2009年上海市宝山区大场社区60岁及以上人群盲和低视力患病率调查

目的 探讨上海市宝山区大场社区60岁及以上人群的盲和低视力患病率、致盲原因及其相关因素。方法 横断面现况调查研究。由上海市眼病防治中心和上海市宝山区疾病预防控制中心于2009年10至12月期间对上海市宝山区大场社区60岁及以上并在当地居住10年以上的常住户籍人口进行随机整群抽样调查。对调查对象完成视力、眼压、验光、裂隙灯显微镜、免散瞳数字眼底照相等检查,采用世界卫生组织视力损伤标准和日常生活视力和视力损伤标准确立盲或低视力,并明确主要致盲原因。组间率的比较采用卡方检验。结果 实际受检4545人,受检率为87.42％。受检人群均为近10年内随着城市化进程从原农村人口转变而来的城市人口。按照世界卫生组织视力损伤标准：双眼盲30人,患病率0.67％;双眼低视力145人,患病率3.19％。白内障、黄斑变性、眼球萎缩或缺如、青光眼、糖尿病视网膜病变（或角膜病）是前5位致盲眼病。女性低视力患病率高于男性,差异有统计学意义(x2 =4.88,P＜0.05)。按照日常生活视力和视力损伤标准：双眼盲39人,患病率0.86％,双眼低视力401人,患病率8.82％;75岁后成为视力损害的高速发展期。白内障、未矫正的屈光不正、黄斑变性、眼球萎缩或缺如、青光眼是前5位致盲原因。女性低视力患病率高于男性,差异有统计学意义(x2=13.345,P＜0.01)。结论 在上海市城市化进程较快的老龄化社区中,白内障、未矫正的屈光不正、黄斑变性是引起日常生活视力盲的前3位原因,女性低视力患病率明显高于男性。对这类社区居民需要进行更多的有针对性眼的保健教育与服务工作。     

南通市新城桥街道60岁及以上人群白内障流行病学调查

目的调查江苏省南通市城市人口中60岁及以上人群白障患病率、白内障盲人手术覆盖率和白内障人社会负担率,了解白内障患病情况及评价近十年来南通市实施以白内障手术治疗为主的防盲治盲工作效果。方法随机整群抽取新城桥街道14个社区中的8个,并对所有60岁及以上人群进行视力和眼部检查。了解接受白内障手术情况。结果3040例受检者中,白内障患病率为34.87%。2002年南通市城市人口60岁及以上人群白内障手术率为8553。以较好眼小孔视力<0.05为盲标准,白内障盲人手术覆盖率为60%,女性和文盲分别为50%和30%。白内障盲人社会负担率为2.14%,女性和文盲分别为2.63%和4.40%。以双眼日常生活视力<0.1为盲的标准,白内障盲人手术覆盖率为57.33%,女性和文盲分别为50%和31.82%。白内障盲人的社会负担率为2.47%,女性和文盲分别为2.99%和4.84%。结论白内障盲人所造成的社会负担率较重,在女性和文盲中,白内障是严重的公共卫生问题。防盲工作的首要任务仍是根治白内障盲。     

云南省高海拔农村多民族聚居区盲和低视力患病率调查

目的 探讨云南省高海拔农村多民族聚居区贡山县盲和低视力患病率及分布特点。方法 采用整群随机抽样的方法。2008年2至4月选取云南省贡山县全年龄组常住居民作为调查对象。调查地点为人选居民所在的村庄。调查程序包括问卷调查、预调查、视力检查、眼压、裂隙灯显微镜检查及眼底检查。盲定义为较好眼最佳矫正视力＜0.05,低视力定义为较好眼最佳矫正视力≥0.05且＜0.3。按年龄、性别、职业、教育程度、民族及居住地海拔高度分别计算盲和低视力的患病率,同时确定盲和低视力的原因。患病率的分层比较采用四格表卡方检验、Rx2卡方检验、趋势卡方检验。结果 3070名入选对象中2460名接受检查,受检率为80.1％。其中有159例视力损伤,总体患病率为6.46％,包括19例双眼盲患者,46例单眼盲患者,49例双眼低视力患者,45例单眼低视力患者。视力损伤在不同民族之间差异无统计学意义(x2 =0.75,P=0.388),而视力损伤在不同海拔居住地的居民之间差异有统计学意义(x2 =18.34,P=0.000)。年龄大（≥70岁）、文盲和从事体力劳动者视力损伤患病率高,分别为2.24％、4.19％、5.65％。42.1％(8/19)的双眼盲患者的致盲原因是白内障,角膜混浊占26.32％ (5/19)及眼底异常占21.1％ (4/19)。白内障也是双眼低视力的主要原因,占42.9％ (21/49)。结论 白内障是云南省贡山县的主要致盲原因,需要当地卫生机构采取措施来降低当地盲和低视力患病率,尤其是白内障盲。     

