Trends in blind and low vision registrations in Taipei City

PURPOSE: To determine the overall reported incidence and causes of registrable blindness and low vision in Taipei, Taiwan, that have occurred in the previous 10 years. METHODS: Study data were obtained from disability identification registration forms completed between January 1995 and December 2004. Definitions of low vision and blindness were defined by WHO criteria: low vision included visual acuity worse than 6/18 (20/60) to a lower limit of 3/60 (20/400). Blindness was defined as visual acuity worse than 3/60 (20/400) in the better eye with best possible correction. RESULTS: There were 3151 registrations for visual impairment during the study period. A total of 239 registrations were excluded due to insufficient data. Of the remaining 2912 (1518 males and 1394 females), 640 males and 647 females were legally blind (44.20%). A total of 878 males and 747 females were partially sighted. The six leading causes of low vision and blindness, in decreasing frequency, were glaucoma, optic neuropathy, diabetic retinopathy, retinitis pigmentosa, age-related macular degeneration, and myopic macular degeneration. CONCLUSIONS: The proportions of new registrations owing to glaucoma, diabetic retinopathy, age-related macular degeneration, and myopic macular degeneration have changed significantly since 2000; the proportion due to diabetic retinopathy has increased.     

Cytomegalovirus retinitis and ocular complications in AIDS patients in Togo

BACKGROUND: Cytomegalovirus retinitis seems to be an uncommon complication in African AIDS patients. This study was conducted in 200 patients in order to evaluate AIDS eye related complications with specific focus to cytomegalovirus retinitis. MATERIAL AND METHODS: During a period of 20 months, 200 patients (83 men and 117 women) presenting WHO AIDS case definition diagnosis were enrolled for a complete ocular examination comprising external, anterior segment and retinal fundus and fluorescein angiographic examination. RESULTS: For the whole, 200 patients underwent ocular examinations; of them 121 (60.5%) developed ocular complications.The most frequent complications were cotton wool spots (25.5%), cytomegalovirus (CMV) retinitis (21.5%), retinal hemorrhage (6%), papilloedema (3%), chorioretinal toxoplasmosis (3%), peripheral retinal vascularitis (2. 5%), herpes zoster ophthalmicus (2%). Among those with CMV retinitis, bilateral lesions were found in 30 cases, and unilateral ones in 13 cases. Poor vision was associated with the presence of CMV retinitis in 88% of cases.Death occurred in a mean range of 22 days after the "presumed" diagnosis of CMV retinitis. CONCLUSION: Cytomegalovirus retinitis represents the second ocular complication in AIDS patients in this study. Poor visual outcome was associated in 88% of cases. These results demonstrate that in some west African countries, CMV retinitis may be a common complication in AIDS patients.     

Ocular manifestations of HIV infection

Ophthalmic abnormalities are common in HIV-infected patients. Serious ophthalmic diseases often result from opportunistic infections and can cause blindness in the absence of prompt diagnosis and therapy. We review recent advances in the diagnosis and management of HIV-associated ocular disease, including cytomegalovirus retinitis, the leading cause of vision loss in HIV-infected patients. The widespread use of highly active antiretroviral therapy (HAART) over the past 3 years has reduced the morbidity and mortality associated with HIV infection. HAART has dramatically altered the incidence and natural history of many opportunistic infections, and we discuss the impact of HAART on ophthalmic disease.     

