数字化筛查模式研究上海城乡老年人群视力损害及影响因素分析  

Digital screening model for eye disease and its influencing factors of visual impairment in Shanghai urban and rural elderly population

作　　者：童晓维[1] 邹海东[2] 朱剑锋[1] 俞军[1] 朱梦钧[1] 何鲜桂[1] 王旌[1] 陆丽娜[1] 邱斌[1] 赵惠娟 严雪芳 王伟炳[5] 赵蓉 

机构地区：[1]上海市眼病防治中心,200040 [2]上海交通大学附属第一人民医院眼科,200040 [3]上海市宝山区疾病控制中心,200040 [4]上海市金山区廊下社区卫生服务中心,200040 [5]复旦大学公共卫生学院流行病教研室,200040 [6]上海申康医院发展中心,200040

出　　处：《中国实用眼科杂志》2013年第11期1488-1496,共9页Chinese Journal of Practical Ophthalmology

摘　　要：目的应用数字化眼病筛查模式研究上海城乡社区老年人群视力损害及其影响因素。方法采取整群抽样的方法应用一套数字化的眼病筛查技术和工作模式对上海城乡社区目标人群进行眼病筛查。通过问卷调查、进行视力、眼压、验光、裂隙灯眼前节、免散瞳数字眼底照像等检查，将数据作信息储存、传输与处理并由专科医生确立主要病因及作影响因素分析。结果调查共纳入7879人（其中宝山区5223人；金山区2656人），实际受检6695人，受检率为85．0％。根据最佳矫正视力分类：双眼盲65人，患病率为0．97％；双眼低视力32／人，患病率为4．79％。盲和低视力经年龄标准化后分别为1．01％和5．13％。根据日常生活视力分类：双眼盲82人，患病率为1．22％；双眼低视力868人，患病率为12．96％，盲和低视力经年龄标准化后分别为1．28％和13．69％。两种视力标准下致盲原因依次为白内障、糖尿病视网膜病变、其他眼底疾病、未矫正的屈光不正、黄斑变性和青光眼。未矫正的屈光不正、白内障、黄斑变性、糖尿病视网膜病变是位居前四位的低视力原因。女性在日常生活低视力患病率高于男性；农村地区、年老、文盲、糖尿病病史与视力损害相关，具有统计学意义。结论在中国经济发达城市开展防盲治盲工作仍是一个重要的公共卫生课题。应用一套数字化眼病筛查模式技术及工作模式，有针对性地做好相关人群的眼病筛查、保健教育与服务工作；关注对屈光不正的矫正，持续开展白内障复明手术，加强糖尿病视网膜病变、黄斑变性等眼底退变性疾病的筛查和干预，尤其针对女性、文盲和农村地区人群，将能更好地提高中国上海的防盲治盲效率。Objective To apply a digitalized eye disease screening mode to investigate the preva- lence and risk factors for blindness and vision impairment in older adults of urban and rural popula- tion in Shanghai, China. Methods A cross-sectional study was carried out by Shanghai Municipal Center for Eye Disease treatment ＆ Prevention. A set of digitalized eye disease screening mode was utilized to screen the main eye diseases which could result in blindness and vision impairment for the people who were ≥60-year-old in Baoshan and Jinshan district of Shanghai from June 2008 to December 2009. And randomly cluster sampling was used to identify the targeted populations. Pre- senting visual acuity （PVA） and best corrected visual acuity （BCVA） based on auto-refraction and subjective refraction was measured separately in each eye. External eye, anterior segment and ocular fi.mdus were examined by the ophthalmologist using slit lamp-microscopes direct ophthalmoscopy and non-mydriatic digital camera. All the data were stored, transmitted and treated by specialists to estab- lish the main cause and the risk factors for blindness and vision impairment were analyzed. The Chi square test was used between the groups of rate comparison. Results Of 7879 enumerated sub- jects ≥60 years of age, 85.0% （6695/7879） were examined, 5223 in Baoshan district （urban） and 2656 in Jinshan district （rural）. In this population, with BCVA, 65 persons were diagnosed as blind- ness, 321 as low vision. The prevalence of blindness and low vision were 0.97% and 4.79%, respec- tively. After age-standardized, the prevalence of blindness and low vision were 1.01% and 5.13%, re- spectively. With presenting visual acuity, 82 persons were diagnosed as blindness, 868 as low vision. The prevalence of blindness and low vision were 1.22% and 12.96%, respectively. After age-standard- ized, the prevalence of blindness and low vision were 1.28% and 13.69%, respectively. With these two VA standards, the leading causes of blindness were catarac

关 键 词：盲 视力 低 老年 流行病学 社区卫生服务 视力筛查 

分 类 号：R395.2[哲学宗教—心理学]