成都市郫都区50岁以上人群青光眼筛查分析

Analysis of Glaucoma Screening in People over 50 Years Old in Pidu District, Chengdu

摘要: 目的：本研究旨在评估郫都区50岁以上人群青光眼的患病情况，并探讨基层筛查模式的可行性和优化策略。方法：采用横断面研究设计，对郫都区50岁以上居民进行青光眼知识宣教及系统性眼科检查，包括视力、眼压、前房深度评估，必要时行眼底照相、视野检查及视盘光学断层扫描等进一步青光眼检查。结果：4237例筛查人群中，原发性青光眼患病率1.13%，新检出48例青光眼患者中，其中闭角型青光眼比例较高(55.75%)；检出人群中77.1%已进展至中晚期，提示当前被动就医模式的局限性。结论：基层青光眼筛查可有效提高早期诊断率，但受限于屈光介质混浊、高龄人群覆盖率不足等因素，可能存在漏诊。未来需优化筛查策略，加强基层医生培训，并建立长期随访机制，以降低青光眼致盲负担。

Abstract: Objective: This study aims to evaluate the prevalence of glaucoma among people aged 50 and above in Pidu District and explore the feasibility and optimization strategies of the primary-level screening model. Methods: A cross-sectional study design was adopted. Knowledge education on glaucoma and systematic ophthalmic examinations was conducted among residents aged 50 and above in Pidu District, including visual acuity, intraocular pressure, and anterior chamber depth assessment. Further glaucoma screening such as fundus photography, visual field examination, and optical coherence tomography of the optic disc was carried out when necessary. Results: Among the 4237 screened individuals, the prevalence of primary glaucoma was 1.13%. Among the 48 newly detected glaucoma patients, the proportion of angle-closure glaucoma was relatively high (55.75%); 77.1% of the detected cases had progressed to the middle and advanced stages, indicating the limitations of the current passive medical-seeking model. Conclusion: Primary-level glaucoma screening can effectively improve the early diagnosis rate. However, due to factors such as turbid refractive media and insufficient coverage of the elderly population, there may be missed diagnoses. In the future, it is necessary to optimize the screening strategy, strengthen the training of primary-level doctors, and establish a long-term follow-up mechanism to reduce the burden of blindness caused by glaucoma.