Blindness and low vision in Cape Verde Islands: results of a national eye survey

AIMS: Prior to establishing a national prevention of blindness program a population based survey was conducted in Cape Verde Islands in1998. The objectives of the survey were to estimate the overall and age-specific prevalence of blindness and low vision, to identify the main disorders causing blindness and low vision, and to estimate the population need for basic eye care services. METHODS: A two-level cluster random sampling procedure was used, selecting 30 clusters from the nine inhabited islands and 3,803 persons of all ages were included in the sample. RESULTS: 3,374 persons were examined (coverage 88.7%). The prevalence of bilateral blindness (visual acuity in the better eye less than 3/60) was 0.8% (95% confidence interval [CI] 0.5-1.1), of bilateral low vision (6/18 to 3/60 in the better eye) 1.7% (95% CI: 1.3-2.2) and of monocular blindness 1.5% (95% CI: 1.2-2.0). The major causes of blindness were age related cataract and glaucoma (57.7% and 15.4%, respectively, of blind people recruited). The major causes of bilateral low vision were cataract, refractive errors, and macular disorders (46.2%, 26.8%, and 8.9%, respectively, of persons with low vision). Nontrachomatous corneal opacities accounted for 7.7% of bilateral and for 11.5% of monocular blindness. Vascular retinopathy was responsible for 7.7% of bilateral and for 9.6% of monocular blindness. Trachoma is not a public health problem as only 2.3% of children less than 10 years of age were suffering from active trachoma. Palpebral or limbal vernal conjunctivitis were encountered in 4.5% of persons under 25. CONCLUSION: More than half of the visual impairments are treatable by provision of cataract surgery and cataract has been indicated as a priority target in the recently designed National Blindness Program of the Cape Verde Republic. Pathologic conditions such as diabetes are emerging as serious burden for ageing populations and account for most of the retinal vascular disease.     

Causes of blindness, low vision, and questionnaire-assessed poor visual function in Singaporean Chinese adults: The Tanjong Pagar Survey

OBJECTIVE: To determine the prevalence rates and causes of low vision, blindness, and patient-assessed deficient visual function among Singaporean Chinese adults. DESIGN: Population-based cross-sectional survey. PARTICIPANTS: Singaporean Chinese adults 40 to 79 years old (n = 1152). METHODS: From an initial sampling frame of 40- to 79-year-old Chinese in the Tanjong Pagar district in Singapore, 2000 subjects were selected using a disproportionate, stratified, clustered, random-sampling method. Of 1717 eligible subjects, 1232 were examined (participation rate = 71.8%), and 80 adults who did not have visual acuity (VA) data were excluded from the analysis. MAIN OUTCOME MEASURES: Bilateral low vision was defined as best-corrected VA (BCVA) worse than 6/18 and 3/60 or better, and bilateral blindness as BCVA worse than 3/60 in the better eye or constriction of the visual field to within 10 degrees of fixation, in accordance with the World Health Organization criteria. Patient-assessed visual function was measured using a modified VF-14 questionnaire. RESULTS: The age- and gender-adjusted prevalence rates were 1.1% (95% confidence interval [CI], 0.6-1.8) for bilateral low vision and 0.5% (95% CI, 0.2-1.1) for bilateral blindness, and the mean visual function score was 98.6. The rates of bilateral low vision and blindness increased with age, whereas visual function scores decreased with age, even after adjusting for gender and education. Cataract accounted for 58.8% of bilateral low vision, 20.0% of bilateral blindness, and 52.0% of poor visual function (score<90). Glaucoma contributed to 60.0% of bilateral blindness. CONCLUSION: The age- and gender-adjusted rates of low vision and blindness were 1.1% and 0.5%, respectively. Glaucoma is a leading cause of blindness in Singaporean Chinese adults, in addition to well-recognized causes in the rest of Asia such as cataract.     

Prevalence of blindness and low vision: a study in the rural Heilongjiang Province of China

