【摘要】 目的了解北京地区中老年人群局限性视网膜神经纤维层缺损(RNFLD)10年发病率及其危险因素。设计人群为基础的队列研究。研究对象"北京眼病研究"人群,2001年4439人(40岁及以上),2011年复查2695人(存活随访率66.4%)。方法对研究对象进行详细眼科检查及全身检查。通过闪烁比较2001年与2011年的数码眼底像,检测新发的局限性RNFLD。局限性RNFLD定义:后极部视网膜神经纤维出现沿其走行方向的楔形缺损,与盘沿接触或不接触,范围≤以视盘为圆周的60°。Logistic回归分析确定局限性RNFLD危险因素。主要指标局限性RNFLD的10年发病率及危险因素。结果共有78例(90眼)新发生了局限性RNFLD,发病率按人计算为3.3%±0.2%。其中,单眼新发RNFLD 66例,双眼12例。通过Logistic回归分析,局限性RNFLD的10年发病率与脑卒中史和糖尿病视网膜病变相关,OR值分别为2.55(95%CI:1.07-6.11,P=0.035)和5.41(95%CI:1.68-17.41,P=0.005),而与居住地(P=0.078)、眼压(P=0.126)、收缩压(P=0.827)、体质指数(P=0.803)、糖化血红蛋白含量(P=0.559)、高血压病史(P=0.776)及糖尿病史(P=0.600)无关。结论北京地区中老年人群局限性RNFLD 10年发病率为3.3%±0.20%,脑卒中及糖尿病视网膜病变是其主要发病危险因素。(眼科,2014,23:9-12)更多还原

【Abstract】 Objective To describe the 10-year incidence of localized retina nerve fiber layer defects(RNFLD) and risk factors in adult Chinese. Design Population-based cohort study. Participants The Beijing Eye Study, which included 4439 subjects(40 years and older) in 2001, was re-conducted in 2011 with 2695 subjects participating(66.4% of the survivors). Methods The study participants underwent a detailed ophthalmic and physical examination. Fundus photographs in 2001 and 2011 were flickered for comparision and evaluated for the new development of localized RNFLD. A localized RNFLD can be defined as a wedge-shaped, not a spindle-like defect, running toward or touching the optic disc border for not more than 60° of the circumference of the optic disc. Logistic regression analysis was used for determining risk factors. Main Outcome Measures 10-year incidence of localized RNFLDs and the risk factors. Results The incident localized RNFLDs were detected in 78 subjects and 90 eyes, the incidence was 3.3%±0.2%(by person). In Logistic analysis, the incidence of localized RNFLDs were significantly associated with the diabetic retinopathy(P=0.005; OR=5.41; 95% CI: 1.68, 17.41), cerebral infarction or hemorrhages(P=0.035; OR=2.55; 95% CI: 1.07, 6.11), and not significantly associated with rural region(P=0.078), intraocular pressure(P =0.126), systolic blood pressure(P =0.827), body mass index(BMI)(P =0.803), Hb1c(P =0.559), hypertension history(P=0.776) and diabetes history(P=0.600). Conclusions The 10-year incidence of localized RNFLD in adult Chinese is 3.3%± 0.2%. It is mainly associated with the diabetic retinopathy and cerebral infarction or hemorrhages.(Ophthalmol CHN, 2014, 23: 9-12)更多还原