云南省高海拔农村多民族聚居区屈光不正患病率调查

目的:调查中国西南部高海拔农村多民族聚居区人群屈光不正患病率,获得该地区整体人群屈光不正的流行病学资料。方法:采用整群随机抽样的方法选取云南省贡山县常住居民做为调查对象。所有调查对象均接受全面的眼科检查及屈光状态检查。分析屈光不正整体情况及屈光不正发生与年龄、性别、文化程度等相关因素的关系。结果:入选对象3070例中实际接受调查人数为2422例(受检率78.9%)。对4843眼的屈光不正数据进行统计分析:正视眼2635眼(54.4%);近视1106眼(22.8%);远视1102眼(22.8%),其中散光4451眼(91.9%)。正视所占比率随年龄增长呈下降趋势(P<0.05),近视患病率不随年龄增长而增长(P>0.05),远视眼患病率随年龄增长呈上升趋势(P<0.05)。散光的发生中,顺规散光81·6%,随年龄增长顺规呈下降趋势,逆规散光15.1%,随年龄增长呈上升趋势(P<0.05)。女性远视眼患病率较男性人群高(P<0.05)。初中学历以上人群中重度近视发生率较初中以下学历人群为高(P<0.05)。结论:获得中国西南部高海拔偏远山区整体人群屈光不正统计数据,表明受教育程度越高近视发生率越高,年龄改变与散光轴向改变相关。     

广州市荔湾区学龄儿童屈光不正患病率的现况调查

目的 探讨广州市荔湾区5～15岁儿童的屈光不正患病率情况.方法 采用人群为基础的横断面调查方法.在2002年10月至2003年1月期间,中山大学巾山眼科中心对广州市荔湾区居住的全部5～15岁儿童,通过随机整群抽样和逐户登记确定样本与受检对象,在71个学校和19个社区检查点进行检查,眼部榆查包括视力、眼球运动、散瞳检影验光、自动验光、外眼、眼前段、屈光间质及眼底检查.屈光不正与儿童的年龄、性别及家长教育程度的关系采用多元回归模型进行分析.结果 在登记的5053名儿童中,实际检查4364人,受检率为86.4%.以等效球镜-0.50 D以下作为界定,近视的患病率为35.1%(95%可信区间:33.2%～36.9%),患病率从5岁的3.3%增加到15岁时的73.1%(根据检影验光);女性儿童具有较高的患病率,调整比数比为1.29(95%可信区间:1.11～1.51);以等效球镜+2.00 D以上作为界定,远视患病率为5.8%(95%可信区间:5.3%～6.3%),从5岁时16.7%减少到15岁时低于1.0%.散光(柱镜屈光度≥0.75 D)的患病率在视网膜检影法为33.6%,而在自动验光法为42.7%.Logistie回归模型显示近视与年龄(OR=1.52,95%可信区间:1.48～1.56)、女性(OR=1.29,95%可信区间:1.11～1.51)和父母教育程度(OR=1.22,95%可信区间:1.05～1.42)有关.结论 广州市荔湾区学龄儿童具有较高的近视患病率,近视已经成为重要的公共卫生问题,提高儿童屈光矫正的覆盖率和质量足当前的主要挑战.     

城乡学生屈光不正调查及相关因素研究

和敏感性意义.乡村学生课余看电视时间明显多于城市学生.结论 城乡学生视力低常的主要原因是近视.影响因素主要是长时间近距离作业,遗传,环境因素等;电视对近视的影响相关性小.     

