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。

A prevalence investigation of blindness and vision impairment in 2009 in older adults of Dachang Blocks of Baoshan District, Shanghai, China

Objective To investigate the prevalence of blindness and low vision and the leading causes of blindness in residents aged ≥ 60 years in Dachang Blocks of Baoshan District, Shanghai,China. Methods A cross-sectional study was carried out by Shanghai Eye Disease Prevention & Treatment Center and the Center for Disease Control and Prevention in Baoshan District of Shanghai from October to December in 2009. Randomly cluster sampling was used to identify the adults aged ≥60 years who had lived in Dachang Blocks of Baoshan District, Shanghai for more than 10 years. Presenting visual acuity (PVA)and best-corrected visual acuity (BCVA) based on autorefraction and subjective refraction were measured separately in each eye. External eye, anterior segment and ocular fundus were examined by the ophthalmologist using slit lamp-microscopes direct ophthalmoscopy and non-mydriatic digital camera. And the leading causes of visual impairment were assured. The Chi square test was used between the groups of rate comparison. Results Of 5199 enumerated subjects ≥60 years of age, 87.42％ (4545/5199) were examined. All subjects were urban population who were originally changed from the rural population in nearly 10 years. In this population,with best-corrected visual acuity, 30 persons were diagnosed as blindness, 145persons were diagnosed as low vision. The prevalence of blindness and low vision were 0. 67％, 3. 19％,respectively. Low vision was associated with female gender. It was statistically significant difference (x2 =4. 88 ,P ＜0. 05 ). The leading causes of blindness were cataract, macular degeneration, ocular absence or atrophy, glaucoma, and diabetic retinopathy or corneal diseases. With presenting visual acuity,39 persons were diagnosed as blindness,401 persons were diagnosed as low vision. The prevalence of blindness and low vision were 0. 86％, 8. 82％ , respectively. Blindness and low vision were associated with older age. The prevalence of blindness and low vision increased rapidly in aged 75 years or older people. The leading causes of blindness were cataract, uncorrected refractive error, macular degeneration, ocular absence or atrophy,glaucoma. Low vision was associated with female gender. It had statistically significant difference (x2 =13.345,P ＜0.01). ConclusionsIn rapidly urbanized and aging community of Shanghai, cataract,uncorrected refractive error, macular degeneration were the leading causes of blindness with presenting visual acuity. The prevalence of low vision in females was higher than that of males which had statistically significant difference. These kinds of residents needed more targeted eye health education and services.