员出诊；在教学门诊开展4个月后，通过问卷调查和临床技能考核的形式采集反馈意见并评估教学效果。结果：共有16名老师和8名学员参加了督导式教学门诊，调查问卷结果显示100%的带教老师和学员认可该教学模式，参加过教学门诊的学员临床技能考核得分显著高于对照组(t=3.631,P <0.0 5)。结论：督导式教学门诊应用于眼科住院医师规范化培训具有实际可行性，并可以提高学员的临床技能水平。     

眼科互联网护理咨询门诊的探索与实践

目的：通过中山大学中山眼科中心眼科互联网护理咨询门诊建设与运营经验,对互联网专科护理服务模式及效果进行分析,为眼科互联网+护理服务提供参考。方法：依托医院优质资源,成立眼科互联网护理咨询门诊;根据眼科患者的实际需求,制订互联网护理咨询门诊服务制度、工作流程,对出诊专家进行资质审核、培训与考核。收集、统计眼科互联网护理咨询门诊接诊量、患者满意度、首诊问题分类及护士职业获益感等数据。结果：2021年6月26日至12月31日累计接诊患者1266人次;接诊时间主要在08:00—22:00;咨询次数最多的问题种类是眼健康知识科普;患者对眼科互联网护理咨询门诊的总体满意度为99.52%;眼科互联网护理咨询门诊运营后,眼科护士职业获益感总分及各维度得分均有提高,差异均有统计学意义(均P<0.05)。结论：眼科互联网护理咨询门诊服务可有效满足各类人群的眼健康护理需求,患者满意度高,亦可提高眼科护理人员的职业获益感,值得进一步推广。     

中山眼科中心近年在SCI收录期刊发表的青光眼临床基础研究成果

本文简介了中山大学中山眼科中心青光眼专业近年来在SCI收录期刊发表的青光眼临床基础研究成果，主要包括青光眼遗传学及流行病学的研究、干细胞的研究、发病机理的研究、嘌呤调节青光眼发病机制以及视神经保护研究等几个方面，约发表SCI论文30篇。     

眼科门诊干眼的流行病学调查及相关危险因素分析

目的 了解眼科门诊就诊者中干眼患病状况,并探讨干眼发病的相关危险因素.方法 收集2005年4月至6月、9月至11月眼科门诊就诊的650例30岁以上者作为研究对象,在获得知情同意后进行干眼问卷调查及泪膜破裂时间(break up time,BUT)试验,对其中干眼症状阳性及BUT<10 s者进行角膜荧光素染色、睑板腺功能检查、基础泪液分泌试验、虎红染色4项干眼的客观检查,对确诊的干眼患者按12配比的方法进行病例对照研究,分析其相关危险因素.结果 650例调查对象(年龄30～83岁,平均49.9岁)干眼总的患病率为20.6%,女性(26.2%)多于男性(15.0%,P＜0.001);干眼的患病率随年龄增长而增高,在60岁以上年龄组患病率高于60岁以下年龄组(P＜0.05),30岁年龄组患病率最低(11.1%),眼部不适症状中最多见的是干涩感182例(28.0%),其次为疲劳感158例(24.3%),最少见的症状为眼痛42例(6.5%);平均BUT为(9.50±2.86)s,男性(10.22±2.30)s高于女性(8.76±3.16)s,泪膜稳定性高于女性(t'＝6.641,P=0.000),BUT随年龄增长而缩短,60岁以下年龄组BUT高于60岁以上年龄组(P＜0.001);农民干眼的患病率高于其他职业(P＜0.001).多因素条件Logistic回归分析显示以下因素是与干眼相关的危险因素:滴眼液(P＜0.001,OR 1.890,CI 1.338～2.668)、糖尿病(P＜0.001,OR 3.144,CI 1.788～5.529)、翼状胬肉(P＜0.001,OR 3.982,CI 1.982～7.783)、使用视频终端(P＜0.05,OR 1.737,CI 1.192～2.532),而服用阿斯匹林、多种维生素,甲状腺疾病、高血压、过敏性疾病、青光眼、眼部手术及屈光不正病史与干眼无相关性.结论 干眼与年龄、性别及职业相关,糖尿病、翼状胬肉、长期使用滴眼液和视频终端这些因素可能是新疆干眼相关的危险因素.     

