Glaukomas skrīnings

Abstract

Darba mērķis. Noskaidrot pirmreizējā pieraksta glaukomas riska grupas pacientu biežumu, to subjektīvos un objektīvos datus. Darba metodes. Pētījumā tika iekļauti pirmreizējā pieraksta pacienti kuri sasnieguši vismaz 40 gadu vecumu un nav datu par glaukomu anamnēzē. Kā skrīninga metode tika izmantota optiskā koherentā tomogrāfija un citi izmeklējumi (bezkontakta tonometrs, autorefraktometrs), kā arī 15 jautājumu anketa, lai noskaidrotu glaukomas riska faktorus un diagnozes varbūtību. Rezultāti. No pētījumā iekļautajiem 50 pacientiem, asimptomātiska glaukoma tika konstatēta 4% pacientu (n=2) un 2% pacientu (n=1) aizdomas par glaukomu. Glaukomas pacientiem statistiski ticami biežāk bija vīrieši, ar kardiovaskulārām slimībām, kā arī tendence uz arteriālu hipertensiju un smēķēšanu anamnēzē. Pacientiem ar glaukomu (n=2) labajā acī statistiski ticami augstāks vidējais IOS 20,5 ± 3,5 mmHg salīdzinot ar pacientiem bez glaukomas (n=47, 16,2 ± 3,0 mmHg; p=0,052), līdzīga tendence vērojama arī kreisajā acī. Pacientiem ar glaukomu (n=2) kreisajā acī statistiski ticami mazāka RNFL vidējais biezums 59,5 ± 2,1 μm salīdzinot ar pacientiem bez glaukomas (n=47, 90,0 ± 10,2 μm; p=0,001), labajā acī RNF biezums nozīmīgu atšķirību starp abām grupām nesasniedza. Pacientiem ar glaukomu (n=2) kreisajā acī statistiski ticami mazāka GCL-IPL biezuma mediāna 44,5 μm [29,3; 51,5] salīdzinot ar pacientiem bez glaukomas (n=47, 78,0 μm [73,0; 83,0]; p=0,007), līdzīga tendence vērojama arī labajā acī. Secinājumi. Asimptomātiska glaukoma bija 4% pirmreizējās vizītes pacientu. Ievērojami biežāk asimptomātiskas glaukomas pacientiem bija kardiovaskulāras slimības, smēķēšana anamnēzē. Asimpomātiskas glaukomas pacientiem statistiski ticami augstāks intraokulārias spiediens, bet redzes asuma izmaiņas netika novērotas. RNFL un GCL-IPL biezums pacientiem ar agrīnu glaukomu ir ievērojami mazāks nekā pacientiem bez glaukomas.

Introduction. Glaucoma is a chronic, progressive and irreversible optic nerve neuropathy. The major glaucoma risk factor is high intraocular pressure (IOP). Glaucoma is the second major cause of blindness in the world. Because of the long-term asymptomatic stage of, in most cases it is diagnosed late. Aim of the work. To obtain statistical results of the glaucoma prevalence in patients who had oftalmologist appointment for the first time. Methods. The study included patients who were at least 40 years of age and without recorded glaucoma. Optical coherent tomography and other tests (non-contact tonometer, autorefractometer), also questionnaire consisting of 15 questions, to determine glaucoma risk factors and diagnosis probability. Results. From 50 patients the asymptomatic glaucoma was found in 4% of patients (n = 2) and 2% of patients (n = 1) had suspicion of glaucoma. Results show that glaucoma prevalence is significantly higher in men. From the results one can obtain that cardiovascular diseases, tendency to hypertension, as well as smoking is a risk factor for glaucoma. Patients with glaucoma (n = 2) had statistically significant higher mean IOP in the right eye (20.5 ± 3.5 mm Hg) compared to those without glaucoma (n = 47, 16.2 ± 3.0 mmHg, p = 0.052). Similar trend is also observed for the left eye. Patients with glaucoma (n = 2) statistically significantl lower RNFL thickness in the left eye (mean 59.5 ± 2.1 micrometre) compared to those without glaucoma (n = 47, 90.0 ± 10.2 micrometre; p = 0.001). The right eye RNF thickness difference did not reach statistical significance between patients with and without glaucoma. In patients with glaucoma (n = 2) the left eye had statistically significant thinner GCL-IPL thickness (median 44.5 micrometre [29.3; 51.5]) compared to those without glaucoma (n = 47, 78.0 micrometre [73.0; 83.0]; p = 0.007). Similar trend was observed also for the right eye. Conclusions. Asymptomatic glaucoma was diagnosed for 4% of initial patients. Significantly more often asymptomatic glaucoma patients had cardiovascular diseases or smoking in their anamnesis. Asymptomatic glaucoma patients had statistically significant higher intraokulārias pressure. Visual acuity changes were not observed for glaucoma patients. RNFL and GCL-IPL thickness in patients with early glaucoma is significantly thinner than in patients without glaucoma.