澳大利亚老年住院患者的视力障碍和眼部疾病

Visual impairment and eye diseases in elderly institutionalized Australians.

作者信息

VanNewkirk M R, Weih L, McCarty C A, Stanislavsky Y L, Keeffe J E, Taylor H R

机构信息

Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia.

出版信息

Ophthalmology. 2000 Dec;107(12):2203-8. doi: 10.1016/s0161-6420(00)00459-0.

DOI:10.1016/s0161-6420(00)00459-0

PMID:11097596

Abstract

OBJECTIVE

To study the prevalence and distribution of visual impairment and eye diseases by age and gender in an urban institutionalized population.

DESIGN

Cross-sectional study.

PARTICIPANTS

Four hundred three residents of nursing homes and hostels.

METHODS

Fourteen nursing homes were randomly selected from 104 nursing homes and hostels located within a 5-km radius of each of nine clusters studied in the Visual Impairment Project (VIP) urban cohort. Participants completed a standardized orthoptic and dilated ophthalmic examination, including measurement of visual acuity and visual fields. The major cause of vision loss was identified for participants with visual impairment.

MAIN OUTCOME MEASURES

Presenting visual acuity and ophthalmic diagnoses.

RESULTS

The participants' mean age was 82 years (standard deviation, 9.24), with an age range of 46 years to 101 years. Women outnumbered men by 318 to 85. Seventy-one (22%) of 318 women had bilateral profound visual impairment (blindness), defined as best-corrected visual acuity <3/60 and/or visual field constriction <5 degrees compared with 10 (12%) of 85 men. However, this difference is not significant when age-standardized. Age-related macular degeneration was the principal diagnosis of vision loss in the better eye of 74 (44%) of the 167 participants with bilateral low vision (<6/18 and/or visual field constriction to <20 degrees radius). The age-adjusted rate of blindness or profound visual impairment in the VIP institutional cohort of 5.2% (95% confidence interval [CI], 1.8, 8.6) was significantly greater than in the VIP urban and rural cohorts of 0.13% (95% CI, 0, 0.25) and 0.29% (95% CI, 0, 0.57), respectively.

CONCLUSIONS

Underestimation of visual impairment may occur in residential population-based studies that exclude institutional or residential nursing homes and hostels for the aged citizens. Expanded methods are required for visual assessment in institutional populations.

摘要

目的

研究城市机构化人群中视力损害和眼病按年龄和性别的患病率及分布情况。

设计

横断面研究。

参与者

403名养老院和宿舍的居民。

方法

从视觉损害项目（VIP）城市队列研究的9个集群中，在每个集群半径5公里范围内的104家养老院和宿舍中随机选取14家。参与者完成了标准化的斜视和散瞳眼科检查，包括视力和视野测量。确定了视力损害参与者视力丧失的主要原因。

主要观察指标

呈现的视力和眼科诊断。

结果

参与者的平均年龄为82岁（标准差9.24），年龄范围为46岁至101岁。女性人数多于男性，为318人对85人。318名女性中有71人（22%）患有双侧严重视力损害（失明），定义为最佳矫正视力<3/60和/或视野缩窄<5度，而85名男性中有10人（12%）。然而，年龄标准化后，这种差异并不显著。年龄相关性黄斑变性是167名双侧低视力（<6/18和/或视野缩窄至<半径20度）参与者中较好眼视力丧失的主要诊断。VIP机构队列中失明或严重视力损害的年龄调整率为5.2%（95%置信区间[CI]，1.8, 8.6），显著高于VIP城市和农村队列中的0.13%（95%CI，0, 0.25）和0.29%（95%CI，0, 0.57）。