Tran T H C, Nguyen Van Nuoi D, Baiz H, Baglin G, Leduc J-J, Bulkaen H
Service d'ophtalmologie, hôpital Saint-Vincent-de-Paul, groupe hospitalier de l'institut catholique de Lille, boulevard Belfort, BP 387, 59020 Lille cedex, France.
J Fr Ophtalmol. 2011 Dec;34(10):723-8. doi: 10.1016/j.jfo.2011.04.014. Epub 2011 Oct 11.
To study visual impairment and the etiology of visual loss in fallers and non-fallers in older patients.
Cross-sectional study including two groups of patients: elderly patients admitted for a fall (group 1) and elderly individuals who did not report a fall during the 6 months before admission (group 2). Visual acuity was measured in both eyes of all participants. Complete ophthalmologic evaluation was performed in the fallers group.
The fallers group included 98 patients (mean age, 83.4 ± 6.3) and the non-fallers group included 106 patients (mean age, 79 ± 6.6). The fallers had lower vision than non-fallers (P<0.001). Visual impairment (visual acuity less than 20/40) was more frequent in the fallers (49.5% vs 15.3%, P<0.001). Causes of visual impairment in fallers were cataract (47.4%), association of cataract and age-related macular degeneration (17.5%), age-related macular degeneration without cataract (13.4%), and optic neuropathy (9.3%). Management of fallers was difficult, and only 17 of 48 eyes (35.4%) with cataract had undergone surgery.
Fallers have a higher prevalence of visual impairment and blindness. Vision may improve with surgery in half of these eyes. This study highlights the need for systematic ophthalmologic evaluation in this high-risk population in order to prevent falls.
研究老年患者中跌倒者与未跌倒者的视力损害及视力丧失的病因。
横断面研究，包括两组患者：因跌倒入院的老年患者（第1组）和入院前6个月内未报告跌倒的老年人（第2组）。测量所有参与者双眼的视力。对跌倒者组进行了全面的眼科评估。
跌倒者组包括98例患者（平均年龄83.4±6.3岁），未跌倒者组包括106例患者（平均年龄79±6.6岁）。跌倒者的视力低于未跌倒者（P<0.001）。视力损害（视力低于20/40）在跌倒者中更为常见（49.5%对15.3%，P<0.001）。跌倒者视力损害的原因包括白内障（47.4%）、白内障与年龄相关性黄斑变性并存（17.5%）、无白内障的年龄相关性黄斑变性（13.4%）和视神经病变（9.3%）。对跌倒者的治疗存在困难，48例白内障眼中仅有17例（35.4%）接受了手术。
跌倒者视力损害和失明的患病率更高。这些眼中半数通过手术视力可能改善。本研究强调了对这一高危人群进行系统眼科评估以预防跌倒的必要性。
