Al-Merjan J I, Pandova M G, Al-Ghanim M, Al-Wayel A, Al-Mutairi S
Mohammed Al-Bahar Eye Center, Ibn Sina Hospital, Safat, Kuwait.
Ophthalmic Epidemiol. 2005 Aug;12(4):251-7. doi: 10.1080/09286580591005813.
To estimate the incidence rates and major causes of registered blindness and low vision in Kuwait.
Data on age, gender and cause of blindness and low vision were collected from the Visual Disability Committee while evaluating Kuwaiti citizens applying for a blindness allowance from January 2000 to December 2004. Criteria for legal blindness in Kuwait are visual acuity 6/60 or less in the better eye with best possible correction or a visual field less than 20 degrees around the central fixation point. Incidence rates per 100,000 person years of observation were calculated for both genders in four age subgroups and four severity categories. The causes of registered blindness were classified according to the International Classification of Diseases, 10th edition.
412 persons were registered as blind, 272 males (66.01%) and 140 females (33.98%), mean age 28.7 +/-25.2 years, 39.32% below 20 years of age, 31.79% 21-40 years, 18.68% 41-60 years, and 9.95% 61 years and over . Male gender was prevalent for all age subgroups. The overall incidence rate was 9.97 per 100,000 person years of observation, 13.33 for the male and 6.69 for the female patients. The incidence rates rose from 7.35 for those 20 years and younger to 14.80 for the age subgroup 41-60 and 23.16 for those 61 years and above. The rates of severe visual impairment classified in categories 4 and 5 were higher than the rates for categories 2 and 3. Retinitis pigmentosa was the leading cause of blindness, followed by congenital anomalies and optic atrophy. In the subgroup below 20 the rate of optic atrophy was highest, followed by congenital malformations, retinitis pigmentosa and retinopathy of prematurity. In the next age subgroup (21-40 years), the rate of retinitis pigmentosa was three times as high as in the younger subgroup, followed by optic atrophy, congenital malformations and albinism. In the subgroup 41-60 the incidence rate for phthisis bulbi was twice as high as the rates for retinitis pigmentosa and optic atrophy. For those 61 years and older, the incidence rate of phthisis bulbi was almost five times as high as that for optic atrophy. The incidence rates for the male patients were higher for the major causes of disability in all age subgroups.
The overall incidence rate of registered blindness for Kuwait is less than in many other national registries. The marked prevalence of the male gender in all age subgroups is specific for Kuwait. The rates of the leading causes of registered blindness reflect the prevalence of the younger subgroups in our registry. Additional data on co-morbidity and dedicated efforts to reveal unrecognized and unregistered blindness, particularly among females, will overcome the limitations of the registry, and will serve to outline the tendencies in avoidable vision loss and monitor the efficacy of the prevention programs in the future.
评估科威特登记在册的失明和视力低下的发病率及主要病因。
在2000年1月至2004年12月期间，从视觉残疾委员会收集申请失明津贴的科威特公民的年龄、性别以及失明和视力低下病因的数据。科威特法定失明的标准是最佳矫正后较好眼的视力为6/60或更低，或中心注视点周围视野小于20度。计算了四个年龄亚组和四个严重程度类别中男女每10万人年观察期的发病率。登记失明的病因根据《国际疾病分类》第10版进行分类。
412人登记为失明，男性272人（66.01%），女性140人（33.98%），平均年龄28.7±25.2岁，39.32%低于20岁，31.79%为21 - 40岁，18.68%为41 - 60岁，9.95%为61岁及以上。所有年龄亚组中男性均占多数。总体发病率为每10万人年观察期9.97例，男性患者为13.33例，女性患者为6.69例。发病率从20岁及以下人群的7.35例上升至41 - 60岁年龄亚组的14.80例以及61岁及以上人群的23.16例。4级和5级严重视力损害的发生率高于2级和3级。视网膜色素变性是失明的主要原因，其次是先天性异常和视神经萎缩。在20岁以下亚组中，视神经萎缩的发生率最高，其次是先天性畸形、视网膜色素变性和早产儿视网膜病变。在下一个年龄亚组（21 - 40岁）中，视网膜色素变性的发生率是较年轻亚组的三倍，其次是视神经萎缩、先天性畸形和白化病。在41 - 60岁亚组中，眼球痨的发病率是视网膜色素变性和视神经萎缩发病率的两倍。对于61岁及以上人群，眼球痨的发病率几乎是视神经萎缩发病率的五倍。所有年龄亚组中男性患者主要残疾病因的发病率更高。
科威特登记在册的失明总体发病率低于许多其他国家登记处。所有年龄亚组中男性占显著多数是科威特特有的情况。登记失明主要病因的发生率反映了我们登记处中较年轻亚组的患病率。关于合并症的更多数据以及为揭示未被认识和未登记的失明（特别是女性中的失明）所做的专门努力，将克服登记处的局限性，并有助于勾勒可避免视力丧失的趋势以及监测未来预防项目的效果。
