30岁及以上农村人群视力损伤的流行病学调查:邯郸眼病研究  

An epidemiological survey of visual impairment in rural populations aged 30 and above:the Handan Eye Study

作　　者：张烨 金杉杉 王瑾 王宁利 Zhang Ye;Jin Shanshan;Wang Jin;Wang Ningli(Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Institute of Ophthalmology,Beijing Key Laboratory of Ophthalmology&Visual Sciences,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心,北京市眼科研究所,北京市眼科学与视觉科学重点实验室,北京100730

出　　处：《中华眼科杂志》2024年第10期813-821,共9页Chinese Journal of Ophthalmology

摘　　要：目的探讨防盲治盲的试点地区河北省邯郸市永年县6年间30岁及以上农村人群中盲和视力损伤患病率及病因的演变情况, 以及常见致盲性眼病的发病情况。方法以人群为基础的前瞻性队列研究。2006至2007年, 在该地区采用分层整群抽样的方法, 对30岁及以上的6 830名汉族人进行了常见致盲性眼病的基线调查, 应答率为90.4%(6 830/7 557)。2012至2013年, 采用与基线相同的研究方法对5 394名受试者进行了6年随访调查, 应答率为85.3%(5 394/6 323)。根据世界卫生组织的标准, 视力损伤的定义为视力<20/60但≥20/400, 盲的定义为视力<20/400。通过年龄和性别进行标准化估计盲与视力损伤的患病率及其95%置信区间(CI), 并计算原发性青光眼、年龄相关性黄斑病变及近视性黄斑病变的6年发病率及其95%CI。结果该地区30岁及以上人群中在基线调查时, 依据日常生活视力和最佳矫正视力, 标化后双眼盲的患病率分别为0.6%(41/6 799)和0.5%(31/6 799), 均高于随访调查时的0.5%(27/5 293)和0.3%(17/5 276);但标化后双眼视力损伤的患病率分别为4.7%(361/6 799)和1.0%(85/6 799), 均低于随访调查时的6.5%(355/5 293)和1.4%(74/5 276)。致盲原因在基线和随访调查时没有发生明显的变化, 依据最佳矫正视力判定, 白内障均为基线(13/31, 占41.9%)和随访调查时(7/17)双眼盲共同的首位病因, 而导致双眼盲的其他主要盲因在基线和随访调查时均为近视眼视网膜病变[分别占, 16.1%(5/31)和2/17, 11.8%]、青光眼[分别占9.7%(3/31)和2/17]和角膜混浊(分别占3/31, 9.7%和2/17)。经过6年的随访, 35岁及以上人群中, 原发性青光眼的发病率为1.6%(95%CI:1.2%~1.9%);早期和晚期年龄相关性黄斑病变的发病率分别为4.2%(95%CI:3.8%~4.7%)和0.2%(95%CI:0.2%~0.3%);近视眼黄斑病变的发病率为0.1%(95%CI:0.0%~0.2%)。结论河北省邯郸市永年县农村人群双眼盲的患病率经过6年的防盲治盲�ObjectiveTo investigate the changes in prevalence and causes of blindness and visual impairment over six years among rural populations aged 30 and above in Yongnian County,Handan City,Hebei Province,a pilot area in northern China for blindness prevention and treatment,and to study the incidence of common blinding eye diseases.MethodsThis population-based prospective cohort study included a baseline survey conducted from 2006 to 2007 using stratified cluster sampling,targeting 6830 Han Chinese individuals aged 30 and above,with a response rate of 90.4%,and a follow-up survey conducted from 2012 to 2013 with 5394 participants,maintaining a response rate of 85.3%.Visual impairment was defined according to World Health Organization standards as visual acuity<20/60 but≥20/400,and blindness as visual acuity<20/400.Age-and gender-standardized prevalence rates of blindness and visual impairment,along with their 95%confidence intervals(CI),were estimated.The six-year incidence rates of primary glaucoma,age-related macular degeneration,and myopic maculopathy,along with their 95%CI,were reported.ResultsAt baseline,the standardized prevalence of bilateral blindness in individuals aged 30 and above was 0.6%(41/6799)for presenting visual acuity and 0.5%(31/6799)for best-corrected visual acuity.These rates were higher than those found in the follow-up survey,0.5%(27/5293)and 0.3%(17/5276).Conversely,the standardized prevalence of bilateral visual impairment increased from 4.7%(361/6799)and 1.0%(85/6799)at baseline to 6.5%(355/5293)and 1.4%(74/5276)at follow-up,respectively.The leading cause of bilateral blindness was cataract in both baseline(13/31,41.9%)and follow-up(7/17)surveys.Other major causes included myopic retinal degeneration(5/31,16.1%at baseline;2/17 at follow-up),glaucoma(3/31,9.7%at baseline;2/17 at follow-up),and corneal opacity(3/31,9.7%at baseline;2/17 at follow-up).Over six years,the incidence rates for primary glaucoma,early and late age-related macular degeneration,and myopic maculopathy in individuals age

关 键 词：患病率 视觉障碍 成年人 白内障 队列研究 河北 

分 类 号：R77[医药卫生—眼科] R181.3[医药卫生—临床医学]