Abstract:
Background and objective The majority of glaucoma patients are asymptomatic and are usually diagnosed at an advanced stage of the disease. This study aimed to assess the outcomes of glaucoma screening among known first-degree relatives of primary glaucoma patients. Materials and methods This study involved primary angle-closure glaucoma (PACG), primary open-angle glaucoma (POAG), and juvenile open-angle glaucoma (JOAG) patients who attended the glaucoma clinic at the Hospital Universiti Sains Malaysia between January 2014 and December 2015. First-degree relatives of the patients underwent a preliminary eye-screening evaluation, including visual acuity (Snellen chart), intraocular pressure (IOP) measurement (air-puff tonometry), and non-mydriatic fundus photography. Patients with visual acuity worse than 6/12, IOP measuring more than 21 mmHg or a difference of more than 3 mmHg between the eyes, and a vertical cup-disc ratio (VCDR) of 0.7 or higher were given a comprehensive eye examination. Results Seventy indexed glaucoma patients were recognized, and 368 first-degree relatives were identified. Forty-five relatives underwent the preliminary screening. Of these, 29 showed normal findings (62%), one had corneal pathology (2%), and 16 (36%) underwent a complete eye examination after failing the initial screening. Among the indexed JOAG group, five relatives (11%) were diagnosed as having JOAG; two were treated medically, while the remaining three required surgical intervention. Conclusion Opportunistic glaucoma screening of high-risk groups, especially JOAG is a feasible and cost-effective way to detect early glaucoma and prevent irreversible blindness. However, improvement in our healthcare system, including the involvement of multicentre clinics in other states in screening initiatives, is required to promote and facilitate the response to screening opportunities.
摘要:
背景与目的大多数青光眼患者无症状,通常在疾病晚期被诊断。本研究旨在评估原发性青光眼患者已知一级亲属的青光眼筛查结果。材料和方法本研究涉及原发性闭角型青光眼(PACG),原发性开角型青光眼(POAG),以及2014年1月至2015年12月期间在马来西亚附属医院青光眼诊所就诊的青少年开角型青光眼(JOAG)患者.患者的一级亲属接受了初步的眼部筛查评估,包括视力(Snellen图表),眼内压(IOP)测量(空气抽吸眼压测量),和非散瞳眼底摄影。视力差于6/12,IOP测量超过21mmHg或眼睛之间差异超过3mmHg的患者,垂直杯盘比(VCDR)为0.7或更高的患者进行了全面的眼科检查。结果确诊青光眼患者70例,并确定了368名一级亲属。45名亲属接受了初步筛查。其中,29例显示正常结果(62%),其中一人患有角膜病理学(2%),16例(36%)在初次筛查失败后接受了完整的眼部检查.在索引的JOAG组中,五名亲属(11%)被诊断患有JOAG;两人接受了医学治疗,其余三人需要手术干预。结论机会性青光眼高危人群筛查,特别是JOAG是检测早期青光眼和预防不可逆失明的可行且经济有效的方法。然而,改善我们的医疗保健系统,包括其他州的多中心诊所参与筛查计划,需要促进和促进对筛查机会的反应。