上海市金山区廊下镇老年人盲和低视力流行病学研究

目的研究上海市金山区廊下镇60岁及以上人群的盲和低视力患病率、致盲病因及其相关因素。方法对目标人群进行整群抽样。对调查对象完成视力、眼压、验光、裂隙灯、免散瞳数字眼底照相等检查,采用最佳矫正视力和日常生活视力及其视力损伤标准确立盲或低视力,并明确主要病因。结果本研究实际受检2150人,受检率为80.95%。按照最佳矫正视力损伤标准分类:双眼盲35例,患病率为1.63%;双眼低视力176例,患病率8.18%,白内障、黄斑变性、角膜病、眼球萎缩或缺如、糖尿病视网膜病变是前五位主要病因;女性盲患病率(2.10%)高于男性(0.86%),差异有统计学意义(P<0.05)。按照日常生活视力损伤标准分类:双眼盲43例,患病率为2.00%;双眼低视力467例,患病率为21.72%;女性低视力患病率(8.99%)高于男性(7.00%),差异有统计学意义(P<0.05);白内障、未矫正的屈光不正、黄斑变性、角膜病、眼球萎缩或缺如是前五位主要病因。结论对于上海农村地区的老年人,必须通过加强白内障复明手术的实施、屈光不正的矫正、眼底退变性疾病的筛查和干预来提高防盲治盲的效率。     

上海市北新泾街道60岁及以上人群盲和视力损伤的现况调查

目的 调查上海市北新泾街道60岁及以上老年人低视力、盲的患病率及致盲原因,并与以前调查结果相比较,评价近年该地区实施防盲治盲项目的 效果.方法 应用横断面研究的流行病学调查方法.由上海交通大学附属第一人民医院和上海市长宁区北新泾社区卫生服务中心于2007年11月至2008年4月采用整群随机抽样方法在上海市长宁区北新泾街道抽取8个社区,对其中所有的60岁及以上老年人进行调查,检查日常生活视力和针孔镜矫正视力,应用裂隙灯显微镜、直接检眼镜和眼底照相机等仪器检查受检者外眼、眼前节及眼底等情况.观察低视力及盲的患病情况,分析致盲的主要原因.正式调查前先进行预试验,通过计算kappa值进行不同检查者诊断结果的重复性检验,保证调查质量.结果 在应检录4153人中,受检人数为3851人,受检率为92.73%.按照世界卫生组织视力损伤标准:双眼盲29人,其中男性11人(占37.93%)、女性18人(占62.07%).双眼低视力104人,其中男性37人(占35.58%)、女性67人(占64.42%).双眼盲和双眼低视力的患病率分别为0.75%和2.70%.致盲的主要原因依次为:黄斑变性、白内障、角膜瘢痕或混浊及视网膜脱离.按照日常生活视力和视力损伤标准:重度双眼盲61人,其中男性20人(占32.79%)、女性41人(占67.21%).轻度双眼盲66人,其中男性27人(占40.91%)、女性39人(占59.09%).单眼盲276人,其中男性120人(占43.48%)、女性156人(占56.52%).重度双眼盲、轻度双眼盲、单眼盲的患病率分别为1.58%、1.71%和7.17%.致盲的主要原因依次为:黄斑变性、白内障、屈光不正及角膜瘢痕或混浊.结论 黄斑变性仍是致盲的首要原因,眼底病患病率逐渐上升,社区防盲项目已初显成效.     

新疆限定城乡40岁及以上人群低视力与盲的患病率及病因调查

目的 了解新疆维吾尔自治区城乡居民低视力与盲的患病率及病因构成,为地区性防盲、治盲提供资料和依据.方法 采用整群随机抽祥原则,以世界卫生组织盲目分级为标准,对新疆乌鲁木齐市及库车县农村抽取8295例进行低视力和盲的流行病学调查.结果 双眼低视力与盲的患病率分别为5.26％(城市3.65％,农村6.82％)和2.51％(城市1.56％,农村3.44％);男性双眼低视力与盲的患病率分别为5.47％和2.75％;女性双眼低视力与盲的患病率分别为5.10％和2.33％; 60岁～组及70岁～组低视力和盲的患病率增高明显.结论 城乡低视力与盲的患病率差异较大,致低视力和致肓眼病均以白内障为首位,其他致盲眼病依次为青光眼、眼底病、眼表疾病等.     

