Hsu Wen-Ming, Cheng Ching-Yu, Liu Jorn-Hon, Tsai Su-Ying, Chou Pesus
Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.
Ophthalmology. 2004 Jan;111(1):62-9. doi: 10.1016/j.ophtha.2003.05.011.
Few population-based data on the prevalence and causes of visual impairment are available from East Asia. The purpose of this study was to determine the prevalence and causes of visual impairment in an elderly Chinese population in Taiwan.
Population-based cross-sectional study.
The Shihpai Eye Study was a survey of vision and ocular disease among an elderly Chinese population 65 years of age or older residing in Shihpai, Taiwan. A random sample of 2045 elderly residents was identified and selected from the household registration databank. Among them, 1361 (66.6%) underwent a detailed ophthalmic examination.
The ophthalmic examination included best-corrected visual acuity measurements using standardized protocols. Visual acuity was assessed with a Snellen E chart. The major cause of visual loss was identified for all participants who were visually impaired.
Low vision and blindness were defined as a best-corrected visual acuity in the eye with better vision worse than 20/60 to a lower limit of 20/400 and worse than 20/400, respectively, according to World Health Organization categories of visual impairment.
The mean age of the participants was 72.2 (range, 65-91) years old. A total of 40 participants met the World Health Organization criteria of low vision, and 8 were diagnosed as blind. The rate of blindness and low vision was estimated to be 0.59% (95% confidence interval, 0.25%, 1.16%) and 2.94% (95% confidence interval, 2.11%, 3.99%), respectively. There was a significant increase in the rate of low vision (P<0.001) from 0.83% at 65 to 69 years of age to 8.33% at age 80 years or older. There was no gender difference in the prevalence of blindness or low vision. The leading cause of visual impairment was cataract (41.7%), followed by myopic macular degeneration (12.5%) and age-related macular degeneration (10.4%).
The rate of blindness and low vision is close to that reported for other developed countries. The high frequency of myopic macular degeneration as a major cause of visual loss, however, is not observed in European-derived populations. Specific prevention or low-vision rehabilitation programs should be developed for the elderly Chinese population.
东亚地区基于人群的视力损害患病率及病因数据较少。本研究旨在确定台湾老年中国人群中视力损害的患病率及病因。
基于人群的横断面研究。
石牌眼科研究是一项针对居住在台湾石牌的65岁及以上老年中国人群的视力和眼病调查。从户籍数据库中随机抽取2045名老年居民作为样本。其中，1361人（66.6%）接受了详细的眼科检查。
眼科检查包括使用标准化方案测量最佳矫正视力。视力用Snellen E视力表评估。为所有视力受损的参与者确定视力丧失的主要原因。
根据世界卫生组织视力损害分类，低视力和盲分别定义为视力较好眼的最佳矫正视力低于20/60至下限20/400以及低于20/400。
参与者的平均年龄为72.2岁（范围65 - 91岁）。共有40名参与者符合世界卫生组织低视力标准，8人被诊断为盲。盲和低视力的患病率估计分别为0.59%（95%置信区间，0.25%，1.16%）和2.94%（95%置信区间，2.11%，3.99%）。低视力患病率从65至69岁的0.83%显著增加（P<0.001）至80岁及以上的8.33%。盲或低视力的患病率无性别差异。视力损害的主要原因是白内障（41.7%），其次是近视性黄斑变性（12.5%）和年龄相关性黄斑变性（10.4%）。
盲和低视力的患病率与其他发达国家报告的相近。然而，在欧洲裔人群中未观察到近视性黄斑变性作为视力丧失主要原因的高频率情况。应为老年中国人群制定特定的预防或低视力康复计划。
