Dineen B P, Bourne R R A, Ali S M, Huq D M Noorul, Johnson G J
International Centre for Eye Health, Clinical Research Unit, Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
Br J Ophthalmol. 2003 Jul;87(7):820-8. doi: 10.1136/bjo.87.7.820.
To determine the age, sex, and cause specific prevalences of blindness and visual impairment in adults 30 years of age and older in Bangladesh.
A nationally representative sample of 12 782 adults 30 years of age and older was selected based on multistage, cluster random sampling with probability proportional to size procedures. The breakdown of the cluster sites was proportional to the rural/urban distribution of the national population. The examination protocol consisted of an interview, visual acuity (VA) testing, autorefraction, and optic disc examination on all subjects. Corrected VA retesting, cataract grading, and a dilated fundal examination were performed on all visually impaired subjects. The definitions of blindness (<3/60) and low vision (<6/12 to >or=3/60) were based on the presenting visual acuity in the better eye. The World Health Organization/Prevention of Blindness proforma and its classification system for identifying the main cause of low vision and blindness for each examined subject was used.
In total, 11 624 eligible subjects were examined (90.9% response rate) across the 154 cluster sites. A total of 162 people were bilaterally blind (1.53% age standardised prevalence) while a further 1608 subjects (13.8%) had low vision (<6/12 VA) binocularly. Visual acuity was >6/12 in the "better eye" in the remaining 9854 subjects (84.8%); however, 748 of these people had low vision in the fellow eye. The main causes of low vision were cataract (74.2%), refractive error (18.7%), and macular degeneration (1.9%). Cataract was the predominant cause (79.6%) of bilateral blindness followed by uncorrected aphakia (6.2%) and macular degeneration (3.1%).
There are an estimated 650 000 blind adults (95% CI 552 175 to 740 736) aged 30 and over in Bangladesh, the large majority of whom are suffering from operable cataract. This survey indicates the need for the development and implementation of a national plan for the delivery of effective eye care services, aimed principally at resolving the large cataract backlog and the inordinate burden of refractive error.
确定孟加拉国30岁及以上成年人失明和视力损害的年龄、性别及特定病因患病率。
基于多阶段、整群随机抽样且抽样概率与规模成比例的程序，选取了12782名30岁及以上具有全国代表性的成年人样本。整群抽样地点的分布与全国人口的城乡分布成比例。检查方案包括对所有受试者进行访谈、视力（VA）测试、自动验光和视盘检查。对所有视力受损受试者进行矫正视力复测、白内障分级和散瞳眼底检查。失明（<3/60）和低视力（<6/12至≥3/60）的定义基于较好眼的当前视力。使用世界卫生组织/防盲表格及其分类系统来确定每个检查受试者低视力和失明的主要原因。
在154个整群抽样地点共检查了11624名符合条件的受试者（应答率为90.9%）。共有162人双眼失明（年龄标准化患病率为1.53%），另有1608名受试者（13.8%）双眼视力为低视力（<6/12 VA）。其余9854名受试者（84.8%）的“较好眼”视力>6/12；然而，其中748人对侧眼有低视力。低视力的主要原因是白内障（74.2%）、屈光不正（18.7%）和黄斑变性（1.9%）。白内障是双眼失明的主要原因（79.6%），其次是未矫正的无晶状体眼（6.2%）和黄斑变性（3.1%）。
孟加拉国估计有65万30岁及以上的失明成年人（95%可信区间为552175至740736），其中绝大多数患有可手术治疗的白内障。这项调查表明需要制定并实施一项国家计划，以提供有效的眼保健服务，主要目的是解决大量白内障积压问题和屈光不正带来的过度负担。