早期青光眼患者普通与蓝、黄视野阈值的比较分析

目的：为蓝黄视野计在开角型青光眼早期诊断方面的作用提供先导分析。方法：对17例（27眼）早期青光眼患分别采用普通与蓝黄视野计进行视野检查,并对其相应的阈值作统计学比较分析。结果：普通视野计与蓝黄视野计对早期青光眼的检查结果有高度统计学差异（P＜0．01）,蓝黄视野在诊断早期青光眼时更敏感。结论：蓝黄视野分析是一种可靠,准确,简便,更适合早期青光眼诊断的方法。     

青光眼公众知晓率亟待提升

青光眼是全球范围内第二大致盲性眼病,然而由于青光眼公众知晓率低等原因,使得青光眼的未诊断率居高不下。即使在发达国家,约50%的青光眼患者尚未察觉自己已经患病而未作任何治疗;在发展中国家,这个数字更是高达90%。根据对国内以及国际上青光眼认知度调查的结果分析来看,提高青光眼公众知晓率已迫在眉睫。我们倡议通过更广泛的形式及途径开展青光眼的宣传教育,以及增强基层医院眼科医生的技能培训并装备必要的检查设备,期望能在较短时间内显著提高我国青光眼的公众知晓率和疾病诊断率。     

Determinants of glaucoma awareness in a general eye clinic

PURPOSE: Heightened public awareness about glaucoma may increase the chance of identifying undetected cases. To ascertain determinants of glaucoma awareness, we surveyed a population visiting a general eye clinic. DESIGN: Cross-sectional study. PARTICIPANTS: 1197 general eye clinic patients and their companions. METHODS: We designed and administered a questionnaire about glaucoma to general eye clinic patients and their companions. We created multivariate logistic regression models to ascertain the effect of demographic and clinical features on the likelihood of being unaware of glaucoma. MAIN OUTCOME MEASURES: Adjusted odds ratio (OR) with 95% confidence intervals of survey attributes associated with self-perceived unfamiliarity with glaucoma. RESULTS: Glaucoma awareness overall (72%) approached that found in the subgroup self-reporting a diagnosis of glaucoma (80%). Survey attributes associated with an increased likelihood of being unaware of glaucoma were African American race (OR = 1.69 [1.28-2.20], Hispanic ethnicity (OR = 2.13 [1.46-3.02]), and less than a college education (OR = 1.67 [1.37-2.05]). Age was also a determinant of glaucoma awareness (for ages 50-64 years, OR = 0.60 [0.44-0.80] and for ages 65-79 years, OR = 0.56 [0.41-0.75] compared with ages less than 35 years). A self-report of glaucoma was not a determinant of glaucoma awareness (OR = 0.63 [0.33-1.17]), although there was a trend toward enhanced glaucoma awareness in this subgroup. Finally, respondents with a history of employment in the health field (OR = 0.63 [0.49-0.82]) myopia (OR = 0.68 [0.56-0.82]), glaucoma in a first-degree relative (OR = 0.68 [0.53-0.87]), and respondents who reported having a dilated eye examination (OR = 0.53 [0.42-0.66]) were less likely to be unaware of glaucoma than those who did not have these attributes. CONCLUSIONS: Although glaucoma awareness in this population was high, Hispanics, African Americans, and those with less than a college education were more likely to be unfamiliar with the disease. Interestingly, a self-report of having glaucoma was not a statistically significant determinant of glaucoma awareness.     

挫伤性房角后退和房角退缩性青光眼的临床研究

目的探讨房角后退与房角退缩性青光眼的关系.方法研究1978年1月～1999年3月连续294例294只房角后退眼,其中随访1～3年者201只眼,3～6年者60只眼,6～20年者33只眼.重点分析这些眼的临床表现、前房角镜检查所见及房角后退与房角退缩性青光眼的关系.结果26只眼发生了房角退缩性青光眼(8.8%),其中24只眼为早发型,2只眼为晚发型.在26只房角退缩性青光眼中,24只眼房角后退的范围均＞180°.结论所有眼钝伤患者均应行前房角镜检查.房角退缩性青光眼的发生与房角后退的范围有关.如果房角后退范围＞180°,应定期随访患者的眼压、眼压描记、C/D和视野变化,以便早期发现房角退缩性青光眼.     

Knowledge and awareness of glaucoma in Mexican patients with and without glaucoma diagnosis in an Ophthalmology Referral Center

AIM: To assess and compare knowledge and awareness of glaucoma in subjects with and without glaucoma diagnosis attending an Ophthalmology Referral Center. METHODS: This cross-sectional study was conducted at Asociación Para Evitar la Ceguera in Mexico City, using a questionnaire formulated by a group of experts following the Delphi panel rules, and pre-tested in a pilot study. The questionnaire was applied and compared between: glaucoma patients, relatives of glaucoma patients and patients without glaucoma. Socio-demographic data was collected to assess correlation with the level of knowledge using Logistic regression models, estimating the odds ratios (OR), 95% confidence intervals, and P<0.05. RESULTS: Three hundred and ninety-four subjects were enrolled; with a median age of 61y. One hundred and thirty-four (34%) were patients with glaucoma, 152 (38.6%) patients without glaucoma, and 108 (27.4%) relatives of patients with glaucoma. Two hundred and ninety-one (73.9%) participants were aware of the term “glaucoma”. Regarding knowledge 46.7% had moderate knowledge, 37.8% had poor knowledge, and 15.5% good knowledge. Overall, relatives of glaucoma patients had the highest scores, and patients without glaucoma got the lowest scores. A positive correlation was found between better knowledge and frequent ophthalmological examinations OR 2.24 (P=0.02), higher education level OR 4.17 (P=0.00) and having a family member with glaucoma OR 3.28 (P=0.00). CONCLUSION: Awareness and knowledge of glaucoma in subjects attending an Ophthalmology Referral Center is predominantly moderate or poor. This has important implications regarding attitudes that can result in lack of follow up in ophthalmological care.     

