Foran Suriya, Wang Jie Jin, Mitchell Paul
Department of Ophthalmology, University of Sydney (Centre for Vision Research, Westmead Hospital) and the Westmead Millennium and Save Sight Institutes, Sydney, Australia.
Ophthalmic Epidemiol. 2003 Oct;10(4):215-25. doi: 10.1076/opep.10.4.215.15906.
To describe the causes of bilateral and unilateral blindness and visual impairment in two cross-sections of an older Australian population 6 years apart.
The Blue Mountains Eye Study examined 3654 persons aged 49-97 years during 1992-1994 (population cross-section 1). Cohort survivors (2335) and 1174 persons who moved to the area or reached an eligible age were examined during 1997-2000, a total of 3509 persons (population cross-section 2). LogMAR visual acuity was measured after standardized refraction. Blindness and visual impairment were respectively defined by visual acuity <6/60 and <6/12. Causes were determined for the two temporal cross-sections.
Age-related macular degeneration (AMD) was the principal cause of bilateral and unilateral non-correctable blindness in both cross-sections. AMD caused 77% of bilateral blindness in Cross-section 1 and 50% in Cross-section 2. Cataract, glaucoma, corneal and neurological disease were next equally frequent causes (6% each) of bilateral blindness in Cross-section 1. In Cross-section 2, cataract ranked as the third most frequent principal cause (10%) after other retinal diseases (40%). The proportion of unilateral blindness with AMD as principal cause was very similar (around one-third of cases) in the two cross-sections; while in Cross-section 2 blindness was less frequently caused by cataract (19% vs. 13%). Cataract was the principal cause of both bilateral and unilateral visual impairment, responsible for 50% of bilateral (better eye) and 35-40% of unilateral (worse eye) impairment, with slightly lower rates found in Cross-section 2 than in Cross-section 1. AMD was consistently the second most frequent cause, causing one-third of bilateral and one-fifth of unilateral visual impairment.
These data indicate a relative stable pattern of causes for blindness and visual impairment, with AMD and cataract, respectively, dominating these two levels.
描述相隔6年的两个澳大利亚老年人群横断面中双眼和单眼失明及视力损害的原因。
蓝山眼研究在1992 - 1994年期间检查了3654名年龄在49 - 97岁的人（人群横断面1）。队列幸存者（2335人）以及1174名迁入该地区或达到 eligible 年龄的人在1997 - 2000年期间接受了检查，共计3509人（人群横断面2）。在标准化验光后测量LogMAR视力。失明和视力损害分别定义为视力<6/60和<6/12。确定了两个时间横断面的病因。
年龄相关性黄斑变性（AMD）是两个横断面中双眼和单眼不可矫正失明的主要原因。AMD导致横断面1中77%的双眼失明和横断面2中50%的双眼失明。白内障、青光眼、角膜病和神经病是横断面1中双眼失明的其次常见且同等常见的原因（各占6%）。在横断面2中，白内障是仅次于其他视网膜疾病（40%）的第三大常见主要原因（10%）。两个横断面中以AMD为主要原因的单眼失明比例非常相似（约占病例的三分之一）；而在横断面2中，白内障导致失明的频率较低（19%对13%）。白内障是双眼和单眼视力损害的主要原因，导致50%的双眼（较好眼）和35 - 40%的单眼（较差眼）视力损害，横断面2中的发生率略低于横断面1。AMD始终是第二大常见原因，导致三分之一的双眼和五分之一的单眼视力损害。
这些数据表明失明和视力损害的病因模式相对稳定，AMD和白内障分别在这两个层面占据主导地位。