宁夏回族自治区同心县50岁及以上农村人群屈光不正患病率调查

目的 调查宁夏回族自治区同心县50岁及以上农村人群屈光不正的患病情况,并了解屈光矫正前后,盲和低视力的患病情况.方法 调查研究.采用单纯随机抽样的方法对宁夏同心县50岁及以上的农村人群进行一般情况的问卷调查和视力、眼压、验光、裂隙灯显微镜、免散瞳数字眼底照相等眼部专科检查.采用卡方检验对数据进行分析.结果 共5 493例符合纳入标准,其中5 046例接受并完成了检查,应答率为91.86％,在受检的5 046例中,屈光不正2 116例,屈光不正患病率为41.93％.根据日常生活视力(PVA)标准和最佳矫正视力(BCVA)标准,盲的患病率分别为5.35％、2.02％,差异有统计学意义(x2=78.78,P＜0.01),低视力的患病率分别为15.28％、5.77％,差异有统计学意义(x2=244.54,P＜0.01).受教育程度小学以下、小学、初中、高中及以上屈光不正患病率分别为45.94％、36.42％、25.38％、33.79％,不同教育程度患病率差异有统计学意义(x2=97.89,P＜0.01);回族和汉族患病率分别为43.33％、35.92％,差异有统计学意义(x2=17.40,P＜0.01).结论 宁夏同心县50岁及以上农村人群屈光不正患病率为41.93％,根据不同标准,盲和低视力的患病率不同,不同年龄、教育程度、民族之间患病率也不同.通过屈光矫正,低视力患病率显著降低.     

中老年人屈光不正的流行病学研究进展

屈光不正是指外界物象在无调节状态下经眼的屈光系统折射后,不能准确聚焦于视网膜形成清晰的图像.随着我国步入老龄化社会,中老年人的屈光不正日益受到社会关注.本文对中老年人屈光不正的现状及发展的相关问题作一综述.     

儿童屈光不正的流行病学调查现状

屈光不正已成为影响儿童视觉健康的主要原因之一.国内外学者对儿童屈光不正的流行病学研究逐步深入,但研究方法和结果不尽相同.儿童屈光不正的患病率在不同国家与地区、不同种族间差异较大,如亚洲地区的新加坡、日本、中国香港及澳门地区较高;欧美国家其次;非洲最低.相关研究发现遗传因素、环境因素(如环境光照、近距离工作、户外活动时间...     

美国、西欧和澳洲成人中屈光不正的患病率

目的：评估≥40岁人群中屈光不正的患病率。     

2010年上海市宝山区小学生屈光不正和视力损伤的患病率调查

背景 流行病学调查表明,青少年视力损伤是一个全球性的公共卫生问题,其首要原因是未矫正的屈光不正,因此一定规模的流行病学调查对儿童屈光不正的矫正具有重要意义.目前尚缺乏上海市大规模儿童视力损伤和屈光不正的流行病学调查资料. 目的 调查上海市6 ～12岁小学生视力损伤与屈光不正的患病情况.方法 采用横断面调查研究设计,于2010年5月至2011年4月分层随机整群抽取上海市宝山区6所学校的4 686名小学生进行研究,眼部检查包括视力、外眼、眼前节、屈光间质、眼底和眼压检查,并记录睫状肌麻痹后电脑验光的结果和眼位.结果 实际受检学生4 594人,应答率为98.0％,接受睫状肌麻痹后验光者3 975人,占84.8％.双眼裸眼视力≤0.5者占14.4％（662/4 594）,其中343人配戴眼镜,占51.8％.所有受检者中,任一眼裸眼视力≤0.5者1 031人,占22.4％.受检的视力损伤者中屈光不正占96.9％（999/1 031）,弱视占3.6％（37/1 031）.接受睫状肌麻痹后验光的小学生中,近视、远视和散光的患病率分别为31.1％、4.3％和33.0％.公办学校的小学生近视患病率高于外来务工随迁子女学校的学生,差异有统计学意义（x2=5.46,P=0.02）.Logistic回归分析显示,年龄和女生与近视的发生及发展明显有关（年龄：OR=1.60,95％ CI：1.53 ～ 1.68,P＜0.01;女生：OR=1.33,95％CI：1.16～1.54,P＜0.01）. 结论 中国上海市小学生视力损害的主要原因是近视,应注意筛查并提高小学生屈光不正的矫正覆盖率.     

新疆少数民族1000例屈光不正统计分析

新疆少数民族１０００例屈光不正统计分析新疆伊犁哈萨克自治州友谊医院眼科刘金华，腊敏我国人的屈光情况，国内已有不少论述，为了进一步了解新疆少数民族的屈光情况，现将我科１９９０－１９９２年门诊屈光检查的１０００例少数民族屈光不正病例，作了统计分析如下。检...     

