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目的调查50岁以上的中老年人群的原发性闭角型青光眼患病率并讨论其相关影响因素。方法于2006年11～12月在江西省吉安县以自然村为单位,通过重组随机整群抽样确定50岁以上人群为检查对象,对5013人进行青光眼筛查。采用Van Herick法检测周边前房深度,常规检测视力、屈光状态,直接眼底镜检查视乳头C/D大小,询问病史和家族史,对可疑青光眼和青光眼患者进行青光眼标准检查,其中包括便携式Goldmann压平式眼压检查、Glodmann房角镜前房角检查、视野检查、HRTⅡ、SL-OCT等检查。结果本次调查50岁以上农村特定人群的应答率93.1%(5031/5402),人群中PACG患病率1.5%(76/5013),95%可信区间(CI)0.9%～2.0%,男性和女性患病率分别为1.0%(95%CI0.6%～1.2%)、1.9%(95%CI1.4%～2.1%),在50～59、60～69和70～87岁年龄组中分别为0.5%、2.3%和2.4%。60岁以上年龄段为患病率骤升年龄段,前房角<20°者中有40.6%(76/187)为原发性闭角型青光眼,HRTⅡ对原发性闭角型青光眼的检出率为89.5%(68/76)。回归校正混杂作用后,PACG患病率与前房角解剖、性别、年龄相关。结论原发性闭角型青光眼是重要致盲性眼病,年龄、性别和前房角度数大小为其发病的高危因素。
Objective To investigate the prevalence of primary angle-closure glaucoma in middle-aged and elderly people over 50 years old and to discuss the related factors. Methods From November to December 2006 in Ji’an County, Jiangxi Province, natural villages were used as a unit. 5013 people were examined by glaucoma screening through reorganization random cluster sampling. Van Herick method was used to detect the peripheral anterior chamber depth, routine examination of visual acuity and refractive status, direct ophthalmoscopy for C / D size, history and family history, and for glaucoma in suspected glaucoma and glaucoma patients, including portable Goldmann Flattened intraocular pressure examination, Glodmann gonioscopy anterior chamber angle examination, visual field examination, HRT Ⅱ, SL-OCT and other tests. Results The survey found that the response rate was 93.1% (5031/5402) in specific rural population over 50 years old, the prevalence rate of PACG in population was 1.5% (76/5013), 95% confidence interval (CI) was 0.9% ~ 2.0% And women’s prevalence were 1.0% (95% CI 0.6% -1.2%) and 1.9% (95% CI 1.4% -2.1%), respectively. The prevalence rates in women aged 50- 59, 60-69 and 70-87 In the 0.5%, 2.3% and 2.4% respectively. 40 years old (76/187) in the age group above 60 years old had a sharp rise in the prevalence rate, and 40.6% (76/187) in the anterior chamber angle <20 ° had primary angle-closure glaucoma. The detection of HRT Ⅱ in primary angle-closure glaucoma The rate of 89.5% (68/76). After regressing for confounding, the prevalence of PACG correlated with anatomy, gender, and age at the anterior chamber. Conclusions Primary angle-closure glaucoma is an important blinding ophthalmopathy. Age, gender and the number of anterior chamber angle are the risk factors.