上海市盲校学生病因及视力调查分析

目的通过对上海盲校学生病因及视力调查分析,为防治儿童盲提出依据。方法对盲校224名学生进行矫正视力、裂隙灯、眼底镜、眼压等眼部检查,并对病因和视力进行分析。结果224例盲校学生中97例为盲,低视力97例,矫正视力≥0.3者30例。第1位致盲眼病是早产儿视网膜病变(retinopathyofprematurity,ROP)占32.99%;低视力病因中第1位为先天性白内障术后无晶状体占21.65%;124例患屈光不正学生中配戴矫正眼镜54例。结论上海盲校学生中ROP已成为第1位致盲性眼病,提示建立ROP筛查网络和开展综合防治的重要性。先天性白内障、青光眼的早期诊断和治疗,提高手术成功率及屈光不正儿童的早期验光配镜对于防治儿童盲是十分重要的。     

天津市视力残疾鉴定15834例分析

目的 调查“十一五”期间天津市进行视力残疾鉴定患者的基本情况、等级分布及主要致残原因,为日后低视力康复工作的开展提供有价值的资料.方法 调查研究.收集2006年1月至2010年12月天津市进行视力残鉴定并明确诊断的视残患者15834例.记录患者个人情况及眼部情况,根据第二次全国残疾人抽样调查视残废分级标准,对患者进行分级并明确致残原因.不同致残原因所致盲和低视力频数分布的差异进行x2检验.结果 男性视残患者多于女性,市区多于郊县,较高年龄、较低文化程度及低家庭经济收入者所占比例较大.15834名视残患者中盲6598例(41.67％),其中一级5015例(31.67％),二级1583例(10.00％);低视力9236例(58.33％),其中三级1713例(10.82％),四级7523例(47.51％).白内障5196例(32.82％),其中盲32.98％,低视力32.70％.除白内障外,盲与低视力主要致病原因的构成不完全相同(x2=38.33,P＜0.01).致盲病因主要为视网膜/葡萄膜病变(15.40％)、角膜病(13.78％),而致低视力病因主要为屈光不正/弱视(18.32％)、视网膜/葡萄膜病变(17.37％).结论 天津市“十一五”期间确定的视残者中低视力患者多于盲患者,白内障仍是首要致残原因.     

先天性白内障的发病年龄及其对手术前后视力的影响

对５类８７６例先天性白内障患者的发病年龄及其手术前后视力进行了统计研究，发现：（１）在出生后６个月内，发病率最高的是全性白内障，致密核性白内障次之，前极性，后极性和绕核性白内障则均以３岁后病率较高；（２）术前视力与发病年龄有关，在２岁前发病时，视力〉０．３的分布比率最差的是全性白内障，致密核性白内障次之；２～４岁发病时，仍以这两型白内障的视力差，后极性白内障的视力分布变化不大，前极性白内障视力相对     

白内障术后早期低视力原因分析

目的探讨白内障术后早期低视力的主要原因及处理方法。方法回顾性分析我院2008年6月至2011年8月444例(444眼)白内障术后144眼早期(一周内)视力低于0.3者的临床资料,探讨分析影响术后低视力的原因。结果本组术后视力低于0.3的144眼中,术前原有眼病32眼占22.22%,术中并发症35眼占24.31%,术后并发症77眼占53.47%。结论术前原有眼病和手术并发症是造成白内障术后低视力的主要原因。预防原发眼病,减少手术并发症是降低白内障术后低视力的主要措施。     

视力筛查仪在低视力青少年屈光检查中的应用

目的 探讨视力筛查仪在低视力青少年的屈光状态检查中的应用.方法 分别对先天性眼底病组(15例)和先天性白内障术后无晶体眼组(10例)及有晶体眼组(10例)共35例低视力青少年,应用手持视力筛查仪进行验光及常规眼科检查.应用校正的卡方检验或Fisher精确概率法对各组之间检出率进行比较,应用校正的卡方检验对屈光状态分布进...     