中老年人屈光不正的流行病学研究进展

屈光不正是指外界物象在无调节状态下经眼的屈光系统折射后,不能准确聚焦于视网膜形成清晰的图像.随着我国步入老龄化社会,中老年人的屈光不正日益受到社会关注.本文对中老年人屈光不正的现状及发展的相关问题作一综述.     

北京城乡人群视网膜静脉阻塞患病情况调查

目的了解北京城区和农村中老年人群视网膜静脉阻塞(RVO)的患病情况及流行病学特征。设计人群为基础的横断面研究。研究对象"北京眼病研究"40岁以上人群4439人(应答率83.4%),农村1973人,城市2466人。方法对每位受检者进行详细的眼科检查包括散瞳后彩色眼底照相。依据眼底照片表现诊断RVO。主要指标RVO患病率。结果RVO患病率为1.3%(58/4335,95%CI:1.0%～1.6%)。RVO患病率随年龄的增长而增加(P<0.001)。城市(1.4%,95%CI:0.9%～1.9%)和农村(1.3%,95%CI:0.8%～1.8%)患病率无统计学差异(P=0.400)。男性(1.3%,95%CI:0.8%～1.8%)和女性(1.4%,95%CI:0.9%～1.9%)患病率无统计学差异(P=0.578)。右眼和左眼患病率无统计学差异(0.8%/0.6%,P=0.195)。视网膜分支静脉阻塞占91.4%,视网膜中央静脉阻塞占8.6%。双眼RVO仅2例。RVO导致的单眼低视力及盲占本研究中单眼低视力及盲总人数的4.5%和2.1%。结论40岁以上者视网膜静脉阻塞的患病率为1.3%。患病率随年龄增长而增加,无性别及城乡差异。     

Prevalence and associations of refractive error in indigenous Australians within central Australia: the Central Australian Ocular Health Study

Purpose: To determine the prevalence and associations of refractive error within the indigenous Australian population living in central Australia. Methods: 1884 individuals aged 20 years or older, living in one of 30 remote communities within the statistical local area of ‘central Australia’ were recruited for this study. This equated to 36% of those aged 20 years or older and 67% of those aged 40 years or older within this district. Participants were recruited as they presented to the eye clinic at each remote community. Participants underwent subjective refraction to determine spherical equivalent and then had a slit‐lamp anterior segment examination. Participants were only included if they were phakic and only the right eye was considered. The prevalence of hypermetropia worse than +1.0 dioptres (D), myopia worse than ?0.5 D and astigmatism worse than 1.0 D is presented. Results: From those recruited, 15.2% were hypermetropic; 11.1% were myopic; and 6.2% had astigmatism. Participants became progressively more hypermetropic with increasing age until the age of 70 years, after which time they become more myopic. Furthermore, there was an increasing likelihood of myopia and a decreasing likelihood of hypermetropia with increasing nuclear opalescent cataract. Conclusion: Our study has shown that indigenous Australians are less likely to be ametropic compared with non‐indigenous groups. Variations with age and nuclear opalescent cataract seen in other previous work have also been observed in our sample.     

北京市怀柔城区和郊区学龄前儿童视觉调查

目的对2009年北京市怀柔区25个幼儿园(其中区中心15个,郊区10个)4～6岁学龄前儿童进行视觉状况的普查,比较城区和郊区儿童视觉状况及相关因素。方法分别对城区2150例儿童和郊区1679例儿童进行了视力检测,包括远近视力(裸眼和戴镜视力)、外眼检查、眼位及眼球运动。对视力低于0.8进行散瞳验光。结果怀柔区城区和郊区儿童视力低常率有显著性差异。视力低常率:城区占13.02%,其中4岁占9.39%,5岁15.29%,6岁14.95%;郊区占9.17%,其中4岁占7.59%,5岁13.16%,6岁8.08%。各年龄组视力低常率有统计学意义,(P<0.01)。视力低常率与年龄相关。视力低常儿童中,其中疾病包括屈光不正;斜视;先天眼病(先天上睑下垂和先天眼球震颤);眼外伤。视力低常屈光不正占96.31%。屈光不正分布:远视74.16%,其中4岁占75.22%,5岁84.47%,6岁51.51%;近视10.77%,其中4岁占4.42%,5岁4.85%,6岁30.30%;混合散光15.07%,其中4岁占20.35%,5岁10.67%,6岁18.18%。弱视患病率4.3%;对弱视相关因素调查显示,屈光参差性占36.36%,轻度65.00%,中度31.67%,重度3.33%;斜视性占15.15%,轻度28.00%,中度60.00%,重度12.00%;形觉剥夺性占2.43%,轻度0%,中度50.50%,重度50.50%。结论学龄前儿童视力低常率和地域有一定的关系。低常率随年龄增加而降低,表明视功能发育逐渐成熟。屈光不正中各组比例提示远视是4～6岁学龄前儿童视力低下的主要原因。近视、斜视、弱视等因素所占比例提示普查手段十分重要,可以早发现早治疗。     

