东帝汶低视力患病率及原因调查

Morbidity and causes of low vision in East Timor

目的探讨东帝汶≥40岁人群中视功能情况以及分析导致眼疾的病因和诱因。方法2004年11月～2005年7月对东帝汶两个行政区的目标人群进行了视功能检查和流行病学调查。采取分层配额抽样后,由视光学医师对抽样人群进行视功能、眼前后节形态检查以及眼病意识问卷调查;初筛出眼盲和低视力患者后,由东帝汶首都医院眼科医师进一步对患者进行确诊和治疗。结果共纳入1500人调查,实际调查1414人,受检率为94.3%。东帝汶盲眼率比例为(4.7±1.1)%,低视力眼比例为(18.5±2.0)%。受检男性盲眼率为2.49%,低视力率为15.93%,受检女性盲眼率为6.5%,低视力率为21.1%。女性盲眼患病率明显高于男性(P<0.05),而低视力患病率则差异无显著性(P>0.05)。在东帝汶盲人中,最终的致盲病因前三位的依次是白内障62.12%,角膜病24.24%,先天性疾病13.64%;而在低视力人群中,致病原因的前三位因素是屈光不正54.41%,白内障39.08%,角膜病6.51%。东帝汶社会族氏及家庭、患者家庭经济收入、眼病相关卫生知识、个人文化程度、职业及心理等因素对当地患者延迟眼科治疗有影响。结论东帝汶为达到WHO的“视觉2020”行动纲领的治盲重点在于白内障和屈光不正。特别要加强老年患者、女性患者、边远地区患者的治疗和普及基本的眼疾卫生知识。

[Objection] To investigate the prevalence of the visual function and etiology in East Timor residents older than 40 years. [Methods] 1414 individuals were surveyed with visual function and interviewed with a questionnaire concerning medical, economic, social , family, and psychological factors by Australian optometrists from Nov. 2004 to Jul. 2005 at two districts in East Timor. The patients with blindness and visual impairment were treated at HNGV hospital by Chinese ophthalmologist. [Results] The blindness prevalence is （4.7±1.1）% and the low vision prevalence is （18.5±2.0）% in East Timor. In these 40 years old or above population, the prevalence of blindness was 2.49% in male group and 6.5% in female group. There is a significant difference between the two groups. The prevalence of low vision was 15.93% in male group and 21.1% in female group. There is no significant difference. The major reason of blindness is cataract（62.12%）, keratopathy（24.24%） and congenital defects（13.64%）. The major reason of low vision is refractive error（54.41%）, cataract（39.08%） and keratopathy（6.51%）. The factors of social and race culture, family economy, ophthalmic knowledge, individual literate, career, and psychology play some important roles in the delay of visual impairment treatment. [Conclusions] Cataract and refractive error remain the major causes of blindness and low vision in ET. It is believed that the goals of the Vision 2020-the right to sight initiative can be achieved if there are strong attentions in groups of the elder, female and rural regions.