陕西省视力残疾抽样调查结果及致残原因分析

目的:调查陕西省视力残疾人的数量、患病率及其性别、年龄分布以及致残原因。方法:2006-04-01/05-31,按照分层、多级、概率比例、整群的抽样方法(PPS抽样),陕西省共抽出22个县(区),176个调查小区,实际调查样本量73425人。由经过专门视力残疾鉴定培训的眼科医生对其进行视功能检查,经鉴定属于视力残疾者再进一步行裂隙灯及眼底镜检查,判断出其最主要的一个致残原因,并按照全国抽样调查办公室统一印发的表格进行登记。结果:陕西省视力残疾总患病率为1.12%,其中盲的患病率为0.42%,低视力的患病率为0.69%,与1987年第一次全国残疾人抽样调查的患病率比较无统计学差异(P>0.05);盲与低视力的患病率分别为男0.14%,0.28%,女0.29%,0.41%,女性均显著高于男性(P<0.01),农村显著高于城市(P<0.05)。盲与低视力的患病率随年龄增长而呈明显的递增趋势(P<0.01)。视力残疾的主要致残原因依次是白内障(48.72%),屈光不正、弱视(17.70%),视网膜、色素膜病变(11.60%),角膜病(10.87%)和青光眼(9.52%)。结论:白内障和屈光不正、弱视是我省致盲眼病的主要原因,防盲治盲工作任务还很艰巨,还需要做大量的工作。     

先天性白内障不同视力变化与病程依赖关系分析

目的探讨不同病程变化对人类先天性白内障视功能及愈后的关系。方法对８７６例五种先天性白内障术前和术后视力进行了回顾性统计。结果病程变化与术前视力关系：病程＜１年时，ＶＡ在低视力级的有ＣＴＣ，ＶＡ≥０．３的有ＣＤＮＣ，ＣＡＰＣ，ＣＰＰＣ，ＣＰＮＣ；１～４年病程时，低视力级有ＣＤＮＣ及ＣＰＮＣ，ＶＡ≥０．３的有ＣＡＰＣ及ＣＰＰＣ，４年以上病程时，低视力级的有ＣＡＰＣ及ＣＰＰＣ，ＶＡ≥０．３的有ＣＡＰＣ及ＣＰＰＣ，各型先天性白内障愈后与术前视力水平有关。结论病程越长，对术前和术后视力的影响也越大，且受晶体混浊程度的影响。     

泉州市盲校学生视力损伤病因

目的：探讨泉州市盲校学生视力损伤的病因及残余视力的情况。方法：横断面研究。在2016 年期间对泉州盲校126 名低视力和盲学生进行病史采集,应用眼科常规检查方法对其行全面的眼科检查,并对学生的主要病因进行诊断和分析。结果：60 名盲学生的病因中：早产儿视网膜病变居第1 位,占23.3%（14 例）,角膜变性和视神经萎缩均列第2 位,各占13.3%（8 例）,第4 位为先天性青光眼占11.7%（7例）。66名低视力学生的病因中,先天性白内障居首位,占27.3%（18例）,眼球震颤为第2位,占13.7%（9 例）,视神经萎缩为第3 位,占10.6%（7 例）,角膜变性为第4 位,占9.1%（6 例）。结论：泉州市盲校的126 名学生中,先天性或遗传性疾病是导致视力损伤的主要原因,早产儿视网膜病变是致盲的首要病因,而先天性白内障是导致低视力的主要原因。     

哈尔滨市盲校学生致盲原因及视力调查

目的探讨儿童盲早期防治和康复的重要性。方法应用眼科常规方法对73名盲校学生进行全面检查。并对致盲原因及视力进行分析。结果病因以先天性和遗传性眼病为主要因素。其中第一位为先天性白内障、术后无晶体眼(24.66%);第二位为重度屈光不正(伴有或不伴有斜视),占13.70%。视力,该盲校中有可利用残余视力(视力≥0.02)者为79.46%。视力为光感与无光感者15例,占总数的20.55%。盲目者占47.94%;低视力及以上者占52.06%。结论哈尔滨市盲校学生致盲原因中,第一位为先天性白内障、术后无晶体眼,提示眼病的早期诊断和治疗的重要性。第二位为重度屈光不正,提示屈光不正患儿的早期验光配镜对于防盲是极为重要的。学生中存在大量有残余视力者,根据视力情况进行分班教学、区别教育极为重要。     

