眼科 ›› 2014, Vol. 23 ›› Issue (1): 9-12.doi: 10.13281/j.cnki.issn.1004-4469.2014.01.004

• 论著 • 上一篇    下一篇

40岁以上人群局限性视网膜神经纤维层缺损10年发病率及其危险因素

任杰   王亚星  杨桦  张莉  李建军  徐亮  Jonas Jost B.   

  1. 100005首都医科大学附属北京同仁医院 北京同仁眼科中心 北京市眼科研究所 北京市眼科学与视觉科学重点实验室 国家眼科诊疗设备工程技术中心(任杰、王亚星、杨桦、张莉、李建军、徐亮);Department of Ophthalmology, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Mannheim, Germany(Jonas Jost B.)
         
  • 收稿日期:2013-11-28 出版日期:2014-01-25 发布日期:2014-01-22
  • 通讯作者: 徐亮,Email:xlbio1@163.com
  • 基金资助:

    国家自然科学基金(81170890)

Ten-year incidence and risk factors of localized retina nerve fiber layer defect in adult Chinese 

REN  Jie,   Wang-Ya-Xing, YANG  Hua, ZHANG  Li, LI  Jian-Jun, XU  Liang, Jonas  Jost B.   

  1. REN Jie1, WANG Ya-xing1, YANG Hua1, ZHANG Li1,  LI Jian-jun1, XU Liang1, Jonas Jost B2. 1. Beijing Institute of Ophthalmology; Beijing Ophthalmology & Visual Sciences Key Lab.; Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China; 2. Department of XU
  • Received:2013-11-28 Online:2014-01-25 Published:2014-01-22
  • Contact: Email: xlbio1@163.com

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)

关键词: 视网膜神经纤维层缺损, 发病率, 流行病学

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)

Key words: retinal nerve fiber layer defect, incidence, epidemiology