目的:确定亚洲多民族人群原发性开角型青光眼(POAG)和高眼压症(OHT)的发生率和危险因素。
方法:以人口为基础,队列研究参与者:新加坡眼科疾病流行病学研究纳入了2004年至2011年基线检查的10,033名参与者。在他们当中,在2011年至2017年期间,有6,762人(反应率=78.8%)参加了为期6年的随访。
方法:进行标准化检查和调查,包括裂隙灯生物显微镜,眼内压(IOP)测量,测厚仪,房角镜检查,视盘检查和静态自动视野检查。根据临床评估的组合定义青光眼,眼部成像(眼底照片,视野,和OCT)以及国际地理和流行病学眼科学学会给出的标准。OHT的定义是基于高于正常上限的IOP,即20.4mmHg,21.5mmHg,中国人22.6mmHg,印度人,和马来人队列分别,无青光眼视盘改变。
方法:POAG发生率,OHT和OHT进展结果:6岁年龄校正后POAG和OHT的总发生率分别为1.31%(95%置信区间[CI]:1.04-1.62)和0.47%(95%CI:0.30-0.70)。基线OHT至POAG的6年进展率为5.32%。中国人和印度人的POAG发生率相似(1.37%),马来人的POAG发生率较低(0.80%)。马来人OHT的发病率(0.79%)高于印度人(0.38%)和中国人(0.37%)。与较高POAG风险相关的基线参数是年龄较大(比值比[OR]=每十年1.90;95%CI:1.54-2.35,P<0.001),较高的基线眼压(OR=1.20/mmHg;95%CI:1.12-1.29,P<0.001)和较长的眼轴长度(OR=1.22/mm;95%CI:1.07-1.40,P=0.004)。
结论:在亚洲多种族人群中,POAG的6年发病率为1.31%。年纪大了,较高的IOP和较长的眼轴长度与较高的POAG风险相关.这些发现可以帮助未来的预测,并指导公共医疗政策决策,以筛查有风险的个人。
OBJECTIVE: To determine the incidence and risk factors for primary open-angle glaucoma (POAG) and ocular hypertension (OHT) in a multiethnic Asian population.
METHODS: Population-based cohort study.
METHODS: The Singapore Epidemiology of Eye Diseases study included 10 033 participants in the baseline examination between 2004 and 2011. Of those, 6762 (response rate = 78.8%) participated in the 6-year follow-up visit between 2011 and 2017.
METHODS: Standardized examination and investigations were performed, including slit lamp biomicroscopy, intraocular pressure (IOP) measurement, pachymetry, gonioscopy, optic disc examination and static automated perimetry. Glaucoma was defined according to a combination of clinical evaluation, ocular imaging (fundus photo, visual field, and OCT) and criteria given by International Society of Geographical and Epidemiological Ophthalmology. OHT was defined on the basis of elevated IOP over the upper limit of normal; i.e., 20.4 mmHg, 21.5 mmHg, and 22.6 mmHg for the Chinese, Indian, and Malay cohort respectively, without glaucomatous optic disc change.
METHODS: Incidence of POAG, OHT, and OHT progression.
RESULTS: The overall 6-year age-adjusted incidences of POAG and OHT were 1.31% (95% confidence interval [CI], 1.04-1.62) and 0.47% (95% CI, 0.30-0.70). The rate of progression of baseline OHT to POAG at 6 years was 5.32%. Primary open-angle glaucoma incidence was similar (1.37%) in Chinese and Indians and lower (0.80%) in Malays. Malays had higher incidence (0.79%) of OHT than Indians (0.38%) and Chinese (0.37%). Baseline parameters associated with higher risk of POAG were older age (per decade: odds ratio [OR], 1.90; 95% CI, 1.54-2.35; P < 0.001), higher baseline IOP (per mmHg: OR, 1.20; 95% CI, 1.12-1.29; P < 0.001) and longer axial length (per mm: OR, 1.22; 95% CI, 1.07-1.40, P = 0.004).
CONCLUSIONS: Six-year incidence of POAG was 1.31% in a multiethnic Asian population. Older age, higher IOP, and longer axial length were associated with higher risk of POAG. These findings can help in future projections and guide public healthcare policy decisions for screening at-risk individuals.
BACKGROUND: The authors have no proprietary or commercial interest in any materials discussed in this article.