[A comparative study of optic nerve damage between primary open angle glaucoma and normal tension glaucoma].

OBJECTIVE: To investigate the differences in the characteristics of optic nerve damage in patients with primary open angle glaucoma (POAG)and normal tension glaucoma (NTG). METHOD: The optic disc parameters and retinal nerve fiber layer (RNFL) of 47 eyes of 39 subjects with POAG (IOP > 24 mmHg) and 38 eyes of 32 subjects with NTG (IOP < 21 mmHg) were measured by using a Heidelberg retina tomograph II, color stereo-optic disc photographs, and an Octopus automated perimetry. RESULTS: (1) Rim area, rim/disc area ratios and three sectors except temporal quadrant of optic disc were significantly smaller, whereas C/D was significantly larger in patients with NTG than those of POAG. The mean RNFL thickness and RNFL cross-sectional areas at temporal/interior and temporal/superior in those with NTG were significantly (P < 0.05) smaller than those of POAG. The rim volume was significantly (P < 0.05) smaller and mean cup depth was significantly (P < 0.05) larger in patients with NTG than POAG. (2) The defect types of RNFL: RNFL diffuse loss and local defect ratio were 53.19% and 4.26% in POAG, respectively; while were 21.05% and 55.26% in NTG, respectively. The difference between the proportions of the defect type of RNFL in patients with POAG and those of NTG is statistically significant (P < 0.01). CONCLUSIONS: Our results demonstrate that the varieties of C/D area ratio, rim area, RNFL thickness, and defect types of RNFL with NTG and POAG indicate that the different mechanisms are involved in optic nerve damage in the two types of glaucoma.

[The prevalence and its effective factors of primary angle-closure glaucoma in defined populations of rural and urban in Beijing].

OBJECTIVE: To investigate the prevalence of primary angle-closure glaucoma (PACG) of urban and rural residents in Beijing, China. A quantitative comparison was made based on the data collected from this epidemiological survey. We also identify some of the most typical risk factors associated with PACG. METHODS: Glaucomatous screening examination was applied to specific age group populations (aged 40 and older) in the defined district of Beijing and its remote rural county, from June to October, 2001. There are 4451 subjects in all, 1980 rural subjects and 2471 urban subjects, 1939 males and 2512 females. The screen and diagnostic methods used in this survey included van Herick methods and gonioscopy examination to estimate the peripheral depth of the anterior chamber, visual acuity, intraocular pressure, refraction status, stereoscopic fundus photography, and threshold-related visual field tests. Subjects regarded as suspected glaucoma and glaucoma patients are reexamined with standard glaucomatous examination. RESULTS: The response rate of rural and urban population is 79.6% (1980/2488), 87.1% (2471/2836), respectively. The prevalence of PACG (in aged 40 years or older population) resulted from this survey was 1.2% (95% CI 0.9% - 1.5%). However, the prevalence was different between urban and rural residents, 1.1% (95% CI 0.8% - 1.4%) vs. 1.6% (95% CI 1.2% - 2.0%). The prevalence of PACG in female was more than that in male, 1.7% (95% CI 1.3% - 2.1%) vs.0.8% (95% CI 0.5% - 1.1%). A drastic increase in prevalence of PACG with age increase was identified in both survey sites, however, this increase in rural subjects (aged 60-69 years group) occurred ten years earlier than those from urban subjects (aged more than 70 years group). Compared to urban residents, rural residents showed higher prevalence of unilateral low vision (39.3% vs. 20.6%) and blindness (28.6% vs. 14.7%). This survey also confirmed that, as people aging, refraction status became hyperopia, the depth of peripheral anterior chamber became narrow. In the different age groups, female and male groups, the changes of refraction status and the depth of peripheral anterior chamber paralleled the prevalence of PACG. CONCLUSIONS: The prevalence of PACG was obviously different in different groups. This could due to several factors including gender, age, change of refraction status and chamber angle as well.

[Prevalence of low vision and blindness in defined populations in rural and urban areas in Beijing].

OBJECTIVE: To investigate the prevalence and causes of low vision and blindness in Beijing residents aged 40 and over. METHODS: 4,451 residents aged 40 and over in 3 rural communities and 5 urban communities in Beijing underwent eye examination, including examination of distant and near visual acuity (VA), best corrected distant and near VA, pinhole VA, and visual field, slit lamp biomicroscopy, and dilated ocular examination in the form of in-home survey by defined population-based sampling. The medical history was surveyed too. The data were analyzed based on the criteria of the World Health Organization. RESULTS: The general prevalence rates of low vision and blindness were 0.99% (95% CI: 0.70-1.28) and 0.39% (95% CI: 0.21-0.57) respectively. The prevalence rate of low vision in females was 1.45%, 2.23 times that of males (0.65%) (OR: 1.97, 95% CI: 1.00-3.95). The prevalence rate of low vision of rural residents was 1.76%, 2.89 times that of urban residents (0.61%) (OR: 2.93, 95% CI: 1.43-6.11). The prevalence rate of blindness in females was 0.64% and 0.37% in males. The prevalence rate of blindness of rural residents was 1.06%, 2.04 times that of the urban residents (0.52%) (OR: 3.77, 95% CI: 1.41-10.62). The 3 major causes of blindness were cataract (37.50%), glaucoma (29.20%), and high myopic macular degeneration (8.30%). The prevalence of blindness increased with age. CONCLUSION: The prevalence rates of low vision and blindness are higher in the rural areas. Cataract, glaucoma, and high myopic macular degeneration are the major causes of blindness. The prevalence of low vision and blindness are influenced by age, sex; area, health care level, educational level, and environmental factors.