广西少数民族地区学龄儿童低视力原因分析

目的:调查及分析广西田阳及隆林两县学龄儿童低视力及盲目原因。方法:经当地医院筛查后的矫正视力<0.3,病程>5a的单或双眼低视力儿童74例在我科进行全面眼部检查,明确低视力及盲目原因并指导治疗。结果:单眼盲原因为眼外伤及角膜病变,双眼盲原因多为先天性眼球发育不良及先天性白内障;单眼及双眼低视力的主要原因为屈光不正引起的弱视。结论:由于屈光不正/弱视占致残原因之首,因此目前儿童眼病应加强卫生宣教,预防为主。     

Incidence of visual loss in the Ponza Eye Study, Italy

AIM: To study the incidence of visual loss over a 12-year period in the survivors of an original cohort aged 40 years or older at baseline. METHODS: Visual acuity (VA) was measured by means of a standardized logMAR chart. World Health Organization definition of blindness and low vision was adopted (respectively, best-corrected VA >1.3 logMAR or a visual field <10 degrees around central fixation, and best-corrected VA >0.5-1.3 logMAR or a visual field <20 degrees around central fixation). Moreover, binocular visual loss incidence (VA>0.5 logMAR) was calculated in a 'healthy' group who had uncorrected VA of 0.0 logMAR or better in both eyes at baseline and absence of eye diseases. RESULTS: Of the 584 eligible survivors, 411 (70.7%) had a 12-year follow-up visit. The overall incidence figures were as follows: best-corrected binocular blindness (0.7%), binocular low vision (3.9%), monocular blindness (2.7%), and monocular low vision (5.0%), respectively. The results for presenting VAs were 1.2, 9.5, 4.2, and 15.3%. Figures for uncorrected, best-corrected, and presenting binocular visual loss incidence in the 'healthy' group were respectively 12.7, 0.9, and 3.7%. CONCLUSION: The discrepancy between the ideal and real situations that emerges from this study has important implications for health-care planning. Over a period of 12 years, a substantial percentage of 'healthy' subjects will have to seek medical care. Incident visual loss was caused mainly by untreated cataract, glaucoma, myopia, and age-related macular degeneration.     

不同病程对先天性白内障术前和术后视力影响的研究

目的了解不同病程变化对先天性白内障患者视功能的影响。方法对五种先天性白内障８７６例的病史进行回顾性研究。结果（１）病程越长，术前视力受损越重，病程＜１年时，以全性白内障视力下降最明显；病程在１～４年时，以致密核性白内障视力下降最明显；病程＞４年时，除前极性白内障外的四种白内障视力均明显下降。（２）术后视力恢复依赖于术前视力水平，以病程＜１年时这一关系最为明显。（３）某些先天性白内障视力变化有加速趋势，尤以先天性致密核性白内障最为明显。结论及早发现，及时治疗是确保良好视功能的关键。     

砂同病程对先天性白内障术前和术后视力影响的研究

了解不同病程变化对先天性白内障患者视功能的影响。对五种先天性白内障８７６例的病史进行回顾性研究。结论及早发现，及时治疗是确保良好视功能的关键。     

Public health impact of neovascular age-related macular degeneration treatments extrapolated from visual acuity