Background: The prevalence of blind individuals in the north of China is unknown. The study aimed to investigate the prevalence and causes of blindness and low vision in rural areas in Heilongjiang province of China in 2008–2009. Design: Cross‐sectional study. Participants or Samples: A cluster random sampling method was used to recruit participants of all ages in rural areas of Heilongjiang. Methods: Trained professionals performed interviews and clinical examinations to measure visual acuity. The relationships between blindness or low vision and age, gender and education level were analysed. Main Outcome Measures: The main outcome measure was prevalence rates of bilateral blindness and bilateral low vision. Results: Of the 11 787 subjects, 10 384 (88.1%) were surveyed. The overall age‐adjusted prevalence rates were 0.7% (95% confidence interval: 0.5–0.8%) for bilateral blindness and 1.7% (95% confidence interval: 1.4–1.9%) for bilateral low vision. The prevalence rates of blindness and low vision were higher in the elderly and uneducated population (P < 0.05). The main causes for blindness and low vision were cataracts (44.1 and 46.0%, respectively) and refractive errors (17.7 and 42.5%, respectively). Conclusion: Blindness and low vision are highly prevalent among people with cataracts and refractive errors. Eye care planning must focus on treating the avoidable and curable forms of blindness.     

The impact of Vision 2020 on global blindness

INTRODUCTION: Recent data suggest that there are 37 million blind people and 124 million with low vision, excluding those with uncorrected refractive errors. The main causes of global blindness are cataract, glaucoma, corneal scarring (from a variety of causes), age-related macular degeneration, and diabetic retinopathy. CONCLUSION: It would appear that the global Vision 2020 initiative is having an impact to reduce avoidable blindness particularly from ocular infections, but more needs to be done to address cataract, glaucoma, and diabetic retinopathy.     

Blindness and Low Vision in Cape Verde Islands: Results of a National Eye Survey

Aims: Prior to establishing a national prevention of blindness program a population based survey was conducted in Cape Verde Islands in1998. The objectives of the survey were to estimate the overall and age-specific prevalence of blindness and low vision, to identify the main disorders causing blindness and low vision, and to estimate the population need for basic eye care services. Methods: A two-level cluster random sampling procedure was used, selecting 30 clusters from the nine inhabited islands and 3,803 persons of all ages were included in the sample. Results: 3,374 persons were examined (coverage 88.7%). The prevalence of bilateral blindness (visual acuity in the better eye less than 3/60) was 0.8% (95% confidence interval [CI] 0.5–1.1), of bilateral low vision (6/18 to 3/60 in the better eye) 1.7% (95% CI: 1.3–2.2) and of monocular blindness 1.5% (95% CI: 1.2–2.0). The major causes of blindness were age related cataract and glaucoma (57.7% and 15.4%, respectively, of blind people recruited). The major causes of bilateral low vision were cataract, refractive errors, and macular disorders (46.2%, 26.8%, and 8.9%, respectively, of persons with low vision). Nontrachomatous corneal opacities accounted for 7.7% of bilateral and for 11.5% of monocular blindness. Vascular retinopathy was responsible for 7.7% of bilateral and for 9.6% of monocular blindness. Trachoma is not a public health problem as only 2.3% of children less than 10 years of age were suffering from active trachoma. Palpebral or limbal vernal conjunctivitis were encountered in 4.5% of persons under 25. Conclusion: More than half of the visual impairments are treatable by provision of cataract surgery and cataract has been indicated as a priority target in the recently designed National Blindness Program of the Cape Verde Republic. Pathologic conditions such as diabetes are emerging as serious burden for ageing populations and account for most of the retinal vascular disease.     

Low vision in Nigerians with diabetes mellitus

Objectives: To determine the prevalence and causes of low vision in diabetes mellitus patients in Nigeria. Materials and methods: All consecutive new patients seen at the Diabetic Eye Clinic, Nnamdi Azikiwe University Teaching Hospital Nnewi Nigeria, between March 1997 and September 1998 were the subjects of the study. Examination methods included interviewer-administered structured questionnaire, visual acuity test, external eye examination, refraction, tonometry, gonioscopy, binocular indirect ophthalmoscopy and slit lamp fundus examination with 78D non-contact lens. Results: Of the 100 new patients examined, 47 (47%) did not know that diabetes could lead to visual loss; 53 (53%) had not been examined by any eye health worker. Eighteen patients (18%) were bilaterally blind and 26 (26%) had monocular blindness; visual impairment was present in the better eyes of 30 patients (30%), with 20 (20%) having bilateral visual impairment. Glaucoma, cataract, diabetic retinopathy, central retinal vein occlusion, age-related macular degeneration, and leukoma were the causes of blindness. Visual impairment was due to diabetic macular edema, ametropia, cataract, age-related macular degeneration, glaucoma, uveitis and branch retinal vein occlusion. Conclusion: The causes of low vision in the patients are treatable and visual defects from them are thus avoidable. It is recommended that (a) all diabetics be made aware that diabetic complications cause visual loss; (b) laser photocoagulation facilities be provided for treating diabetic retinopathy.     