Screening for refractive error and fitting with spectacles in rural and urban India: Cost-effectiveness

Objectives:?To assess the cost-effectiveness of screening for refractive error and fitting with glasses in India.

Methods:?We populated a decision tree with the costs of screening and spectacles, prevalence of varying levels of presenting and best corrected visual acuity (BCVA) from two studies, and sensitivity and specificity of screening. We calculated dollars spent per disability adjusted life year (DALY) averted separately in urban and rural areas for school-based screening (SBS) and primary eye care (PEC) programs that fit spectacles to individuals presenting for care. We conducted a series of univariate and probabilistic sensitivity analyses. An intervention was inferred to be highly cost-effective if the incremental cost-effectiveness ratio (ICER) was less than the gross domestic product (GDP) per capita and moderately cost-effective if the ICER was less than three times this level.

Results:?Compared with no screening, urban SBS was highly cost-effective; rural SBS was moderately cost-effective for ages 5–15 and highly cost-effective for ages 7–15. Both urban and rural PEC were moderately cost-effective in comparison to SBS. Probabilistic sensitivity analysis suggested that SBS is likely the most cost-effective solution for refractive error in India if the 5–15 year old age group is targeted; primary eye care is the best choice if a high value is placed on DALYs and the 7–15 year old age group is targeted.

Conclusion:?Both SBS and PEC Interventions for refractive error can be considered cost-effective in India. Which is the more cost-effective depends on the choice of targeted age group and area of the intervention.     

Prevalence and predictors of refractive error in a genetically isolated population: the Norfolk Island Eye Study

Background: We aimed to determine the prevalence and associations of refractive error on Norfolk Island. Design: Population‐based study on Norfolk Island, South Pacific. Participants: All permanent residents on Norfolk Island aged ≥15 years were invited to participate. Methods: Patients underwent non‐cycloplegic autorefraction, slit‐lamp biomicroscope examination and biometry assessment. Only phakic eyes were analysed. Main Outcome Measures: Prevalence and multivariate associations of refractive error and myopia. Results: There were 677 people (645 right phakic eyes, 648 left phakic eyes) aged ≥ 15 years were included in this study. Mean age of participants was 51.1 (standard deviation 15.7; range 15–81). Three hundred and seventy‐six people (55.5%) were female. Adjusted to the 2006 Norfolk Island population, prevalence estimates of refractive error were as follows: myopia (mean spherical equivalent ≥?1.0 D) 10.1%, hypermetropia (mean spherical equivalent ≥ 1.0 D) 36.6%, and astigmatism 17.7%. Significant independent predictors of myopia in the multivariate model were lower age (P < 0.001), longer axial length (P < 0.001), shallower anterior chamber depth (P = 0.031) and increased corneal curvature (P < 0.001). Significant independent predictors of refractive error were increasing age (P < 0.001), male gender (P = 0.009), Pitcairn ancestry (P = 0.041), cataract (P < 0.001), longer axial length (P < 0.001) and decreased corneal curvature (P < 0.001). Conclusions: The prevalence of myopia on Norfolk Island is lower than on mainland Australia, and the Norfolk Island population demonstrates ethnic differences in the prevalence estimates. Given the significant associations between refractive error and several ocular biometry characteristics, Norfolk Island may be a useful population in which to find the genetic basis of refractive error.