中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2013年
2期
144-150
,共7页
李运%毕宏生%王利华%王婷%杨少远%刘丽萍%周成超
李運%畢宏生%王利華%王婷%楊少遠%劉麗萍%週成超
리운%필굉생%왕리화%왕정%양소원%류려평%주성초
盲%视觉障碍%屈光不正%黄斑变性%中年人%老年人
盲%視覺障礙%屈光不正%黃斑變性%中年人%老年人
맹%시각장애%굴광불정%황반변성%중년인%노년인
Blindness%Vision disorders%Refractive errors%Macular degeneration%Middle aged%Aged
目的 调查山东省农村50岁及以上人群盲和中、重度视力损伤的主要眼病构成.方法 采用以人群为基础的随机整群抽样方法.2008年4月至7月在山东省3种不同经济发展水平的县(市)中各选择1个县(市)作为调查地,另外选择1个人均国内生产总值中等城市的郊区农村作为调查地.各调查地按照单纯随机抽样方法在编号排序的基本抽样单位(BSU)中抽取调查点(村).受检者在当地设置的检查站进行眼科检查,对任一只眼日常生活视力(PVA) ≤0.5者检查最佳矫正视力(BCVA),应用裂隙灯和直接眼底镜进行眼前节和眼底检查,怀疑青光眼者应用Schiotzs眼压计测量眼压.根据检查结果对所有PVA＜0.3的眼做出引起盲和视力损伤的主要眼病的诊断.分别以PVA和BCVA为标准,计算引起盲和中、重度视力损伤的眼病构成比.结果 以PVA为标准,按人数计算,引起盲的前3位主要眼病依次为白内障(59.8％,168/281)、眼底病(12.1％,34/281)、角膜混浊或瘢痕(4.3％,12/281)和未矫正的屈光不正(4.3％,12/281)；引起盲和中、重度视力损伤的前3位主要眼病依次为白内障(55.2％,844/1530)、未矫正的屈光不正(18.2％,278/1530)、眼底病(11.9％,182/1530).以BCVA为标准,按人数计算,引起盲的前3位主要眼病依次为白内障(64.6％,153/237)、眼底病(10.5％,25/237)、角膜混浊或瘢痕(4.7％,11/237)；引起盲和中、重度视力损伤的前3位主要眼病依次为白内障(66.4％,590/889)、眼底病(16.0％,142/889)、视神经萎缩(3.0％,27/889).按眼数计算,年龄越轻者未矫正的屈光不正和眼底病所占构成比越大,年龄越大者白内障所占构成比越大；男性和女性的眼病构成比基本相同；在不同调查地区中,济南市槐荫区的白内障构成比略低于其他地区,而其未矫正的屈光不正和眼底病构成比略高于其他地区.结论 在山东省农村50岁及以上人群中,白内障依然是引起盲和中、重度视力损伤的首位原因,未矫正的屈光不正和以年龄相关性黄斑变性为主的眼底病变是中老年人盲和视力损伤的重要原因.
目的 調查山東省農村50歲及以上人群盲和中、重度視力損傷的主要眼病構成.方法 採用以人群為基礎的隨機整群抽樣方法.2008年4月至7月在山東省3種不同經濟髮展水平的縣(市)中各選擇1箇縣(市)作為調查地,另外選擇1箇人均國內生產總值中等城市的郊區農村作為調查地.各調查地按照單純隨機抽樣方法在編號排序的基本抽樣單位(BSU)中抽取調查點(村).受檢者在噹地設置的檢查站進行眼科檢查,對任一隻眼日常生活視力(PVA) ≤0.5者檢查最佳矯正視力(BCVA),應用裂隙燈和直接眼底鏡進行眼前節和眼底檢查,懷疑青光眼者應用Schiotzs眼壓計測量眼壓.根據檢查結果對所有PVA＜0.3的眼做齣引起盲和視力損傷的主要眼病的診斷.分彆以PVA和BCVA為標準,計算引起盲和中、重度視力損傷的眼病構成比.結果 以PVA為標準,按人數計算,引起盲的前3位主要眼病依次為白內障(59.8％,168/281)、眼底病(12.1％,34/281)、角膜混濁或瘢痕(4.3％,12/281)和未矯正的屈光不正(4.3％,12/281)；引起盲和中、重度視力損傷的前3位主要眼病依次為白內障(55.2％,844/1530)、未矯正的屈光不正(18.2％,278/1530)、眼底病(11.9％,182/1530).以BCVA為標準,按人數計算,引起盲的前3位主要眼病依次為白內障(64.6％,153/237)、眼底病(10.5％,25/237)、角膜混濁或瘢痕(4.7％,11/237)；引起盲和中、重度視力損傷的前3位主要眼病依次為白內障(66.4％,590/889)、眼底病(16.0％,142/889)、視神經萎縮(3.0％,27/889).按眼數計算,年齡越輕者未矯正的屈光不正和眼底病所佔構成比越大,年齡越大者白內障所佔構成比越大；男性和女性的眼病構成比基本相同；在不同調查地區中,濟南市槐蔭區的白內障構成比略低于其他地區,而其未矯正的屈光不正和眼底病構成比略高于其他地區.結論 在山東省農村50歲及以上人群中,白內障依然是引起盲和中、重度視力損傷的首位原因,未矯正的屈光不正和以年齡相關性黃斑變性為主的眼底病變是中老年人盲和視力損傷的重要原因.