Blindness and eye disease in Cambodia

PURPOSE: To assess the prevalence and etiology of blindness and low vision and to assess the prevalence of common eye diseases in central Cambodia. METHODS: In this cross-sectional, population-based study, 6,558 residents of Kandal Province, Cambodia were registered, and 5,803 (88.5%) were interviewed and examined. This house-to-house survey was conducted by a team consisting of a senior ophthalmologist, a Cambodian eye doctor, and eight Cambodian eyecare workers. RESULTS: The prevalence of bilateral blindness (visual acuity <3/60) is 1.1% (95% confidence interval [CI], 0.9-1.4), and an additional 4.4% (95% CI, 3.9-5.0) have low vision (visual acuity < 6/18, > or =3/60 in the better eye). The major causes of bilateral blindness are cataract (67.4%), phthisis (6.1%), uncorrected refractive error (6.1%), corneal scar (5.3%), uncorrected aphakia (3.0%), trachoma corneal scar (3.0%), optic atrophy (3.0%), and others (6.1%). The major causes of low vision are uncorrected refractive error (49.8%) and cataract (42.7%). The prevalence of unilateral blindness is 1.2% (95% CI, 0.9-1.4), often caused by cataract, corneal scar, or phthisis. Trauma due to landmine explosions and war-related injuries was frequently the underlying etiology in subjects with phthisis, corneal scarring, or other pathology.CONCLUSIONS: The prevalence of blindness and low vision in Cambodia is relatively high compared to other developing countries. Most of the causes of blindness and low vision are treatable or preventable. Landmines and other war-related injuries are an important cause of ocular injury. These results will assist in developing a national plan for the prevention of blindness in Cambodia.     

乌鲁木齐市老年公寓中50岁及以上人群盲与低视力调查

目的了解乌鲁木齐市19所正式登记的老年公寓入住50岁及以上人群的盲与低视力构成比及主要致盲原因。设计横断面调查。研究对象乌鲁木齐市19所老年公寓中50岁及以上符合入选标准的475人。方法对符合此次调查准入标准的475人进行常规日常生活视力、小孔视力的检查。筛选出盲和低视力的患者,对其眼病进行相应辅助检查,分析致盲的主要原因。主要指标盲与低视力构成比。结果被调查的475人中,按照A标准:双眼盲构成比为6.9%,双眼低视力的构成比为8.4%,单眼盲构成比为14.9%,单眼低视力构成比为12.0%。按照B标准:视力损伤构成比为17.1%,单眼盲、轻度盲和重度盲构成比分别为15.4%、2.9%和6.9%。致盲的主要病因依次为白内障(59.87%)、屈光不正(11.84%)、眼底病变(15.13%)、角膜混浊(5.92%)、眼球萎缩或缺如(2.96%)、青光眼(2.63%)、不确定(1.64%)。结论乌鲁木齐市老年公寓50岁及以上人群,随年龄增加易患致盲性眼病。白内障为主要致盲原因。     