PURPOSE: To estimate the potential public health impact of treatment with new medications intended to preserve vision in patients with neovascular age-related macular degeneration (AMD). METHODS: A Markov model was used to simulate the natural history of AMD over the lifetime of patients with diagnosed neovascular AMD from clinical trials and epidemiologic surveys. It applied to a cohort of patients aged 75 years, with newly diagnosed neovascular AMD in one eye, whose visual acuity was 0.7 logMAR. Probabilities were calculated for the risk of AMD in the remaining eye and for premature mortality. Results of the model were expressed as the duration of low vision (worse eye VA>1.0 and better eye VA>0.7 logMAR) and blindness (bilateral VA >1.0 logMAR). Health consequences of blindness and low vision were estimated for depression, hip fractures, institutionalization, and life expectancy. RESULTS: For AMD patients with a 50% probability of VA >1.0 logMAR at 1 year, in one eye, the probability of lifetime bilateral blindness was >47%. The patients would live approximately 7 years with monocular vision >1.0 logMAR and an additional 4 years with bilateral blindness and a >15% probability of depression due to AMD. Life expectancy was decreased by approximately 2 years, >90/1000 patients would sustain a new hip fracture, and 1.5% of the patients would require institutional care for visual impairment due to AMD. To achieve a defined public health outcome (visual impairment and consequent comorbidity), it was necessary for the VA effectiveness of new treatments to increase in parallel with disease severity. CONCLUSIONS: Comorbidity related to visual impairment contributes significantly to the public health impact of AMD. Aggressive lesions need highly effective treatments. Models may be used to compare the public health impact of placebo-controlled clinical trial results.     

先天性白内障人工晶状体植入术临床观察

目的探讨先天性白内障手术时机及术后并发症处理。方法对35例47眼先天性白内障用超声乳化的注吸系统进行吸出手术并植入人工晶状体，应用SRK三元回归公式计算人工晶状体屈光度，且植入人工晶状体度数低于所得度数2D，并进行后囊环行撕囊。术后随访10．26月。结果检查合作者21例30眼，视力〉0．7者4眼（13．33％）；〉0．3者20眼（66．67％）；脱盲率为90％，脱残率67％。术后并发症后囊浑浊17眼；瞳孔夹持4眼。人工晶状体前膜5眼。结论先天性白内障致盲原因主要是形觉剥夺，应尽早施行手术，并及时处理术后并发症和进行弱视训练。     

Prevalence of blindness and low vision in an Italian population: a comparison with other European studies

AIM: The scientific literature contains recent data on the prevalence of blindness and low vision for a few European countries, but most of these studies have been focused exclusively on the elderly sector of the populations. The purpose of the present study was to provide age-specific estimates of the prevalence and causes of visual loss in an Italian population aged 40 years and over. METHODS: In total, 847 of the 1,200 citizens >40 years of age (70.6%) in the island community of Ponza underwent complete standardized ophthalmological examinations. Visual acuity (VA) was measured using a standard logarithmic chart. World health organization (WHO) definitions of blindness and low vision were adopted (respectively, VA>1.3 logMAR or a visual field <10 degrees around central fixation, and VA >0.5 to 1.3 logMAR or a visual field <20 degrees around central fixation). Prevalence rates based on presenting VAs were also calculated. RESULTS: The overall best-corrected prevalence rates were 0.6% (presenting, 0.8%) for better eye blindness, 2.1% (presenting, 6.7%) for better eye low vision, 1.8% (presenting, 2.6%) for monocular blindness, 5.0% (presenting, 11.2%) for monocular low vision. Cataract, glaucoma, degenerative myopia, and AMD were the main causes of better eye visual loss. CONCLUSION: Age-specific prevalence rates in Ponza are fairly consistent with those for other European countries with similar socio-economic conditions and public healthcare systems. A substantial percentage of visual losses remains uncorrected despite the availability of potentially curative therapy. Greater emphasis needs to be placed on educating the public regarding the importance of good vision.     

