Aim

To estimate the risk of blindness with primary angle-closure glaucoma (PACG) compared to primary open-angle glaucoma (POAG) in those population-based studies that reported blindness rates for both PACG and POAG.

Method

A systematic search was performed in PubMed for articles published in English between 2000 and 2020 reporting the prevalence of POAG as well as PACG among various ethnic populations. A study was included if it was (1) population-based (2) had published prevalence and blindness rates for both PACG and POAG in the same cohort. (3) Glaucoma was defined as per the International Society for Geographical and Epidemiological Ophthalmology (ISGEO) criteria. The proportion of blindness for both POAG and PACG for each study and the cumulative proportion taking all the studies were calculated.

Results

We included 23 studies with 78,434 participants. POAG was diagnosed in 1702 persons with 151 (8.9%) blind. There were 724 cases of PACG with 196 (27.0%) blind. The risk ratio of blindness in PACG to POAG varied from 0.73 to 10.6 among the studies. The cumulative risk ratio was 2.39 (95% confidence interval (CI); 1.99, 2.87). Risk ratios for studies including visual field restriction while defining blindness were similar to studies that did not (1.92 vs 2.64, P = 0.11). Risk ratios were also similar for studies that used greater than 2 instead of 3 or more quadrants of iridotrabecular contact to define angle closure (2.79 vs 2.25).

Conclusion

Primary angle-closure disease is more likely to be associated with blindness.

中文翻译：

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青光眼失明：原发性开角型青光眼与原发性闭角型青光眼——一项荟萃分析

目标

在那些报告PACG和POAG失明率的基于人群的研究中，评估原发性闭角型青光眼（PACG）与原发性开角型青光眼（POAG）相比的失明风险。

方法

在 PubMed 中系统搜索了 2000 年至 2020 年间以英语发表的文章，报告了 POAG 和 PACG 在不同种族人群中的流行情况。如果一项研究 (1) 基于人群 (2) 在同一队列中公布了 PACG 和 POAG 的患病率和失明率，则纳入该研究。(3) 青光眼根据国际地理和流行病学眼科学会 (ISGEO) 标准定义。计算每项研究的 POAG 和 PACG 的失明比例以及所有研究的累积比例。

结果

我们纳入了 23 项研究，共有 78,434 名参与者。POAG 在 1702 人中被诊断出，其中 151 人 (8.9%) 失明。共有 724 例 PACG，其中 196 例 (27.0%) 失明。在这些研究中，PACG 与 POAG 的失明风险比从 0.73 到 10.6 不等。累积风险比为 2.39（95% 置信区间 (CI)；1.99, 2.87）。在定义失明的同时包括视野限制的研究的风险比与没有的研究相似（1.92 vs 2.64，P  = 0.11）。对于使用大于 2 个而不是 3 个或更多的虹膜小梁接触象限来定义闭角的研究，风险比也相似（2.79 对 2.25）。

结论

原发性闭角疾病更可能与失明有关。