Blindness and Eye Disease in Cambodia

Purpose: To assess the prevalence and etiology of blindness and low vision and to assess the prevalence of common eye diseases in central Cambodia. Methods: In this cross-sectional, population-based study, 6,558 residents of Kandal Province, Cambodia were registered, and 5,803 (88.5%) were interviewed and examined. This house-to-house survey was conducted by a team consisting of a senior ophthalmologist, a Cambodian eye doctor, and eight Cambodian eyecare workers. Results: The prevalence of bilateral blindness (visual acuity <3/60) is 1.1% (95% confidence interval [CI], 0.9–1.4), and an additional 4.4% (95% CI, 3.9–5.0) have low vision (visual acuity < 6/18, ≥3/60 in the better eye). The major causes of bilateral blindness are cataract (67.4%), phthisis (6.1%), uncorrected refractive error (6.1%), corneal scar (5.3%), uncorrected aphakia (3.0%), trachoma corneal scar (3.0%), optic atrophy (3.0%), and others (6.1%). The major causes of low vision are uncorrected refractive error (49.8%) and cataract (42.7%). The prevalence of unilateral blindness is 1.2% (95% CI, 0.9–1.4), often caused by cataract, corneal scar, or phthisis. Trauma due to landmine explosions and war-related injuries was frequently the underlying etiology in subjects with phthisis, corneal scarring, or other pathology.Conclusions: The prevalence of blindness and low vision in Cambodia is relatively high compared to other developing countries. Most of the causes of blindness and low vision are treatable or preventable. Landmines and other war-related injuries are an important cause of ocular injury. These results will assist in developing a national plan for the prevention of blindness in Cambodia.     

Causes of low vision and blindness in rural Indonesia

AIM: To determine the prevalence rates and major contributing causes of low vision and blindness in adults in a rural setting in Indonesia METHODS: A population based prevalence survey of adults 21 years or older (n=989) was conducted in five rural villages and one provincial town in Sumatra, Indonesia. One stage household cluster sampling procedure was employed where 100 households were randomly selected from each village or town. Bilateral low vision was defined as habitual VA (measured using tumbling "E" logMAR charts) in the better eye worse than 6/18 and 3/60 or better, based on the WHO criteria. Bilateral blindness was defined as habitual VA worse than 3/60 in the better eye. The anterior segment and lens of subjects with low vision or blindness (both unilateral and bilateral) (n=66) were examined using a portable slit lamp and fundus examination was performed using indirect ophthalmoscopy. RESULTS: The overall age adjusted (adjusted to the 1990 Indonesia census population) prevalence rate of bilateral low vision was 5.8% (95% confidence interval (CI) 4.2 to 7.4) and bilateral blindness was 2.2% (95% CI 1.1 to 3.2). The rates of low vision and blindness increased with age. The major contributing causes for bilateral low vision were cataract (61.3%), uncorrected refractive error (12.9%), and amblyopia (12.9%), and the major cause of bilateral blindness was cataract (62.5%). The major causes of unilateral low vision were cataract (48.0%) and uncorrected refractive error (12.0%), and major causes of unilateral blindness were amblyopia (50.0%) and trauma (50.0%). CONCLUSIONS: The rates of habitual low vision and blindness in provincial Sumatra, Indonesia, are similar to other developing rural countries in Asia. Blindness is largely preventable, as the major contributing causes (cataract and uncorrected refractive error) are amenable to treatment.     

尼日利亚阿巴卡利基地区三级医院的先天性眼及附属器疾病

目的：确定在尼日利亚阿巴卡利基地区两个三级医院就诊的先天性眼及附属器疾病的类型和发病率。方法：回顾分析2001—05／2008—04就诊于两个三级医院眼科的1岁及1岁以下的先天性眼病患者的病历记录,用简单的统计方法分析年龄、性别、病种、发病率、眼部及全身的相关疾病等信息。结果：研究共记录有199例眼病患儿。其中先天性眼病的50例（25．1％）。包括男27例（54％）,女23例（46％）。患儿〈6个月龄的占2／3（64％）。最常见的疾病为鼻泪管阻塞10例（20％）,先天性上睑下垂10例（14％）皮样囊肿5例（10％）,牛眼4例（8％）,以及先天性白内障3例（6％）。这些都可能导致可避免的儿童盲。少见的疾病包括白化病1例（2％）,无眼畸形1例（2％）,视网膜母细胞瘤2例（4％）和视神经萎缩2例（4％）。这些是不可逆的导致失明和视力低下的原因。结论：尽管先天性眼病不常见,但是这些疾病是潜在的儿童致盲原因。     

Prevalence and causes of visual impairment in elderly Amis aborigines in eastern Taiwan (the Amis Eye Study)

Purpose

To investigate the prevalence and causes of visual impairment in elderly Amis aborigines in Eastern Taiwan.