儿童盲和低视力的病因与屈光状态及远用助视器康复研究

目的：分析儿童盲和低视力的病因、屈光状态、屈光矫正和配用光学远用助视器矫正后的视力情况。

方法：选取2015-12/2018-04我科门诊接诊及盲校筛查的6～16岁低视力儿童和盲童212例422眼,通过相关检查明确病因和屈光状态,对部分患儿进行屈光矫正和光学远用助视器验配矫正,分析矫正后视力情况。

结果：儿童盲和低视力病因以先天性和遗传性眼病为主,本组病例中先天性白内障是首位原因(19.3%),低视力屈光不正以轻中度远视和近视多见(65.3%),屈光矫正后脱盲率(26.4%)和脱残率(14.6%)均低于联合远用助视器验配矫正后的脱盲率(58.3%)和脱残率(91.1%),差异均有统计学意义(P<0.01)。

结论：儿童盲和低视力病因复杂,应加强预防和筛查工作,低视力儿童应常规进行屈光矫正并配合使用远用助视器矫正,以利获得满意的康复效果。     

视网膜静脉阻塞患者视力预后相关因素分析

目的研究各型视网膜静脉阻塞患者的视力预后、并发症及视力降低的相关因素.方法视网膜静脉阻塞患者913例(944只眼),年龄15～89岁,平均(52.8±11.9)岁;平均随访时间20.7个月.患者所有临床资料均输入计算机,应用SPSS软件进行统计学处理.结果 (1)按部位分型总干阻塞406只眼,占43.0%;半侧阻塞60只眼,占6.4%;分支阻塞478只眼,占50.6%.(2)按缺血分型944只眼中,缺血型633只眼,占67.1%;非缺血型311只眼,占32.9%.(3)患者视力预后各型静脉阻塞患者治疗前、后视力比较,总干阻塞和半侧阻塞的差异无显著性(t=1.45,1.62;均P>0.05),分支阻塞的差异有显著意义(t=7.89,P<0.05).(4) 患者初诊视力水平与预后3种类型静脉阻塞患者视力预后均差;患者的初诊视力水平均与视力预后密切相关(χ2=175.261,21.357,106.408;均P<0.01).(5) 静脉阻塞导致的低视力和盲目率各型静脉阻塞患者的低视力与盲目率比较,差异有显著意义(χ2=85.251,P<0.01).(6) 缺血型与非缺血型患者视力预后比较视网膜静脉总干阻塞、半侧阻塞、分支阻塞患者中缺血型与非缺血型比较,差异均有显著意义(χ2=157.819,19.637,56.737;P<0.01).(7)导致静脉阻塞的危险因素高血压占57.8%,动脉硬化占67.4%,血液黏稠度增高占24.6%,原发性青光眼占1.5%,糖尿病占6.2%.(8) 静脉阻塞患者并发症的发生率黄斑囊样水肿占46.7%,视网膜和(或)视乳头新生血管占21.5%,玻璃体出血占11.4%,新生血管性青光眼占4.2%.其中总干阻塞发生新生血管性青光眼39只眼,占总干阻塞的9.6%,占半侧阻塞的1.7%.(9)并发症导致的低视力和盲目率低视力者中,黄斑囊样水肿占37.9%,新生血管占29.9%;盲目者中,黄斑囊样水肿占19.5%,新生血管占23.0%.新生血管性青光眼导致的盲目者中,视力<0.05者占95.0%.结论视网膜静脉阻塞的致盲率较高,影响视力预后的最重要因素是缺血型视网膜静脉阻塞.初诊视力水平与视力预后关系密切,黄斑囊样水肿、新生血管及新生血管性青光眼为致盲的重要原因.     

合并小眼球和(或)小角膜先天性白内障的人工晶状体植入术

目的 探讨合并小眼球和(或)小角膜的先天性白内障的人工晶状体植入术的手术疗效和操作难点.方法 对9例(18只眼)眼轴长度为18.1～20.5mm和(或)角膜直径为7.5～9.0mm的先天性白内障患者施行超声乳化白内障吸除联合人工晶状体,术后随访时间(12～60)月.结果 术后矫正视力均高于术前矫正视力,脱盲率为93.7%,脱残率16.7%.并发症包括角膜水肿13只眼(72.2%),瞳孔区渗出膜7只眼(38.9%),人工晶状体偏位3只眼(16.7%).结论 对于合并小眼球和(或)小角膜的先天性白内障施行人工晶状体植入术能够有效地改善患者的视功能,但必须注重手术操作技巧,防止并发症的发生.