尼日利亚Gwagwalada原发性开角型青光眼患者的社会人口学和临床特征

Sociodemographic and clinical profiles of patients with primary open angle glaucoma in Gwagwalada, Nigeria

摘要:

目的：探讨比较尼日利亚Gwagwalada原发性开角型青光眼(POAG)与非青光眼患者的临床社会人口学特征。

方法：横断面对比研究。共调查235例成年患者，其中96例POAG及139例非青光眼。记录患者年龄、性别、教育程度、职业、种族、青光眼家族史、眼痒、糖尿病和高血压情况。眼部检查包括视力、中央视野、杯盘比、前房角评估和眼压。

结果：平均年龄为49.88±13.75岁，其中男114例(48.5%)。POAG患者包括42个种族，其中伊博人(24/96，25.0%)和约鲁巴人(20/96，20.8%)最为常见。大多数POAG(74/96，77.1%)年龄在40-69岁之间。POAG(73/96，76.0%)有不同程度的视力障碍。POAG组与非青光眼组的对比如下：青光眼阳性家族史(34/96，35.4%)vs(25/139，18.0%； P=0.012)； 糖尿病史(8/96，8.3%)vs(6/139，4.3%)； 高血压病史(24/96，25.0%)vs(28/139，20.1%)； 糖尿病合并高血压病史(1/96，1.0%)vs(4/139，2.9%； P=0.268)； 使用抗糖尿病药物者(5/96，5.2%)vs(7/139，5.0%)； 使用降压药者(24/96，25.0%)vs(23/139，16.5%)； 联合使用抗糖尿病和抗高血压药物者(4/96，4.2%)vs(5/139，3.6%； P=0.328)； 有眼痒症状者(18/96，18.7%)vs(37/139，26.6%； P=0.328)； 视力障碍\〖右眼(RE)：51/96，53.1%； 左眼(LE)：60/96，62.5%\〗vs(RE：40/139，28.7%； LE：37/139，26.6%； P=0.000)； 垂直杯盘比>0.4(RE：96/96，100%； LE：96/96，100%)vs(RE：131/139，94.2%； LE：124/139，89.2%)(RE：P=0.307； LE：P=0.006)； 眼压>22 mmHg(RE：17/96，17.7%； LE：22/96，22.9%)vs(RE：2/139，1.4%； LE：2/139，1.4%； P=0.006)。大多数POAG患者(60/96，62.5%)正在服用抗青光眼药物，(23/96，24.0%)尚未开始用药，P=0.000。许多POAG(32/96，33.3%)正在服用β受体阻滞剂、前列腺素抑制剂和碳酸酐酶抑制剂的联合抗青光眼药物。

结论：青光眼具有与其他眼部疾病不同的临床社会人口学特征。许多参与者肯定了青光眼的家族史，大多数青光眼参与者正在接受抗青光眼治疗。包括失明在内的视力障碍与青光眼显著相关。该研究证实，开角型青光眼与高杯盘比和高眼内压有关。

Abstract:

AIM: To determine and compare clinico-sociodemographic profiles of primary open angle glaucoma(POAG)with non-glaucoma eye patients in Gwagwalada, Nigeria.

METHODS:A cross-sectional comparative study. A total of 235 adult patients including 96 with POAG and 139 non-glaucoma were included. General characteristics such as age, gender, education, vocation, ethnicity, family history of glaucoma, ocular itching, diabetes mellitus, and hypertension were recorded. Ocular examinations included visual acuity, central visual field, cup disc ratio, anterior chamber angle assessment, and intraocular pressure.

RESULTS:Mean age was 49.88+13.75 years and 114(48.5%)were males. Patients with POAG comprised 42 ethnics with Igbo(24/96, 25.0%)and Yoruba(20/96, 20.8%)being most common. Most POAG(74/96, 77.1%)were in the age range 40-69. The POAG(73/96, 76.0%)had varied visual impairment. The POAG versus non-glaucoma as follows: positive family history of glaucoma(34/96, 35.4%)vs (25/139, 18.0%; P=0.012); history of diabetes mellitus(8/96, 8.3%)vs(6/139, 4.3%); hypertension(24/96, 25.0%)vs(28/139, 20.1%); combined diabetes mellitus and hypertension(1/96, 1.0%)vs(4/139, 2.9%; P=0.268); antidiabetic drugs(5/96, 5.2%)vs(7/139, 5.0%); antihypertensives drugs(24/96, 25.0%)vs(23/139, 16.5%); combined antidiabetic and antihypertensive drugs(4/96, 4.2%)vs(5/139, 3.6%; P=0.328); ocular itching(18/96, 18.7%)vs(37/139, 26.6%; P=0.328); visual impairment \〖right eye(RE):51/96, 53.1%; left eye(LE):60/96, 62.5%\〗 vs(RE:40/139, 28.7%; LE:37/139, 26.6%; P=0.000); vertical cup disc ratio>0.4(RE: 96/96, 100.0%; LE:96/96, 100.0%)vs(RE:131/139, 94.2%; LE:124/139, 89.2%)(RE: P=0.307; LE: P=0.006); intraocular pressure >22 mmHg(RE: 17/96, 17.7%; LE: 22/96, 22.9%)vs(RE: 2/139, 1.4%; LE: 2/139, 1.4%; P=0.006). Most POAG(60/96, 62.5%)were on antiglaucoma drugs and(23/96, 24.0%)were yet to commence medication(P=0.000). Many POAG(32/96, 33.3%)were on combination antiglaucoma drugs of beta blockers, prostaglandin inhibitors and carbonic anhydrase inhibitors.

CONCLUSION:Glaucoma has distinguishing clinico-sociodemographic features from other eye conditions. Many participants affirmed family history of glaucoma, and most glaucoma participants were on antiglaucoma treatment. The visual impairment including blindness was significantly associated with glaucoma. The study affirmed open angle glaucoma was associated with high cup-disc ratio and high intra ocular pressure.