新疆库车县40岁以上维吾尔族农民盲和低视力流行病学调查

目的调查新疆库车县年龄≥40岁维吾尔族农民盲与低视力的患病率及主要致盲原因。方法采用整群随机抽样方法,按世界卫生组织盲目分类标准对随机抽取的新疆库车县2955名维吾尔族农民进行视力调查,对针孔镜下视力低于0.3者进行眼部检查并做主要致盲原因诊断。结果共录入3692人,实际受检2955人,受检率为80.0%。其中双盲患病率为2.1%,双眼低视力患病率为9.9%。60岁组双盲患病率是40岁组的13.5倍,差异有统计学意义(P<0.01);男性双盲患病率是女性的1.4倍,差异无统计学意义(P>0.05);文盲组双盲患病率是非文盲组的4.5倍,差异有统计学意义(P<0.01)。结论新疆库车县年龄≥40岁维吾尔族农民盲及低视力患病率高于国内部分地区,首要致盲眼病仍为白内障,故降低白内障患病率是该地区防盲治盲的关键。     

我国白内障的流行病学调查资料分析

目的 探讨我国白内障的患病率与各地检查条件、诊断标准及地理环境的关系。方法 采用世界卫生组织盲与低视力标准,对全国抽样调查资料进行统计学分析。结果 双眼视力〈０．３的白内障患者约５００万人,患病率为０．４６％;盲与低视力的患病率分别为０．４３％和０．５８％。盲人中白内障致盲占４１．０６％;低视力患者中４９．３８％为白内障所致;白内障致老年盲（年龄≥６０岁）及低视力占７３．１３％。以晶体混及视力〈０     

西藏自治区墨脱县人群盲和低视力现况调查

目的探讨与了解西藏自治区墨脱县人群盲与低视力的流行病学变化情况。方法以村为基础,采用随机整群抽样原则,抽取6个行政村作为调查地点。采用世界卫生组织制定的盲与低视力标准,对全县按2．05％抽样比例抽取样本进行盲与低视力的流行病学调查。结果检录821人中,受检人数为735人,受检率为89．52％。双眼盲19人,盲率为2．59％（男性1．72％,女性3．40％）;双眼低视力32人,低视力患病率为4．35％（男性4．02％,女性4．67％）。≥40岁盲及低视力患者的患病率明显增高。致盲的眼病依次为白内障（42．11％）、角膜病（21．05％）及青光眼（15．79％）。结论西藏自治区墨脱县人群中盲和致低视力的眼病以白内障居首位,因此手术治疗白内障仍是今后防盲治盲工作的首要任务。     

青海省玛沁县40岁及以上世居藏民盲与低视力的患病率调查

目的调查青海省玛沁县40岁及以上世居藏族人群中盲与低视力的患病率及致病原因。方法2004年3～5月采用整群抽样方法，对玛沁县的世居藏族人群进行视力及眼病抽样调查，共抽取26个大队(村)的2760人，根据世界卫生组织视力损伤标准(标准A)及日常生活视力和视力损伤标准(标准B)计算盲与低视力的患病率。结果在应受检的2760人中，实际受检人数为2511人，受检率为90．98％．(1)以标准A计算，双眼盲的患病率为4．1％，双眼低视力的患病率为5．3％；(2)按标准B计算双眼盲的患病率为5．4％．结论玛沁县世居藏民盲的患病率明显高于内地，高于林周县的2．3％(标准A)和3．2％(标准B)。白内障是盲与低视力的最主要原因。     

