关键词: 原发性开角型青光眼, 初诊特征

Abstract:  Objective To study the clinical characteristics at initial diagnosis of patients with primary open-angle glaucoma (POAG). Design Retrospective case series. Participants 395 patients ultimately diagnosed with POAG. Methods The records of patients were reviewed, which from the glaucoma specialty clinic who were ultimately diagnosed with POAG and had complete data from 2004 to 2021. The initial diagnostic characteristics, including reasons for consultation, intraocular pressure (IOP) values, and cup-to-disc ratios, were recorded and compared among patients with different consultation pathways. Visual function damage was classified based on the mean deviation (MD) value of the visual field. Main Outcome Measures Reasons for consultation, proportion of ocular symptoms, and differences in visual function damage among patients with different consultation reasons. Results The proportion of patients who visited the specialty clinic due to high IOP or an abnormal cup-to-disc ratio found during physical examinations was 38% of 395 patients, while 62% visited for other reasons. High myopia accounted for 32.2%. Among patients who visited due to physical examination, only 7.3% had symptoms like blurred vision, eye distension, or perceived visual field narrowing, whereas among those not referred due to physical examination, the proportion was 64.5%. At the initial diagnosis, only 16.2% having IOP>21 mmHg. Best corrected visual acuity >0.5 was found in 73.9% of patients, and 77.2% had a cup-to-disc ratio >0.7, of which 85.6% had an initial IOP <21 mmHg. The average MD value of the visual field was (6.69±0.35) dB. The proportions of patients with mild, moderate, severe, and extremely severe visual function damage were 61.8%, 19.5%, 10.1%, and 8.6%, respectively. Among patients who visited due to physical examination, 87.9% had mild to moderate visual function damage, while among those referred for other reasons, 77.2% had mild to moderate damage, with a higher proportion of severe and extremely severe cases (22.8% vs. 12.1%, P=0.014). Conclusion Regular ocular examinations are crucial for early detection of POAG. Most POAG patients in the early stages have relatively good visual acuity and nearly normal IOP values. (Ophthalmol CHN, 2024, 33: 412-416)

Key words: primary open angle glaucoma, features at initial diagnosis