CAJ | 학술논문

目的了解上海市北新泾街道60岁及以上老年人高度近视眼患病率、高度近视眼视网膜脉络膜病变的患病率及其相关影响因素.方法采用整群随机分层抽样法,对上海市北新泾街道的4153位60岁及以上老年人进行人群普查,受检者3851例,受检率为92.73%.现场调查内容为问卷调查及全面的眼科检查,包括视力、屈光度、裂隙灯显微镜、直接检眼镜检查和眼底照相等.屈光不正用等效球镜度数(SE)表示.若受检者SE>-6.00 D,眼底表现有后巩膜葡萄肿、漆纹样裂纹、Fuchs斑、近视弧形斑等近视性视网膜脉络膜萎缩病灶则诊断为高度近视眼视网膜脉络膜病变.小孔视力按照WHO视力损伤分级:最佳矫正视力≥0.05但<0.3为低视力,<0.05为盲.结果受检者中,高度近视眼207例,占5.37%.其中,183例表现高度近视性视网膜脉络膜病变,占88.40%.随年龄的增长,高度近视眼视网膜脉络膜病变的患病率显著下降(X2=19.21,P<0.01),但男女之间患病率差异无统计学意义(X2=1.83,P>0.05).Logistic回归分析显示,不同年龄、不同文化程度、有无高度近视眼家族史人群的患病率差异均有统计学意义(X2=19.21,32.08,960.68;P<0.01).受检者中,双眼盲29例,单眼盲96例,双眼低视力104例,单眼低视力562例.183例高度近视眼视网膜脉络膜病变患者中,111例存在明显的视力损伤,占60.65%,其中,双眼盲、单眼盲、双眼低视力、单眼低视力的患者分别为10例,11例、31例和59例,分别占总受检人群中视力损伤者的34.48%、11.46%、29.81%和10.50%.结论上海市北新泾地区老年人高度近视眼的患病率较高.年龄、文化程度,高度近视眼家族史是影响高度近视眼视网膜脉络膜病变的重要因素.
목적 료해상해시북신경가도60세급이상노년인고도근시안환병솔、고도근시안시망막맥락막병변적환병솔급기상관영향인소.방법 채용정군수궤분층추양법,대상해시북신경가도적4153위60세급이상노년인진행인군보사,수검자3851례,수검솔위92.73%.현장조사내용위문권조사급전면적안과검사,포괄시력、굴광도、렬극등현미경、직접검안경검사화안저조상등.굴광불정용등효구경도수(SE)표시.약수검자SE>-6.00 D,안저표현유후공막포도종、칠문양렬문、Fuchs반、근시호형반등근시성시망막맥락막위축병조칙진단위고도근시안시망막맥락막병변.소공시력안조WHO시력손상분급:최가교정시력≥0.05단<0.3위저시력,<0.05위맹.결과 수검자중,고도근시안207례,점5.37%.기중,183례표현고도근시성시망막맥락막병변,점88.40%.수년령적증장,고도근시안시망막맥락막병변적환병솔현저하강(X2=19.21,P<0.01),단남녀지간환병솔차이무통계학의의(X2=1.83,P>0.05).Logistic회귀분석현시,불동년령、불동문화정도、유무고도근시안가족사인군적환병솔차이균유통계학의의(X2=19.21,32.08,960.68;P<0.01).수검자중,쌍안맹29례,단안맹96례,쌍안저시력104례,단안저시력562례.183례고도근시안시망막맥락막병변환자중,111례존재명현적시력손상,점60.65%,기중,쌍안맹、단안맹、쌍안저시력、단안저시력적환자분별위10례,11례、31례화59례,분별점총수검인군중시력손상자적34.48%、11.46%、29.81%화10.50%.결론상해시북신경지구노년인고도근시안적환병솔교고.년령、문화정도,고도근시안가족사시영향고도근시안시망막맥락막병변적중요인소.
Objective To investigate the prevalence of high myopia,the prevalence and risk factors of high myopia associated with chorioretinopathy in residents aged 60 years or over in Beixinjing community, Shanghai, China. Methods A cluster stratified random sampling method was used to screen 4153 people aged 60 and over in Beixinjing community. There were 3851participants in total with a 92.73% response rate. Participants were invited to complete a questionnaire and received a comprehensive eye examination including visual acuity, refraction, slit-lamp microscopic examination, direct ophthalmoscopy and fundus photography and so on. Spherical equivalent (SE) was used to determine the degree of refractive errors. The diagnosis of high myopic chorioretinopathy was made if SE>-6.00 D and myopic ehorioretinal atrophy lesions were presented such as posterior seleral staphyloma, lacquer cracks, Fuchs spot and myopic arc spots. The degree of visual acuity impairment was determined according to the World Health Organization (WHO) classification as low vision (the best corrected visual acuity≥0. 05, but <0.3) or blindness (the best corrected visual acuity < 0. 05). Results There were 207/3851 (5.37 %) high myopia patients, in which 183/207 (88.40%) patients were associated with myopic chorioretinopathy. The prevalence of myopic chorioretinopathy decreased while age increased (X2= 19.21, P<0.01), but statistically there was no gender difference (X2= 1.83, P>0.05). Logistic regression analysis showed that there were significant differences in the prevalence of high myopia between people with different age, educational levels and family history (X2= 19.21,32. 08,960. 68; P<0.01). There were 29 cases of bilateral blindness, 96 cases of unilateral blindness, 104 cases of bilateral low vision and 562 cases of unilateral low vision in those participants. In 183 cases of high myopic chorioretinopathy patients, 111(60.65 %)cases had an obvious visual impairment, including 34.48% (10 cases) of bilateral blindness, 11.46% (11 cases) of unilateral blindness, 29.81% (31 cases)of bilateral low vision and 10.50% (59 cases) of unilateral low vision. Conclusions The prevalence of high myopia of residents aged ≥ 60 years in Beixinjing community, Shanghai, China is relatively high. Age, education level and family history are the most important factors affecting the occurrence of chorioretinopathy in high myopia patients.