大小视盘患者青光眼进展的预测因素。

IF 2.8 Q1 OPHTHALMOLOGY Ophthalmology. Glaucoma Pub Date : 2024-03-01 DOI:10.1016/j.ogla.2023.11.002
Connie Ho BA , Victoria L. Tseng MD, PhD , Lourdes Grassi MD , Esteban Morales MS , Fei Yu PhD , Anne L. Coleman MD, PhD , Joseph Caprioli MD
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引用次数: 0

摘要

目的:确定大小视盘患者青光眼进展的相关因素。设计:回顾性审查。受试者:加州大学洛杉矶分校4505名青光眼患者;小椎间盘233个(59.7%),大椎间盘157个(40.3%)。方法:通过光学相干断层扫描(OCT)或海德堡视网膜断层扫描(HRT)分别定义小椎间盘和大椎间盘大小,椎间盘面积≤5%(≤1.3 mm2)和≥95%(≥2.9 mm2)。对医疗记录进行了人口统计学、系统性合并症、青光眼类型、眼部合并症和眼部手术的审查。Logistic回归用于确定小椎间盘和大椎间盘患者视野(VF)进展的预测因素,以及大椎间盘和小椎间盘的预测因素。主要结果指标:VF恶化伴平均偏差(MD)、逐点线性回归(PLR)和青光眼发病率指数(GRI);大圆盘与小圆盘。结果:在椎间盘小的个体中,亚裔与非西班牙裔白人的进展增加相关(GRI的校正比值比[aOR]=4.05,95%置信区间[CI]=1.11214.59)。小椎间盘(GRI范围和峰值的aOR=1.12,CI=1.00,1.27和aOR=1.05,CI=1.00-1.10/1mmHg)和大椎间盘(GRI范围和峰的aOR=1.35,CI=1.12,1.66和aOR=1.11,CI=1.03,1.20/1mmHg。大小椎间盘的多变量预测因素包括血管痉挛表型(aOR=2.58,CI=1.35,5.19)和黑人(aOR=20.46,CI=8.33,61.84)、西班牙裔/拉丁裔(aOR=9.65,CI=4.14,25.39)、亚裔(aOR=4.87,CI=2.96,8.1)和其他(aOR/2.79,CI=1.69,4.63)与非西班牙籍白人。结论:在患有小视盘的青光眼患者中,青光眼进展的几率增加与亚裔和非西班牙裔白人有关,在患有小和大视盘的患者中,眼压范围和峰值增加也有关。具有血管痉挛表型的个体以及来自种族和少数民族背景的个体具有大视盘和小视盘的几率增加。可辨别表型的进一步表征将改善疾病预后,并有助于青光眼的个性化治疗。
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Predictors of Glaucomatous Progression in Individuals with Small and Large Optic Discs

Purpose

To identify factors associated with glaucomatous progression in individuals with small and large optic discs.

Design

Retrospective review.

Subjects

4505 individuals with glaucoma at UCLA; 233 (59.7%) with small discs, 157 (40.3%) with large discs.

Methods

Small and large disc sizes were defined by OCT or Heidelberg Retinal Tomography as disc area ≤ 5% (≤ 1.3 mm2) and ≥ 95% (≥ 2.9 mm2), respectively. Medical records were reviewed for demographics, systemic comorbidities, glaucoma type, ocular comorbidities, and ocular surgery. Logistic regression was used to identify predictors of visual field (VF) progression in individuals with small and large discs and predictors of large versus small discs.

Main Outcome Measures

The VF deterioration with mean deviation, pointwise linear regression, and glaucoma rate index (GRI); large vs. small disc.

Results

In individuals with small discs, Asian versus non-Hispanic White ethnicity was associated with increased progression (adjusted odds ratio [aOR] = 4.05; 95% confidence interval [CI] = 1.12–14.59 for GRI). Higher intraocular pressure (IOP) range and peak were associated with increased progression in individuals with both small discs (aOR = 1.12; 95% CI = 1.00–1.27 and aOR = 1.05; 95% CI = 1.00–1.10 per 1 mmHg for range and peak with GRI) and large discs (aOR = 1.35; 95% CI = 1.12–1.66 and aOR = 1.11; 95% CI = 1.03–1.20 per 1 mmHg for range and peak with GRI). Multivariable predictors of having large vs. small discs included vasospastic phenotype (aOR = 2.58; 95% CI = 1.35–5.19) and Black (aOR = 20.46; 95% CI = 8.33–61.84), Hispanic/Latino (aOR = 9.65; 95% CI = 4.14–25.39), Asian (aOR = 4.87; 95% CI = 2.96–8.1), and other (aOR = 2.79; 95% CI = 1.69–4.63) versus non-Hispanic White ethnicity.

Conclusions

Increased odds of glaucomatous progression were associated with Asian vs. non-Hispanic White ethnicity in glaucoma patients with small optic discs, as well as with increased IOP range and peak in those with small and large discs. Individuals with a vasospastic phenotype and those from racial and ethnic minority backgrounds had increased odds of having large vs. small optic discs. Further characterization of discernible phenotypes would improve disease prognostication and help individualize glaucoma treatment.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

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来源期刊
Ophthalmology. Glaucoma
Ophthalmology. Glaucoma OPHTHALMOLOGY-
CiteScore
4.80
自引率
6.90%
发文量
140
审稿时长
46 days
期刊最新文献
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