上海市金山区廊下镇老年人盲和低视力流行病学研究

A prevalence investigation of blindness and vision impairment in aged people in Langxia Town,Jinshan District,Shanghai,China

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。

Objective To investigate the prevalence of blindness and low vision and the leading causes of blindness in residents aged ≥60 years in Langxia Town,Jinshan District,Shanghai,China.Methods A cross-sectional study was carried out.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 determined.Results The response rate was 80.95%（2 150/2 656）.With BCVA,35 cases were diagnosed as blindness,176 cases were diagnosed as low vision.The prevalence of blindness and low vision were 1.63% and 8.18%.The leading causes of blindness were cataract,macular degeneration,ocular absence or atrophy,corneal diseases and diabetic retinopathy.Blindness prevalences were 2.10% in female and 0.86% in male（P0.05）.With presenting visual acuity,43 cases were diagnosed as blindness,467 cases were diagnosed as low vision.The prevalence of blindness and low vision were 2.00% and 21.72% respectively.The leading causes of blindness were cataract,uncorrected refractive error,macular degeneration,ocular absence or atrophy and corneal diseases.Low vision prevalences were 8.91% in female and 7.00% in male（P0.05）.Cataract,uncorrected refractive error,macular degeneration,corneal diseases,ocular absence or atropy were leading causes.Conclusions Blindness and low vision are important public health problems in rural areas of Shanghai.It can enhance the efficiency of blindness prevention and treatment by continuing to perform cataract surgeries,correcting the refractive error,screening and preventing the retinal degenerative diseases.