CAJ | 학술논문

目的调查上海市盲童学校(以下简称盲校)儿童视力状况及致盲原因,为防治儿童盲提供依据.方法横断面研究.根据世界卫生组织防盲计划(WHO/PBL)儿童盲与低视力检查记录表和工作手册自制调查表,于2010年4月对上海市盲校163名学生进行调查,采用标准对数视力表检查裸眼远视力和最佳矫正远视力,部分儿童辅以电脑验光和主觉验光；采用裂隙灯和眼底镜进行眼前段和眼底检查.数据录入后,按WHO/PBL标准定义进行视力损害分级,并分析盲和严重视力损害的原因.对数据进行分类计数,求百分比.结果 163名盲校儿童中,盲89人(54.6％),严重视力损害者32人(19.6％),一般视力损害者35人(21.5％),视力无损害者7人(4.3％).盲及严重视力损害儿童致盲主要原因为先天性和遗传性因素(37.2％),致盲首要解剖部位为视网膜(41.3％),首要病因是早产儿视网膜病变(ROP)(18.2％).可避免性盲64例(52.9％),其中可预防盲29例(24.0％),可治疗性盲35例(28.9％).导致一般视力损害的主要病因是先天性白内障(15例,42.9％).结论上海市盲校儿童盲和严重视力损害儿童致盲原因构成已与其他发达国家和地区相似,ROP是主要致盲原因,建议加快建立健全ROP筛查与诊治网络,并大力推进低视力康复工作.
목적 조사상해시맹동학교(이하간칭맹교)인동시력상황급치맹원인,위방치인동맹제 공의거.방법 횡단면연구.근거세계위생조직방맹계화(WHO/PBL)인동맹여저시력검사기록표화공작수책자제조사표,우2010년4월대상해시맹교163명학생진행조사,채용표준대수시력표검사라안원시력화최가교정원시력,부분인동보이전뇌험광화주각험광；채용렬극등화안저경진행안전단화안저검사.수거록입후,안WHO/PBL표준정의진행시력손해분급,병분석맹화엄중시력손해적원인.대수거진행분류계수,구백분비.결과 163명맹교인동중,맹89인(54.6％),엄중시력손해자32인(19.6％),일반시력손해자35인(21.5％),시력무손해자7인(4.3％).맹급엄중시력손해인동치맹주요원인위선천성화유전성인소(37.2％),치맹수요해부부위위시망막(41.3％),수요병인시조산인시망막병변(ROP)(18.2％).가피면성맹64례(52.9％),기중가예방맹29례(24.0％),가치료성맹35례(28.9％).도치일반시력손해적주요병인시선천성백내장(15례,42.9％).결론 상해시맹교인동맹화엄중시력손해인동치맹원인구성이여기타발체국가화지구상사,ROP시주요치맹원인,건의가쾌건립건전ROP사사여진치망락,병대력추진저시력강복공작.
Objective To determine the causes of severe visual impairment and blindness (SVI/BL) among students in a school for the blind in Shanghai with a view to promote the control of childhood blindness and low vision.Methods A cross-sectional investigation of 163 students was conducted in April 2010.The data were included in the self-designed survey form from World Health Organization/Prevention of Blindness (WHO/PBL) eye examination record system,which includes classifications and etiological categories for visual impairment and blindness,and classifications of the affected anatomic sites of the eye involved in visual impairment and blindness.Distance uncorrected and corrected visual acuity were measured.Autorefraction and subjective refraction were performed if needed.The anterior segment was examined using a handheld slit lamp.The posterior segment was examined by ophthalmoscopy.Number were counted and measured with percentage.Results Of the 163 students,19.6％ were severe visual impairment,54.6％ were blindness,21.5％ had moderate visual impairment and 4.3％ were mildly impaired.The leading etiological causes of SVI/BL were congenital and hereditary factors (37.2％).The anatomical site for SVI/BL was the retina in 41.3％ of the students.The main disease causing SVI/BL was retinopathy of prematurity (ROP) (18.2％).Blinding disease was considered as "avoidable" in 64 studnets (52.9％),of which 29 cases (24.0％) were preventable,and 35 cases (28.9％) were treatable.The main treatable disease in moderate visual impairment was congenital cataract (15 cases,42.9％).Conclusion The pattern of childhood blindness in Shanghai is similar to that seen in other developed countries.It is recommended to move more quickly to establish a reliable ROP screening and treatment network,and vigorously promote low vision rehabilitation.