METHODS: A retrospective cohort record review study was conducted among 222 patients (222 eyes) with primary glaucoma who were selected from a glaucoma research database of a tertiary center in Malaysia. The patients were Malays and diagnosed with primary open-angle glaucoma (POAG) or primary angle-closure glaucoma (PACG). Patients who were followed up regularly for at least 6 months between 1 January 2009 and 31 December 2014 and completed another 1-year follow-up after recruitment (between 1 January 2015 and 31 December 2015) were selected. Multiple prognostic factors that influence visual field progression were identified. Progression of visual field loss was based on the Advanced Glaucoma Intervention Study and Hodapp-Parrish-Anderson scores. Kaplan-Meier survival and Cox proportional hazard regression analyses were performed.
RESULTS: Sixty-three patients (28.4%) developed visual field progression after a mean (SD) follow-up of 6.9 (3.3) years. Those with POAG progressed faster (mean time, 10.6 years; 95% confidence interval [CI], 9.3, 11.9) than those with PACG (17.3 years; 95% CI, 14.8, 19.9) but not statistically significant. Disc hemorrhage and history of eye pain increased the risk of progression by 2.8-folds (95% CI, 1.6, 4.8) and 2.5-folds (1.4, 4.4), respectively.
CONCLUSIONS: The 5-year survival of the Malay primary glaucoma patients with visual field progression was similar with that of other Asian populations. However, aggressive management is required for those with disc hemorrhages and eye pain related to increased intraocular pressure.
方法:对222例原发性青光眼患者(222眼)进行了回顾性队列记录回顾研究,这些患者是从马来西亚三级中心的青光眼研究数据库中选择的。患者为马来人,诊断为原发性开角型青光眼(POAG)或原发性闭角型青光眼(PACG)。选择在2009年1月1日至2014年12月31日期间定期随访至少6个月并在招募后(2015年1月1日至2015年12月31日)再完成1年随访的患者。确定了影响视野进展的多种预后因素。视野丧失的进展基于高级青光眼干预研究和Hodapp-Parrish-Anderson评分。进行Kaplan-Meier生存和Cox比例风险回归分析。
结果:63例患者(28.4%)在平均(SD)6.9(3.3)年的随访后出现视野进展。那些有POAG的人进步得更快(平均时间,10.6年;95%置信区间[CI],9.3,11.9)比PACG患者(17.3年;95%CI,14.8,19.9),但无统计学意义。椎间盘出血和眼痛病史使疾病进展风险增加2.8倍(95%CI,1.6,4.8)和2.5倍(1.4,4.4),分别。
结论:具有视野进展的马来原发性青光眼患者的5年生存率与其他亚洲人群相似。然而,对于与眼压升高相关的椎间盘出血和眼痛患者,需要积极的治疗.