眼底杯盘比＞0．3人群原发性开角型青光眼危险因素分析

摘要

Objective To investigate the clinical characteristics of Chinese subjects with vertical cup -to-disc ratio (VCDR) larger than 0.3 and to evaluate the risk factors for primary open-angle glaucoma (POAG).Methods A cross-sectional, hospital-based study of subjects from Shanghai , China with VCDR of more than 0.3 was conducted.After fourier-domain optical coherence tomography ( FD-OCT) and other clinical examinations were done , the subjects were diagnosed as normal , glaucoma-suspect or POAG.The age, gender, refraction and VCDR in each subgroup were analyzed.Multivariate logistic regression analysis was performed to identify the factors associated with POAG and the data was shown in odds ratio (OR) and 95%confidence interval (CI).Results In total, 5 137 subjects were enrolled in this study.Among them, 2 828 (55.05%) were normal, 1 525 (29.69%) were glaucoma-suspect, and 784 (15.26%) were POAG.The median values of VCDR in the three subgroups were 0.5, 0.6 and 0.8 respectively. Multivariate logistic regression analysis demonstrated that male gender (OR=1.484, 95%CI:1.323~1.667), older age (OR=1.207, 95%CI:1.128~1.291 per 20-year increase), myopia (OR=1.369, 95% CI:1.298~1.493), and VCDR (OR=1.765, 95% CI:1.698 ~1.834 per 0.1 increase) were associated with an increased risk of POAG. Conclusions The risk for glaucoma was largely increased in subjects with VCDR larger than 0.6.Male gender, older age ( especially age greater than 60 years ) , myopia ( especially moderate and high myopia ) , and together with larger VCDR, are risk factors for POAG.%目的：分析眼底杯盘比＞0．3人群的临床特点，并探讨原发性开角型青光眼（ POAG）的危险因素。方法本研究为一项基于医院的研究，研究对象为临床发现垂直向杯盘比（ VCDR）＞0．3的人群，经过傅里叶相干光断层扫描（ OCT）、视野和其他临床检查后，被判断为正常、青光眼可疑或POAG。将该3组作为因变量，性别、年龄、屈光度、VCDR等因素作为自变量，用logistic回归分析这些因素与POAG的关系，并用危险度（OR）和95％可信限（CI）加以表示。结果共有5137名受试者入选，其中2828（55．05％）为正常，1525（29．69％）为青光眼可疑，784（15．26％）被确诊为POAG；正常组、青光眼可疑组、POAG组VCDR的中位数分别为0．5、0．6、0．8。多元回归分析显示：男性（OR＝1．484，95％ CI：1．323～1．667），年龄（OR＝1．207，95％CI：1．128～1．291每增加20岁），近视（OR＝1．369，95％CI：1．298-1．493），VCDR （OR＝1．765，95％CI：1．698～1．834每增加0．1）是罹患青光眼的危险因素。结论男性、老龄（尤其是＞60岁）、近视（尤其是中高度近视）以及大VCDR是POAG发生的危险因素，VCDR＞0．6的人群患青光眼的风险大大增加，应着重筛查。（中国眼耳鼻喉科杂志，2014，14：278-282）