北京两个社区低视力人群流行病学调查

Community Survey of Low Vision in Two Communities of Beijing in China

目的:了解北京社区中符合曼谷-马德里标准的低视力人群的视功能状况、致病原因、视觉相关生存质量及康复需求。方法:横断面调查研究。于2013年9月至2015年4月选取北京市西城区德胜街道和朝阳区酒仙桥街道2个社区登记在册的视力残疾者388人作为研究对象。采用入户方式进行问卷调查,进行视功能和眼科检查及视觉相关生存质量评估。依据诊断标准,判定研究对象是否属于低视力患者,并对其视功能状况、致病原因、生存质量进行进一步分析。数据采用χ2检验、t检验、秩和检验进行分析,并采用Logistic多因素回归分析影响生存质量评分高低的相关因素。结果:入户访视单纯视力残疾者共151人,占登记人数的39.0%。访视到的患者中,确诊符合曼谷-马德里低视力标准的视力残疾者110人,占受访者的74.3%,其中66人(60.0%)双眼矫正视力均小于0.05或视野半径小于10°。110例低视力患者视功能损伤的主要病因为视网膜或葡萄膜病变[55例(50.0%)],青光眼[15例(13.6%)],遗传或先天发育异常[15例(13.6%)],他们的主要康复需求是独自外出和读书看报,2项需求相加占到81.8%。低视力患者应用低视力者生活质量量表的得分为47.3±26.7,其得分高低与性别、年龄、身体健康状况或视功能损伤程度无相关性。资料完整的148例受访者的Logistic多因素分析显示年龄和残存视野大小(P<0.001)是影响生活质量得分的主要因素。结论:低视力患者在北京2个社区视力残疾患者中占了大多数,其视功能损伤严重,致病原因主要为不可逆性眼病,其生存质量显著下降。在生活中最主要的康复需求是独自外出和读书看报2项。

Objective: To investigate the visual function, major causes of visual impairment, vision-related quality of life and rehabilitation needs of low vision patients in two communities of Beijing. Methods: Visually disabled people registered in the Desheng community, Xicheng district and the Jiuxianqiao community, Chaoyang district in Beijing were included in this cross sectional epidemiological study from September 2013 to April 2015. Interviews, visual acuity tests, slit lamp examination, and funduscopy were performed. Vision-related quality of life, a questionnaire about living conditions and rehabilitation needs were recorded during home visits. Data were analyzed with a χ2 test, t test or rank-sum test. Logistic regression were used to identify the factors relevant to vision-related quality of life. Results: There were 388 visually disabled people registered in these two communities. One hundred fifty-one patients (39.0%) were visited and evaluated at home. Of the 151 participants, 110(74.3%) were identified as low vision according to the Bangkok-Madrid standard. Among them, 66 patients (60.0%) had a best corrected visual acuity for either eye that was lower than 0.05 or the residual visual field radius was less than 10°. The main causes for visual impairment were retinal or uveal diseases 55(50.0%), glaucoma 15(13.6%), or congenital or inherited diseases 15(13.6%). Their main rehabilitation needs were going outside by themselves and reading, which amounted to 81.8%. The average score for quality of life was 47.3±26.7 with a personal interview using the low vision quality-of-life questionnaire (LVQOL). No significant relationship was found between score and sex, age, or vision function among low vision patients. But for all participants, age and residual visual field were the main factors related to quality of life (P<0.001). Conclusions: Low vision people accounted for the major portion of visually disabled people in two Beijing communities. Their visual function is poor, and quality of life drops dramatically. The main causes of their visual impairments are irreversible eye diseases. They need the most help are going outside and reading.