Methods

Population-based cross-sectional study of visual impairment of elderly Amis (65?years of age or older). We conducted ocular examinations on 2,316 participants, which represent 61.2?% of the elderly population. We used WHO criteria to identify visual impaired subjects, and the causes were analyzed.

Results

Ninety-four subjects were identified with low vision and nineteen were blind. The prevalence of low vision was 4.06?% (95?% confidence interval, 3.26, 4.56?%); that of blindness was 0.82?% (95?% confidence interval, 0.45, 1.19?%). Cataracts (47.79?%) were the main cause of visual impairment, followed by age-related macular degeneration (15.93?%), corneal opacity (7.96?%), optic neuropathy (7.96?%), diabetic retinopathy (5.31?%), and retinitis pigmentosa (2.65?%). Glaucoma was a minor cause of visual impairment. There were no significant gender differences in the prevalence and specific causes of visual impairment.

Conclusion

The prevalence of treatable causes of vision impairment, for example cataracts and corneal opacity, is high among the elderly Amis aborigines. They would, therefore, benefit from a more aggressive and in-depth eye-care program as a blindness-prevention strategy.     

Effect of unilateral inferior oblique weakening on fundus torsion in bilateral eyes of children with congenital superior oblique palsy

AIM: To determine the frequency and types of retinal diseases in adult patients attending two public eye clinics of Kinshasa, Democratic Republic of Congo, and the extend of the related visual loss. METHODS: Review of medical records of patients with retinal diseases seen in the major eye clinics in Kinshasa, the University Hospital of Kinshasa (UHK) and Saint Joseph Hospital (SJH), from January 2012 to December 2014. Demographics and diagnoses were retrieved and analyzed. Outcome measures were frequency and prevalence of retinal diseases, blindness and low vision. RESULTS: A total of 40 965 patients aged 40y or older were examined during this period in both clinics. Of these, 1208 had retinal disease, giving a 3-year and an annual prevalence of 3% and 1%, respectively. Mean age was 61.7±10.7y, 55.8% of the patients were males. Arterial hypertension (68.1%) and diabetes (43.3%) were the most common systemic comorbidities. Hypertensive retinopathy (41.8%), diabetic retinopathy (37.9%), age-related macular degeneration (14.6%), and chorioretinitis and retinal vein occlusion (7.3% each) were the most common retinal diseases, with 3-year prevalence rates were 1.3%, 1.0%, 0.43%, and 0.21% respectively. Bilateral low vision and blindness were present in 26.8% and 8.4% of the patients at presentation. Major causes of low vision and blindness were diabetic retinopathy (14.8%), age-related macular degeneration (4.9%), retinal detachment (2.8%), and retinal vein occlusion (2.5%). The prevalence was significantly higher among males than females, and at the UHK than SJH. CONCLUSION: Retinal diseases are common among Congolese adult patients attending eye clinics in Kinshasa. They cause a significant proportion of low vision and blindness.     

