探讨街道老年人青光眼的早期筛查方法，提出预防措施。

回顾性分析2015年8月至2016年2月于深圳市宝安区松岗人民医院眼科门诊体检及就诊的疑似青光眼的街道老年患者364只眼的临床资料。所有受检者均接受视力、眼压、眼部A型超声及裂隙灯显微镜检查。对检查结果为阳性的受检者继续实施青光眼专项检查，包括24 h眼压、前房角镜、视野、光学相干断层扫描(OCT)及超声生物显微镜(UBM)检查。青光眼诊断的描述及早期检查项目实施的描述采用眼数和百分比，并计算各项专项检查诊断青光眼的敏感度、特异度、准确度、阳性预测值、阴性预测值及Youden指数。各检查项目诊断青光眼的敏感度、特异度、准确度、阳性预测值及阴性预测值的比较采用χ²检验。

在364只眼中，开角型青光眼89只眼、闭角型青光眼97只眼、其它眼底疾病27只眼、无法明确诊断31只眼及正常110只眼，分别占比24.4%、26.6%、7.4%、8.5%及30.2%；364只眼共接受青光眼专项检查906次，平均(2.49±1.02)次。各检查项目诊断青光眼的敏感度、特异度、准确度、阳性预测值及阴性预测值差异均有统计学意义(χ²＝66.73，13.41，47.08，11.90，44.20；P<0.05)。24 h眼压检查及OCT检查在老年青光眼专项检查中的敏感度、特异度、准确度、阳性预测值及阴性预测值均高于前房角镜、视野及UBM检查。

OCT检查及24 h眼压检查是老年街道人群青光眼筛查理想的专项检查项目，应建立健全街道老年青光眼的三级预防措施，实现预防、早期诊断、治疗青光眼的目的。

To explore the early diagnosis and prevention measures of glaucoma in the elderly of street.

The clinical data of 364 eyes of elderly patients with suspected glaucoma in the ophthalmology outpatient department of Songgang people′s Hospital of Baoan District, Shenzhen, from August 2015 to February 2016 were retrospectively analyzed. All subjects received visual acuity, intraocular pressure, ocular A and slit lamp microscopy. For those with positive results, glaucoma special examination is continued. It includes 24 h intraocular pressure, anterior chamber angle, field of view, optical coherence tomography (OCT) and ultrasound biomicroscopy (UBM). The description of the glaucoma diagnosis and the description of the early examination project adopted the number and percentage of the eyes, and the sensitivity, specificity, accuracy, positive predictive value, negative predictive value and Youden index were calculated for the diagnosis of glaucoma. Chi square test was used to compare the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of each item in diagnosing glaucoma.

In the 364 eyes, 89 eyes were diagnosed as open angle glaucoma, 97 eyes with angle closure glaucoma, 27 eyes with other fundus diseases, 31 eyes and 110 normal eyes, which accounted for 24.4%, 26.6%, 7.4%, 8.5% and 30.2%, respectively. 364 eyes received 906 times of glaucoma special examination, with an average of (2.49±1.02)times. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of each examination were statistically significant (χ²=66.73, 13.41, 47.08, 11.90, 44.20; P<0.05). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 24 h intraocular pressure and OCT examination in the special examination of senile glaucoma were higher than that of the angle lens, the visual field and the UBM examination.

OCT and 24h IOP examination are an ideal special screening item for glaucoma screening in elderly people. It is necessary to establish and improve the tertiary prevention measures for aged glaucoma in the street and realize the aim of prevention and early diagnosis and treatment of glaucoma.