广州市盲校学生致盲及低视力原因调查

目的:调查盲校学生盲和低视力的原因,以确定潜在的可预防性和可治疗性因素。方法:采用世界卫生组织防盲计划儿童盲及低视力眼检查记录表,对2004年广州市盲校学生盲及低视力情况进行调查,并分析其原因。结果:177名4～33岁(平均13.5岁)学生,男:女为2.1︰1,视力为无光感者55人(31.1%),<0.05者96人(54.2%),<0.1者15人(8.5%),不合作或精神障碍者11人(6.2%)。致盲及低视力的原因依次为早产儿视网膜病变67人(37.9%),视神经萎缩,眼球萎缩及原因不明,视网膜变性分别为15人(8.5%),先天性青光眼9人(5.1%),先天性黄斑异常8人(4.5%),视网膜脱离和先天性白内障分别7人(3.9%),先天性小眼球和角膜病变分别为5人(2.8%),其他24人(13.6%)。其中以早产儿视网膜病变为最重要的致盲因素(占37.9%),分别占≤10岁组的57.7%,≤15岁组的33.9%,≤20岁组的28.6%,大于20岁组的14.3%;以及占无光感组52.7%,视力<0.05组31.3%,不合作或精神障碍组63.6%。可避免性盲(包括早产儿视网膜病变,屈光不正,白内障术后弱视)73人(41.2%),仍有视力提高可能的治疗价值者14人(7.9%)。结论:早产儿视网膜病变是近年来盲童主要致盲原因;加强对早产儿围产期的监测,早发现,早治疗,有助减少致盲的可能。

An Investigation on the Causes of Blindness and Low Vision of Students in Blind School in Guangzhou

PURPOSE: To determine the underlying causes of blindness and low vision, potentially preventable and treatable causes of the students in blind school in Guangzhou. METHODS: In 2004, students in Guangzhou Blind School were examined, and WHO Prevention of Blindness Program (WHO/ PBL) Eye Examination Record for children with blindness and low vision was used. RESULTS: Of the 177 students (4-33 years, 13.5 average), all were blind or visually impaired severely (visual acuity, V/A, less than 0.1 in the better eye). No light perception, V/A < 0.05 and visually impaired (V/A < 0.1) were 31.1%, 54.2% and 8.5% respectively, others refused to be examined or were mental retard. The causes were retinopathy of premature infant (ROP) (37.9%), optic nerve hypoplasia, Phthisis or cause unknown, retinal degeneration (8.5%), congenital glaucoma (5.1%), congenital macular abnormal (4.5%), retinal detachment (3.9%), congenital cataract (3.9%), microphthalmos (2.8%), corneal disease (2.8%) and other causes. ROP was the most important cause (37.9%), accounting for 57.7% cases in < or =10 years group, 33.9% in < or = 15-year group, 28.6% in < or = 20-year group, 14.3% in older than 20-year group; and 52.7% in no light perception group, 31.3% in V/A < 0.05 group 63.6% in incorporated and mental retard group. 73 cases (41.2%) were with avoidable blindness and visual impairment including ROP, refractive error and amblyopia after cataract surgery, V/A in 14 cases (7.9%) could be improved after treatment. CONCLUSIONS: Along with the improvement of health and socio-economic status, ROP become the major causes in children in recent years. Things remained to be done to eliminate childhood blindness.