목적 조사산동성농촌50세급이상인군맹화중、중도시력손상적주요안병구성.방법 채용이인군위기출적수궤정군추양방법.2008년4월지7월재산동성3충불동경제발전수평적현(시)중각선택1개현(시)작위조사지,령외선택1개인균국내생산총치중등성시적교구농촌작위조사지.각조사지안조단순수궤추양방법재편호배서적기본추양단위(BSU)중추취조사점(촌).수검자재당지설치적검사참진행안과검사,대임일지안일상생활시력(PVA) ≤0.5자검사최가교정시력(BCVA),응용렬극등화직접안저경진행안전절화안저검사,부의청광안자응용Schiotzs안압계측량안압.근거검사결과대소유PVA＜0.3적안주출인기맹화시력손상적주요안병적진단.분별이PVA화BCVA위표준,계산인기맹화중、중도시력손상적안병구성비.결과 이PVA위표준,안인수계산,인기맹적전3위주요안병의차위백내장(59.8％,168/281)、안저병(12.1％,34/281)、각막혼탁혹반흔(4.3％,12/281)화미교정적굴광불정(4.3％,12/281)；인기맹화중、중도시력손상적전3위주요안병의차위백내장(55.2％,844/1530)、미교정적굴광불정(18.2％,278/1530)、안저병(11.9％,182/1530).이BCVA위표준,안인수계산,인기맹적전3위주요안병의차위백내장(64.6％,153/237)、안저병(10.5％,25/237)、각막혼탁혹반흔(4.7％,11/237)；인기맹화중、중도시력손상적전3위주요안병의차위백내장(66.4％,590/889)、안저병(16.0％,142/889)、시신경위축(3.0％,27/889).안안수계산,년령월경자미교정적굴광불정화안저병소점구성비월대,년령월대자백내장소점구성비월대；남성화녀성적안병구성비기본상동；재불동조사지구중,제남시괴음구적백내장구성비략저우기타지구,이기미교정적굴광불정화안저병구성비략고우기타지구.결론 재산동성농촌50세급이상인군중,백내장의연시인기맹화중、중도시력손상적수위원인,미교정적굴광불정화이년령상관성황반변성위주적안저병변시중노년인맹화시력손상적중요원인.
Objective To investigate the etiological spectrum of moderate to severe visual impairment and blindness in population aged 50 years or more in rural Shandong province,China.Methods A population based,random cluster sampling was used to screening the adults aged 50 years or more living in rural Shandong Province from April to July 2008.Three counties and one suburb representing the different levels of socioeconomic development within Shandong area were selected as the investigated areas.Geographically defined cluster sampling was used in randomly selecting a cross-section of residents aged ≥50 years from each county.Best corrected visual acuity and intra-ocular pressure were evaluated in those with presenting visual acuity ≤ 0.5 and suspected glaucoma respectively.The major causes of visual impairment and blindness were diagnosed in those with presenting visual acuity ≤ 0.3.According to the results of presenting visual acuity and best corrected visual acuity,the etiology constituent ratios of the moderate to severe visual impairment and blindness were analyzed respectively.Results According to the number of people,the first three principal causes for blindness based on the presenting visual acuity were cataract(59.8％,168/281),fundus disease (12.1％,34/281) and corneal opacity (4.3％,12/281) or ametropia(4.3％,12/281).The first three principal causes for moderate to severe visual impairment and blindness were cataract (55.2％,844/1530),uncorected refractive error (18.2％,278/1530) and fundus disease(11.9％,182/1530).Based on the best corrected visual acuity,the first three principal causes for blindness were cataract (64.6％,153/237),fundus disease (10.5 ％,25/237) and corneal opacity (4.7 ％,11/237),respectively.The first three principal causes for moderate to severe visual impairment and blindness were cataract (66.4％,590/889),fundus disease (16.0％,142/889) and optic nerve atrophy (3.0％,27/889).According to number of the eyes,proportion of cataract in cases with moderate to severe visual impairment and blindness had positive relation with age,the proportion of ametropia and fundus disease had negative relation with age.The etiology constituent ratio had no difference between male and female.The proportion of cataract in cases with moderate to severe visual impairment and blindness in Huaiyin District of Jinan was slightly lower than those in other areas,however,the proportion ratio of ametropia and fundus disease was slightly higher than those in other areas.Conclusion Cataract,uncorected refractive error,and fundus diseases are ranked in the top three causes of moderate to severe visual impairment and blindness in adults aged 50 years or more in rural Shandong Province.
