中文摘要：

目的了解北京地区中老年人群局限性视网膜神经纤维层缺损（RNFLD）10年发病率及其危险因素。设计人群为基础的队列研究。研究对象“北京眼病研究”人群，2001年4439人（40岁及以上），2011年复查2695人（存活随访率66．4％）。方法对研究对象进行详细眼科检查及全身检查。通过闪烁比较2001年与2011年的数码眼底像，检测新发的局限眭RNFLD。局限性RNFLD定义：后极部视网膜神经纤维出现沿其走行方向的楔形缺损，与盘沿接触或不接触，范围≤以视盘为圆周的60°。Logistic回归分析确定局限性RNFLD危险因素。主要指标局限性RNFLD的10年发病率及危险因素。结果共有78例（90眼）新发生了局限性RNFLD，发病率按人计算为3．3％±0．2％。其中，单眼新发RNFLD66例，双眼12例。通过Logistic回归分析，局限性RNFLD的10年发病率与脑卒中史和糖尿病视网膜病变相关，OR值分别为2．55（95％印：1．07-6．11，P=0．035）和5．41（95％凹：1．68—17．41，P=0．005），而与居住地（P=0．078）、眼压（P=0．126）、收缩压（P=0．827）、体质指数（P=0．803）、糖化血红蛋白含量（P=0．559）、高血压病史（P=0．776）及糖尿病史（P=0．600）无关。结论北京地区中老年人群局限性RNFLD10年发病率为3．3％±0．20％，脑卒中及糖尿病视网膜病变是其主要发病危险因素。

英文摘要：

Objective To describe the 10-year incidence of localized retina nerve fiber layer defects （RNFLD） and risk factors in adult Chinese. Design Population-based cohort study. Participants The Beijing Eye Study, which included 4439 subjects （40 years and older） in 2001, was re-conducted in 2011 with 2695 subjects participating （66.4% of the survivors）. Methods The study participants underwent a detailed ophthalmic and physical examination. Fundus photographs in 2001 and 2011 were flickered for comparision and evaluated for the new development of localized RNFLD. A localized RNFLD can be defined as a wedge-shaped, not a spindle-like defect, running toward or touching the optic disc border for not more than 60° of the circumference of the optic disc. Logistic regression analysis was used for determining risk factors. Main Outcome Measures 10-year incidence of localized RNFLDs and the risk factors. Results The incident localized RNFLDs were detected in 78 subjects and 90 eyes, the incidence was 3.3%-0.2% （by person）. In Logistic analysis, the incidence of localized RNFLDs were significantly associated with the diabetic retinopathy （P=0.005; OR=5.41; 95% CI： 1.68, 17.41）, cerebral infarction or hemorrhages （P=0.035; 0R=2.55; 95% CI： 1.07, 6.11）, and not significantly associated with rural region （P=-0.078）, intraocular pressure （P=0.126）, systolic blood pressure （P=0.827）, body mass index （BMI） （P=0.803）, Hblc （P=0.559）, hypertension history （P=0.776） and diabetes history （P=0.600）. Conclusions The 10-year incidence of localized RNFLD in adult Chinese is 3.3%- 0.2%. It is mainly associated with the diabetic retinopathy and cerebral infarction or hemorrhages.