常规检查的结果是否能确定患有原发性开角玻璃眼风险的患者? 理性的临床检查系统审查系统审查
Hussein Hollands1, Davin Johnson, Simon Hollands
1Department of Ophthalmology, Queen’s University, Kingston, Ontario, Canada. hussein.hollands@yahoo.com
JAMA
|May 17, 2013
概括
主要开角青光眼 (POAG) 风险因家族史,高近视,黑人种族,年龄较大,杯与盘的比率增加 (CDR) 和盘出血而增加. 然而,这些因素的缺失并不排除POAG.
科学领域:
- 眼科医生 眼科 眼科
- 公共卫生 公共卫生
- 诊断的准确性 诊断的准确性
背景情况:
- 玻璃眼是全球导致失明的主要原因,由于其阴险的性质,经常被诊断为晚.
- 早期发现和治疗青光瘤可以显著减缓其进展,防止视力丧失.
- 主要开角青光眼 (POAG) 是北美最常见的形式.
研究的目的:
- 评估特定检查结果的诊断准确性和识别POAG.风险因素的风险因素.
- 量化风险因素与POAG患病率之间的关联.
主要方法:
- 在Medline的综合文献搜索和参考/引用跟踪中,发现了41项研究.
- 包括基于人口的研究分析了杯与盘的比率 (CDR),CDR不对称性,眼内压力 (IOP) 和与POAG有关的人口因素.
- 使用元分析来综合诊断准确性和风险因素关联的数据.
主要成果:
- 高近视 (≥6二眼) 和家族史显示出与POAG.最强的关联.
- 增加年龄 (特别是80岁以上),黑人种族,CDR升高 (≥0.7),CDR不对称 (≥0.3),磁盘出血和高内血压 (≥22 mmHg) 与增加POAG风险显著相关.
- 没有单一的发现可靠地排除POAG;缺乏风险因素并不能排除这种疾病.
结论:
- 关键指标如CDR升高,椎间盘出血,高内血压,家族病史,黑人种族和晚年增加POAG风险.
- 这些指标的缺失并不排除POAG,强调需要进行全面的眼科检查.
- 眼科医生检查仍然是最准确的方法来检测玻璃眼瘤.
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