老年性黄斑变性对生活质量的影响

Aims:To describe the impact of age related macular degeneration(AMD)on quality of life and explore the association with vision,health,and demographic variables.Methods:Adult participants diagnosed with AMD and with impaired vision(visual acuity < 6/12)were assessed with the Impact of Vision Impairment(IVI)questionnaire.Participants rated the extent that vision restricted participation in activities affecting quality of life and completed the Short Form General Health Survey(SF-12)and a sociodemographic questionnaire.Results:The mean age of the 106 participants(66% female)was 83.6 years(range 64-98).One quarter had mild vision impairment,(VA < 6/12-6/18)and 75% had moderate or severely impaired vision.Participants reported from at least "a little" concern on 23 of the 32 IVI items including reading,emotional health,mobility,and participation in relevant activities.Those with mild and moderate vision impairment were similarly affected but significantly different from those with severe vision loss(p< 0.05).Distance vision was associated with IVI scores but not age,sex,or duration of vision loss.Conclusion:AMD affects many quality of life related activities and not just those related to reading.Referral to low vision care services should be considered for people with mild vision loss and worse.

单眼和双眼视力丧失对生活质量的影响

Aim: To investigate whether unilateral vision loss reduced any aspects of qual ity of life in comparison with normal vision and to compare its impact with that of bilateral vision loss. Methods: This study used cluster stratified random sa mple of 3271 urban participants recruited between 1992 and 1994 for the Melbourn e Visual Impairment Project. All predictors and outcomes were from the 5 year fo llow up examinations conducted in 1997-9. Results: There were 2530 participants who attended the follow up survey and had measurement of presenting visual acui ty. Both unilateral and bilateral vision loss were significantly associated with increased odds of having problems in visual functions including reading the tel ephone book, newspaper, watching television, and seeing faces. Non-correctable by refraction unilateral vision loss increased the odds of falling when away fro m home (OR=2.86, 95%CI 1.16 to 7.08), getting help with chores (OR=3.09, 95%CI 1.40 to 6.83), and becoming dependent (getting help with meals and chores) (OR =7.50, 95%CI 1.97 to 28.6). Non-correctable bilateral visual loss was associat ed with many activities of daily living except falling. Conclusions: Non-correc table unilateral vision loss was associated with issues of safety and independen t living while non-correctable bilateral vision loss was associated with nursin g home placement, emotional wellbeing, use of community services, and activities of daily living. Correctable or treatable vision loss should be detected and at tended to.

专业的眼科保健机构对未诊断青光眼的检测

Purpose To examine the clinical features of undiagnosed openangle glaucoma (OA G) in people who have attended an eye care provider within the previous 12 month s and to suggest strategies to assist in the early detection of glaucoma. Design Population based cross-sectional study. Participants Permanent residents aged 40 years and older at recruitment during 1992 through 1996. Methods A cluster-s tratified random sample of 4744 participants from the urban and rural cohorts wa s studied. Structured standardized interviews and dilated ocular examinations we re conducted in all eligible participants. Data on demographic characteristics, prior knowledge of eye disease, use of eye care services, intraocular pressures, cup-to-disc ratios, visual fields, and photographyof optic discs were obtaine d. All suspected glaucoma cases were submitted to a panel of 6 ophthalmologists to determine glaucoma diagnosis. Main outcome measures Clinical features of part icipants seen by eye health professionals within the previous 12 months who have previously undiagnosed OAG, previously diagnosed OAG, and no glaucoma. Results Thirty-five previously undiagnosed and 43 previously diagnosed participants had visited an optometrist or ophthalmologist or both in the previous 12 months. Ag e and gender were not significantly different between the undiagnosed and diagno sed glaucoma cases. After logistic regression, the type of eye professional seen (odds ratio OR, 45.17; 95%confidence interval 95%CI, 5.89-346.17; P=0.00 02) and the presence of visual field defects (OR, 0.06; 95%CI, 0.01-0.69, P=0. 020)were the only statistically sig nificant variables between the diagnosed and undiagnosed glaucoma groups. Conc lusions Raised intraocular pressure should not be relied on as the only triggeri ng factor in glaucoma investigations.