Allen Foster Community Eye Health Research Centre, International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, India.
PLoS One. 2013 Jul 23;8(7):e70120. doi: 10.1371/journal.pone.0070120. Print 2013.
To assess the prevalence and causes of visual impairment in urban and rural population aged ≥ 40 years in the South India state of Andhra Pradesh.
A population based cross-sectional study was conducted in which 7800 subjects were sampled from two rural and an urban locations. Visual Acuity (VA) was assessed using a tumbling E chart and eye examinations were performed by trained vision technicians. A questionnaire was used to collect personal and demographic information and previous consultation to eye care providers. Blindness and moderate Visual Impairment (VI) was defined as presenting VA <6/60 and <6/18 to 6/60 in the better eye respectively. VI included blindness and moderate VI.
Of the 7800 subjects enumerated, 7378 (94.6%) were examined. Among those examined, 46.4% were male and 61.8% of them had no education. The mean age of those examined (51.7 years; standard deviation 10.9 years) was similar to those not examined (52.8 years; standard deviation 9.9 years) (p=0.048). Age and gender adjusted prevalence of VI was 14.3% (95% CI: 13.5-15.0). Refractive errors were the leading cause of VI accounting for 47.6% of all VI followed by cataract (43.7%). Together, they contributed to over 91.3% of the total VI. With multiple logistic regression, the odds of having VI increased significantly with increasing age. Those respondents who had no education were twice (95% CI: 1.7-2.5) more likely to have VI compared to those who were educated. VI was associated with rural residence (OR: 1.3; 95% CI: 1.1-1.6). The association between VI and gender was not statistically significant.
The visual impairment remains a public health challenge in Andhra Pradesh, most of which can be addressed with relatively straight forward interventions like cataract surgery and spectacles. The eye care services need to be streamlined to address this challenge.
评估印度安得拉邦城乡 40 岁及以上人群的视力障碍患病率和病因。
本研究采用基于人群的横断面研究，从两个农村和一个城市地点抽取了 7800 名受试者。使用滚动 E 图表评估视力敏锐度（VA），并由经过培训的视力技术人员进行眼部检查。使用问卷收集个人和人口统计学信息以及以前向眼科保健提供者咨询的情况。失明和中度视力障碍（VI）分别定义为较好眼的视力低于 6/60 和 6/18 至 6/60。VI 包括失明和中度 VI。
在所列举的 7800 名受试者中，有 7378 名（94.6%）接受了检查。在接受检查的人群中，46.4%为男性，61.8%没有受过教育。接受检查者的平均年龄（51.7 岁；标准差 10.9 岁）与未接受检查者相似（52.8 岁；标准差 9.9 岁）（p=0.048）。年龄和性别调整后的 VI 患病率为 14.3%（95%CI：13.5-15.0）。屈光不正是 VI 的主要原因，占所有 VI 的 47.6%，其次是白内障（43.7%）。两者合计占总 VI 的 91.3%以上。通过多因素逻辑回归分析，随着年龄的增长，VI 的发生风险显著增加。与受过教育的人相比，没有受过教育的人发生 VI 的可能性高两倍（95%CI：1.7-2.5）。VI 与农村居住有关（OR：1.3；95%CI：1.1-1.6）。VI 与性别之间的关联没有统计学意义。
在安得拉邦，视力障碍仍然是一个公共卫生挑战，其中大部分可以通过白内障手术和眼镜等相对简单的干预措施来解决。需要简化眼科保健服务以应对这一挑战。
