沈阳市眼健康筛查人群眼压分布

doi:10.3760/cma.j.cn115909-20201118-00445

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摘要目的：分析沈阳地区30岁及以上眼健康筛查人群眼压的分布特征。方法：横断面调查研究。收集 2016年3─9月在沈阳市第四人民医院健康体检中心预约进行体检的30岁及以上的本地城市居民，按登记的居住地所属辖区分布，进行分层随机抽样。所有被纳入者在全身健康体检时增加生活视力、眼压和免散瞳眼底照相检查。眼压测量采用非接触眼压计，测量3次取平均值。眼压>21 mmHg （1 mmHg=0.133 kPa）且不伴有眼底异常者定义为可疑高眼压征。眼底照相存在2项及以上青光眼性视神经改变者定义为可疑青光眼。采用t检验和方差分析比较不同性别和年龄人群眼压分布的差异。结果：共纳入15 303例，最终12 374例被检者的数据用于结果分析，包括11 296例（91.3%）眼部健康者、 801例（6.5%）可疑高眼压征和277例（2.2%）可疑青光眼。健康组被检者年龄为（50±13）岁，双眼平均眼压为（16.2±2.2）mmHg，左眼眼压（16.3±2.3）mmHg，高于右眼的（16.0±2.3）mmHg（t=-19.813， P<0.001）；女性眼压为（16.1±2.3）mmHg，高于男性的（15.9±2.3）mmHg（t=-3.264，P=0.001）；眼压随年龄增加呈下降趋势（F=29.729，P<0.001）。可疑高眼压征人群年龄为（49±13）岁，右眼眼压为（21.7±2.3）mmHg，性别及年龄对眼压分布无显著影响。可疑青光眼人群年龄为（56±13）岁，右眼眼压为（18.0±4.0）mmHg，显著高于健康组的眼压，且低于可疑高眼压征（F=2300，P<0.001）。可疑青光眼人群中单眼或双眼眼压>21 mmHg者仅为16.6%，不同性别和年龄在个体间的眼压水平差异无统计学意义。结论：沈阳地区成年健康人群的眼压随年龄增加而降低，女性眼压高于男性。单纯眼压测量在青光眼筛查中的诊断价值有限，建议联合眼底照相，以提高特异性和准确性。

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关键词 ：眼压, 健康体检, 沈阳地区

Abstract： Objective: To investigate the distribution and influencing factors of intraocular pressure (IOP) in healthy people suspected to have ocular hypertension or glaucoma in a screened population in Shenyang. Methods: Cross sectional investigation study. From March 1st to September 30th, 2016, local urban residents aged 30 and over who had made an appointment for a physical examination at the Fourth People's Hospital of Shenyang were invited for this screening. Stratified random sampling was conducted according to the registered domicile of those screened. Enrolled participants underwent a bilateral examination of habitual visual acuity, noncontact pneumotonometry, and non-mydriatic fundus photography. Ocular hypertension was defined as IOP >21 mmHg (1 mmHg=0.133 kPa) in either eye with a normal fundus in both eyes. Suspected glaucoma was diagnosed if two or more glaucomatous optic nerve changes were detected. Distribution of intraocular pressure was analyzed in the different gender and age groups in the sample. Results: A total of 15 303 subjects were enrolled and final data from 12 374 participants were used for analysis according to the exclusion criteria, including 11 296 healthy persons (91.3%), 801 persons suspected to have ocular hypertension (6.5%), and 277 persons suspected to have glaucoma (2.2%). Mean age of the healthy individuals was 50±13 years, and the IOP was 16.2±2.2 mmHg. IOP in the left eye (16.3±2.3 mmHg) was higher than that in the right eye (16.0±2.3 mmHg) (t=-19.813, P<0.001). Women (16.1±2.3 mmHg) had a higher IOP than men (15.9±2.3 mmHg) (t=-3.264, P=0.001), and older individuals had lower IOP than the youngers (F=29.729, P<0.001). IOP for people suspected to have ocular hypertension (mean age, 49±13 years) was 21.7±2.3 mmHg. IOP (18.0±4.0 mmHg) in people suspected to have glaucoma (mean age, 56±13 years) was significantly higher than that in healthy people, but lower than those suspected to have ocular hypertension (F=2300, P<0.001). Only 16.6% of these glaucoma suspects showed an IOP of 21 mmHg or higher. Age and gender did not exert influence on the IOP in people suspected to have ocular hypertension or glaucoma. Conclusions: IOP decreases with age in the adult population in Shenyang. IOP in females is higher than that in males. The value of IOP measurement itself in glaucoma screening is very limited. A combination with fundus photography is highly recommended.

Key words： intraocular pressure health examination Shenyang

收稿日期: 2020-11-18

PACS:

基金资助: 温州市基础科研项目（Y20190695）；温州医科大学附属眼视光医院创新引导重点项目（YNZD2201903）

通讯作者: 张绍丹（ORCID：0000-0002-3655-0683），Email：shaodan_zhang_wmu@126.com

引用本文:

王琳1 江俊宏2 刘驰1 林海双2 梁远波2 张绍丹2. 沈阳市眼健康筛查人群眼压分布[J]. 中华眼视光学与视觉科学杂志, 2021, 23(4): 281-286. Lin Wang1,Junhong Jiang2,Chi Liu1,Haishuang Lin2,Yuanbo Liang2,Shaodan Zhang2. Shenyang Eye Disease Screening Program: Distribution and Related Factors of Intraocular Pressure. Chinese Journal of Optometry Ophthalmology and Visual science, 2021, 23(4): 281-286. DOI: 10.3760/cma.j.cn115909-20201118-00445

链接本文:

https://www.cjoovs.com/CN/10.3760/cma.j.cn115909-20201118-00445 或 https://www.cjoovs.com/CN/Y2021/V23/I4/281

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