Prevalence and causes of visual impairment among the elderly in Nantong, China

PURPOSE: To investigate the prevalence and causes of visual impairment among adults aged 60 and above in Nantong city, China. METHODS: A stratified random sampling was used to select the people from eight communities in Xinchengqiao administrative sub-district of Nantong. The eye examinations were conducted at the community activity centres. The definitions of visual impairment were based on the pinhole visual acuity (low vision: visual acuity <6/18 to 3/60 in the better eye; blindness: visual acuity <3/60 in the better eye). Prevalence of visual impairment based on presenting visual acuity was also calculated. Both univariate and multiple analysis were used to do the statistics. RESULTS: A total of 3040 (90.69%) out of 3352 enumerated subjects participated in the survey. The prevalence of blindness and low vision based on the pinhole visual acuity was 1.35% (presenting, 1.32%) and 1.84% (presenting, 6.05%) respectively. The prevalence of blindness and low vision grew up exponentially with age (R2=0.9993, F=1385.84, P=0.0007; R2=0.9949, F=195.65, P=0.0051) and down with increasing education level (score test for trend of odds: chi2=30.35, P=0.0000; chi2=22.31, P=0.0000), and was higher among women than men (LR chi2=9.62, P=0.0019; LR chi(2)=5.14, P=0.0234). CONCLUSIONS: Blindness and low vision were prevalent in the urban area of China, especially in the elderly women, with cataract the most common cause in the Chinese elderly. Therefore, our study highlights an urgent necessity for launching some programs for blindness and low vision prevention, especially on the early treatment of cataract.     

Prevalence and risk factors for eye diseases, blindness, and low vision in Lhasa, Tibet

AIM:To determine the prevalence and risk factors for eye diseases, blindness, and low vision in Tibet, and to assist the development of eye disease prevention and treatment schemes.METHODS:We carried out a survey of eye diseases among a population living at high altitude. A total of 1 115 Tibetan permanent residents aged 40 years or older from the towns and villages of Qushui County, Lhasa Prefecture, Tibet Autonomous Region, participated in this study. All participants completed a detailed questionnaire, and underwent presenting and pinhole visual acuity tests, and a comprehensive ophthalmic examination.RESULTS:There were 187 blind eyes (8.43%), 231 eyes with low vision (10.41%). The leading cause of visual impairment was cataract of 55.0% (101/187) blindness and of 50.2% (116/231) low vision, followed by fundus lesions of 22.9% blindness and 23.8% low vision, while only a low prevalence of glaucoma of 9.6% blindness and 1.7% low vision was observed. The analysis of 2 219 eyes showed that the most common external eye disease was pterygium (27.2%) in Tibet.CONCLUSION:The high prevalence of blindness and low vision in the Tibetan population at high altitude is a serious public health issue. There is a need to establish and maintain an appropriate effective eye care program in Tibet.     

Prevalence of visual impairment, blindness, and cataract surgery in the Hong Kong elderly

BACKGROUND: The prevalence of vision impairment, unilateral/bilateral blindness, and cataract surgery were estimated in a population based survey among the elderly in a suburban area of Hong Kong. METHODS: 15 public, private, and home ownership scheme housing estates in the Shatin area of Hong Kong were subjected to cluster sampling to randomly select a cross section of people 60 years of age or older. Visual acuity measurements and ocular examinations were conducted at a community site within each estate. The principal cause of reduced vision was identified for eyes with presenting visual acuity worse than 6/18. RESULTS: A total of 3441 subjects from an enumerated population of 4487 (76.7%) completed an eye examination. The prevalence of presenting visual acuity less than 6/18 in at least one eye was 41.3%; and 73.1% in those 80 years of age or older. Unilateral blindness (acuity <6/60) was found in 7.9% of subjects and bilateral blindness in 1.8%. Refractive error and cataract were, respectively, the main causes of vision impairment and blindness. Visual impairment with either eye <6/18 increased with advancing age and was more prevalent in males, the less educated, and those living in public housing estates. The prevalence of cataract surgery was 9.1% and was associated with advancing age and less education. CONCLUSIONS: Blindness and visual disability were common in this socioeconomically advanced population, with most of it easily remedied. Because of a rapidly ageing population, healthcare planners in Hong Kong must prepare for an increasing burden of visual disability and blindness.     

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。     

The Prevalence of Visual Impairment in Older Adults in Mainland China: A Systematic Review and Meta-Analysis