北京市和宁城县非眼科住院患者及家属的青光眼与白内障意识调查

目的调查及比较北京市和宁城县人群中的青光眼和白内障的意识水平,以探索有效的眼病宣教方式。设计横断面调查。研究对象北京同仁医院和内蒙古宁城县医院的206名非眼科住院患者及家属。方法问卷调查。听说过青光眼或白内障病名者定义为有青光眼或白内障意识,至少能说出一个青光眼或白内障症状者定义为有青光眼或白内障知识。分析比较两种疾病间、城乡间眼病意识的差异,Logistic回归分析相关因素。主要指标有青光眼或白内障意识、知识的率。结果有青光眼意识者占全部的74．76％,在北京及宁城分别占90．38％、58．82％（P=0．000）。有白内障意识者占全部的92．94％,在北京及宁城分别占97．12％、86．36％（P=0．008）。有青光眼知识者占有青光眼意识者的48．7％,占全部的36．41％。有白内障知识者占有白内障意识者的59．50％,占全部的55．29％。青光眼、白内障之间及城乡之间均有显著性差异。Logistic回归分析显示,文化程度与青光眼或白内障的意识程度有关。最主要信息来源是听周围人谈论及通过电视节目。50．97％的人会主动学习青光眼或白内障相关知识,主要通过书籍（66％）及与医护人员交流（43％）。仅15．53％的人表示将参加医院举办的知识讲座。结论我国人群中青光眼意识和知识水平还比较低,对白内障的意识和知识水平好于青光眼;且城乡之间存在差别,这与文化程度差异有关。需要更有效的健康教育方式来提高青光眼或白内障的意识和知识水平。     

Factors affecting awareness and knowledge of glaucoma among patients presenting to an urban emergency department

Background:  Until advanced, glaucoma is asymptomatic. For early diagnosis to occur, patients may need to be aware of it and seek assessment regularly. People who have risk factors for glaucoma may have a greater awareness of the disease.
Methods:  Patients presenting to an urban hospital emergency department were surveyed with a brief questionnaire to assess their knowledge of glaucoma. Data was collected about their gender, age, family history of glaucoma and presence of systemic hypertension, diabetes, Raynaud's phenomenon, migraines and myopia.
Results:  Women (Odds ratio 2.3; 95% CI 1.4−3.7; P  < 0.01), people who were 40 years or older (Odds ratio 2.2; 95% CI 1.1−4.4; P  < 0.05) and those who were aware of a family history of glaucoma (Odds ratio 15.7; CI 5.5−45.3; P  < 0.01) knew significantly more about the disease than others. People with other risk factors did not demonstrate significantly greater knowledge despite 89% of all participants having had a previous eye examination.
Conclusion:  This information may be useful to predict which patients may know about glaucoma when they present for an eye examination and who should be targeted in public health campaigns.     

[Online First]Evaluation of retinal and choroidal changes in patients with Alzheimer’s type dementia using optical coherence tomography angiography

AIM: To evaluate the changes in fundus parameters in patients with Alzheimer’s type dementia (ATD) using optical coherence tomography angiography (OCTA), to record flash electroretinograms (ERG) using the RETeval system and to explore changes in retinal function. METHODS: Twenty-nine patients with ATD and 26 age-matched normal subjects were enrolled. All subjects underwent OCTA scans to analyse the superficial retinal vessel parameters in the macular area, including the vessel length density, the vessel perfusion density and the area of foveal avascular zone (FAZ), as well as the choroidal thickness. The differences between the patients with ATD and the normal control group were compared and explored the relevant factors affecting vessel parameters. We also recorded the flash ERGs using the RETeval system and intended to explore changes in retinal function by analysing the ERG image amplitude in patients with ATD. RESULTS: The vessel parameters [Pvessel length density=0.005 and Pvessel perfusion density=0.006) and average choroid thickness (P<0.001) in the macular area of the ATD group was less than the control group, The FAZ area was statistically significantly enlarged in the ATD group (P<0.001). These parameters were correlated with the Mini-Mental State Examination (MMSE) score and the Montreal Cognitive Assessment (MoCA). CONCLUSION: Patients with ATD exhibit decreases in the parameters associated with fundus. In addition, these indicators significantly correlated with the MMSE score and the MoCA score. OCTA may be an adjunct tool with strong potential to track changes in the diagnosis and monitoring the progression of the disease.     

急诊青光眼患者流行病学特征分析

目的 研究急诊青光眼患者人口学特征、诊断分类、季节分布和治疗转归.设计前瞻性病例系列.研究对象2018年10月23日～2019年10月22日就诊于北京同仁医院眼科急诊的急性眼压升高的青光眼患者205例(230眼).方法 初诊时记录患者的病史、体征和诊治情况,急诊救治后由青光眼专家进一步明确诊断,完成后续治疗,随访1年以...