上海市大场镇60岁及以上人群屈光不正欠矫率的流行病学调查

Prevalence of undercorrected refractive errors in elderly population aged 60 years and older in Dachang County, Shanghai

背景目前，屈光不正的欠矫已成为全球视力损伤的主要原因，因此降低屈光不正的欠矫率是中国防盲治盲的主要任务之一。目的分析上海市宝山区大场镇60岁及以上人群中屈光不正的欠矫率。方法采取横断面调查研究设计，采用整群随机抽样的方法，于2009年10-12月对上海市宝山区大场镇10个社区内60岁及以上的常住人群进行视力状况及相关眼病的流行病学调查。受检人群均为10年内随着城市化进程由农村人口转变而来的城市人口。调查指标主要包括视力、眼压、验光、裂隙灯显微镜、免扩瞳数字眼底照相等。欠矫正屈光不正定义参照已有文献的标准，包括2套，定义1为屈光矫正后视力提高≥1行；定义2为屈光矫正后视力提高≥2行，同时分析与屈光不正欠矫有关的人群特征。结果本调查共纳入5199人，实际受检4545人，应答率为87．42％。按照定义1和定义2的标准，该人群中屈光不正欠矫率分别为45．43％或24．84％。女性与年老者屈光不正欠矫的风险较高。根据定义2的标准，单纯近视、单纯远视、单纯散光、近视合并散光和远视合并散光的欠矫率分别为53．54％、53．06％、38．37％、38．99％和36．75％。401例视力损伤（0．05≤较好眼日常生活视力〈0．3）者中，屈光不正欠矫率为78．80％（定义1）或67．58％（定义2）。结论在上海城市化进程较快的老龄化社区中，屈光不正的欠矫是影响老年人视力的重要因素。

Background The undercorrection of refractive error is becoming a major cause of reversible visual impairment worldwide. To investigate and reduce the rate of undercorrected refractive error is one of the primary missions to fight blindness in China. Objective This study was to analyze the prevalence of undercorrected refractive error in residents aged 60 years and older in Dachang County of Baoshan District, Shanghai. Methods This study followed Declaration of Helsinki,and informed consent was obtained from each subject before any medical examination. A cross-sectional study was performed and a random cluster sampling technique was used. All fieldwork was conducted from October to December 2009. All participants were urban population who were changed from the rural population in 10 years ago. The participants received detailed ophthalmic and medical examination,including a standardized refraction and visual acuity examinations, tonometry, slit lamp biomicroscopy, and fundus photography. The undercorrected refractive error was defined based on the criteria of the presenting study,including criterion 1 （ the vision improved by ≥ 1 line after refraction） ,and criterion 2 （the vision improved by I〉2 lines after refraction）. The demographic characteristics of the population with undercorrected refractive error were also analyzed. Results Among the 5 199 people in the project,4 545 received survey,with the response rate 87.42% . The overall prevalence of undereorrected refractive error was 45.43% or 24.84% based on criterion 1 or criterion 2, respectively. Women and older age were significant risk factors of undercorrected refractive error. The prevalence of undercorrected refractive error was 53.54% for myopia only,53.06% for hyperopia only,38.37% for astigmatism only,38.99% for myopia with astigmatism, and 36.75% for hyperopia with astigmatism. In 401 participants with visual impairment, the prevalence of undercorrected refractive error was 78.80% or 67.58% based on criterion 1 or criterion 2 ,respectively. Conclusions In rapid urbanization and aging community of Shanghai,undercorrected refractive error is an important cause that affecting the vision of older persons.