Purpose: This paper presents estimates of the prevalence of blindness and low vision among older adults over 50 years of age in mainland China. Methods: All primary reports of population-based studies that reported the prevalence or incidence of visual impairment among older populations in mainland China were identified. Twenty-four population-based studies were included in this systematic review. Blindness is defined as visual acuity of less than 3/60, or a corresponding visual-field loss to less than 10 degrees in the better eye with the best possible correction; low vision is defined as visual acuity of less than 6/18, but equal to or better than 3/60 in the better eye with the best possible correction. The pooled prevalence estimates of blindness and low vision were calculated assuming a random-effects model. Relative odds with 95% confidence intervals (95% CIs) were calculated, stratified by methodological and socioeconomic variables. Results: The overall pooled prevalence of blindness was 1.7% (95% CI 1.4-2.1). The results of the meta-regression showed the significance of a predictor variable: geographic region. The blindness rates per 100 older adults in various regions were 1.4 (0.9-2.0) in East China, and 1.4 (1.0-2.0) in Central China and 2.5 (1.9-3.2) in Western China. The overall pooled prevalence of low vision was 4.1% (3.4-5.1) and the independent pooled prevalence rates stratified by geographic region were 3.6% (2.6-5.1) in East China, 3.6% (2.4-5.2) in Central China and 5.2% (3.6-7.4) in Western China. Conclusions: Blindness or low vision affects approximately 5.8% Chinese adults older than 50 years. The prevalence of visual impairment, and especially blindness, vary greatly by the developmental status of geographic region.     

Prevalence and causes of blindness and low vision in a rural setting in Pakistan

PURPOSE: To determine the prevalence and causes of blindness and visual impairment in people 40 years of age and older in Budni, Peshawar, Pakistan. METHODS: A population-based cross-sectional study was carried out involving 1,106 men and women 40 years of age and older in a rural area in Pakistan's North West Frontier Province (NWFP). All subjects with a presenting visual acuity < 6/18 in either eye were referred to a centralized clinic for a standardized eye examination that included refraction and dilated fundal examination. The main outcome was blindness (presenting visual acuity < 3/60 in the better eye) and low vision (presenting VA < 6/18-3/60 in the better eye). RESULTS: Of 1,106 people examined, 21 (1.9%; 95% CI: 1.1-2.7%) were blind, while another 27 (2.4%) and 62 (5.5%) subjects had severe visual impairment (< 6/60-3/60) and visual impairment (< 6/18-6/60), respectively. Women, as compared to men, had a higher prevalence of visual impairment and severe visual impairment; but they had a lower prevalence of blindness (1.6 vs. 2.2%); however, the difference was not statistically significant (0.6%; 95% CI: -0.9-2.1%). Similarly farmers had the highest prevalence of blindness. The leading cause of blindness and low vision was cataract, which accounted for 14 of 21 (66.6%) cases of blindness and 49 of 89 (55.5%) cases of low vision. The second leading cause of blindness was uncorrected aphakia. CONCLUSION: Much of the blindness was due to unoperated cataract and uncorrected aphakia. Thus, there is an urgent need to develop ways in which cataract surgical output could be increased, and glasses provided to those who need them.     

Prevalence of blindness and low vision in Malaysian population: results from the National Eye Survey 1996

BACKGROUND: A national eye survey was conducted in 1996 to determine the prevalence of blindness and low vision and their major causes among the Malaysian population of all ages. METHODS: A stratified two stage cluster sampling design was used to randomly select primary and secondary sampling units. Interviews, visual acuity tests, and eye examinations on all individuals in the sampled households were performed. Estimates were weighted by factors adjusting for selection probability, non-response, and sampling coverage. RESULTS: The overall response rate was 69% (that is, living quarters response rate was 72.8% and household response rate was 95.1%). The age adjusted prevalence of bilateral blindness and low vision was 0.29% (95% CI 0.19 to 0.39%), and 2.44% (95% CI 2.18 to 2.69%) respectively. Females had a higher age adjusted prevalence of low vision compared to males. There was no significant difference in the prevalence of bilateral low vision and blindness among the four ethnic groups, and urban and rural residents. Cataract was the leading cause of blindness (39%) followed by retinal diseases (24%). Uncorrected refractive errors (48%) and cataract (36%) were the major causes of low vision. CONCLUSION: Malaysia has blindness and visual impairment rates that are comparable with other countries in the South East Asia region. However, cataract and uncorrected refractive errors, though readily treatable, are still the leading causes of blindness, suggesting the need for an evaluation on accessibility and availability of eye care services and barriers to eye care utilisation in the country.     

广东省斗门县50岁以上农民视力分布及致盲原因调查

目的 调查广东省斗门县５０岁以上农民视力状况及致盲原因。方法 对广东省斗门县５０岁以上农民进行视力抽样调查。在９５％的可信限、０．３６％允许误差、１．２５抽样作用系数及８５％应答率的条件下,采用整群随机抽样。视力检查采用糖尿病视网膜早期治疗研究视力表测定日常生活视力,由眼科医生做外眼、前房、晶体、眼底、眼压等检查,对所有视力〈０．３的患眼进行主要致病原因的诊断。由两个组经预试验检测一致性满意后,执