艾滋病合并巨细胞病毒性视网膜炎19例

目的 了解艾滋病合并巨细胞病毒性视网膜炎的临床特征.设计回顾性病例系列.研究对象北京地坛医院眼科诊治的艾滋病合并新发巨细胞病毒性视网膜炎患者19例29眼.方法 对所有19例患者29眼进行了与艾滋病相关的免疫学检测及肝肾功能检查 所有患者进行视力、眼压、裂隙灯、视野以及眼底照相等眼科检查,并观察其临床特征.主要指标视力,CD4＋细胞,眼底改变.结果 19例患者中,10例双眼发病.中心型巨细胞病毒性视网膜炎5例6眼,其视力指数～0.4 周边型9例15眼,其中14眼视力〉0.5 混合型5例8眼,其中7眼视力〈0.6.17例CD4＋细胞≤50个/μl.15例合并其他部位感染.结论 巨细胞病毒性视网膜炎是艾滋病常见眼部并发症,周边型是其常见类型.CD4＋细胞≤50个/μl的患者更易患病,其视力预后差.     

南通市新城桥街道60岁及以上人群盲和低视力的现况调查

目的调查江苏省南通市城市人口中60岁及以上人群盲和低视力的患病率及其原因。方法采用随机整群抽样方法,抽取新城桥街道14个社区中的8个,并对所有60岁及以上人群进行检查。分别检查小孔视力和日常生活视力,应用裂隙灯显微镜和直接检眼镜等仪器检查受检者外眼、眼前节及眼底等情况。正式调查前先进行预试验。结果共检录3352人,受检人数为3040人,应答率90．69％。按小孔视力和世界卫生组织视力损伤标准,双眼盲和低视力患病率分别为1．35％和1．84％,其中女性分别为1．92％和2．33％,男性为0．66％和1．24％;盲和低视力患病率随着年龄的增长而增加;致盲和低视力的首要原因为白内障。按日常生活视力和视力损伤标准,双眼盲和视力损伤的患病率分别为1．58％和13．59％,其中女性分别为2．10％和15．98％,男性为0．95％和10．66％;盲和视力损伤的患病率亦随年龄的增长而增加;致双眼盲的首要原因亦为白内障。结论南通市60岁及以上城市人群盲的患病率低于华北、华南及西部地区。女性与文盲的盲和低视力患病率分别高于男性与非文盲。南通市城市人口中致盲的主要原因依次为白内障、眼底异常、屈光不正及角膜瘢痕或混浊等。     

Ocular association of HIV infection in the era of highly active antiretroviral therapy and the global perspective

Ocular involvement is a common complication of HIV infection. Since the late 1990s, widespread use of highly active antiretroviral therapy (HAART) has altered the spectrum, and reduced the incidence of ocular involvement in developed countries. The incidence of the most common ocular opportunistic infection, cytomegalovirus retinitis, has decreased tremendously. However, immune recovery uveitis secondary to HAART has emerged as a frequent visually threatening condition. Early diagnosis and treatment with periocular steroids is helpful in minimizing visual loss. Clinicians should also be aware that certain antimicrobial agents used to treat opportunistic infections in HIV-positive patients are associated with potentially serious ocular side effects. In developing countries, where most of the world's 40 million HIV-positive patients live, the spectrum and incidence of ocular involvement differ from those in developed countries. The lack of HAART availability is among the many causes of these differences, which may include nutritional factors, basic medical care availability and the levels of exposure to different infectious agents. These factors add to the already challenging task of treating ocular complications and preventing blindness in HIV-positive patients in developing countries.     

上海市浦东新区残疾人致盲和低视力原因调查

目的调查2004年上海市浦东新区残疾人中低视力和盲的致盲原因。方法根据世界卫生组织提出的盲和低视力的分类标准,对2004年1月～12月间在我院鉴定为残疾的496例患者的低视力和盲原因进行分析。结果2004年1月～12月共检查1205人,其中残疾人496人占41%,致低视力和盲眼病依此为高度近视30.2%、视网膜色素变性11.3%、青光眼9.3%、黄斑变性6.9%、白内障6.9%、弱视5.8%、糖尿病性视网膜病变4.8%、角膜病4.0%、视网膜脱离4.0%、眼球萎缩3.0%。结论2004年上海市浦东新区的首位致残原因为高度近视,首位致盲原因为视网膜色素变性。