Schulze Schwering M, Nyrenda M, Spitzer M S, Kalua K
Augenheilkunde, Universitätsaugenklinik Tübingen.
Klin Monbl Augenheilkd. 2013 Aug;230(8):820-4. doi: 10.1055/s-0032-1328773. Epub 2013 Aug 19.
The aim of this study was to determine the anatomic sites of severe visual impairment and blindness in children in an integrated school for the blind in Malawi, and to compare the results with those of previous Malawian blind school studies.
Children attending an integrated school for the blind in Malawi were examined in September 2011 using the standard WHO/PBL eye examination record for children with blindness and low vision. Visual acuity [VA] of the better eye was classified using the standardised WHO reporting form.
Fifty-five pupils aged 6 to 19 years were examined, 39 (71 %) males, and 16 (29 %) females. Thirty eight (69%) were blind [BL], 8 (15 %) were severely visually impaired [SVI], 8 (15 %) visually impaired [VI], and 1 (1.8 %) was not visually impaired [NVI]. The major anatomic sites of visual loss were optic nerve (16 %) and retina (16 %), followed by lens/cataract (15 %), cornea (11 %) and lesions of the whole globe (11 %), uveal pathologies (6 %) and cortical blindness (2 %). The exact aetiology of VI or BL could not be determined in most children. Albinism accounted for 13 % (7/55) of the visual impairments. 24 % of the cases were considered to be potentially avoidable: refractive amblyopia among pseudophakic patients and corneal scaring.
Optic atrophy, retinal diseases (mostly albinism) and cataracts were the major causes of severe visual impairment and blindness in children in an integrated school for the blind in Malawi. Corneal scarring was now the fourth cause of visual impairment, compared to being the commonest cause 35 years ago. Congenital cataract and its postoperative outcome were the commonest remedial causes of visual impairment.
本研究旨在确定马拉维一所盲人综合学校中儿童严重视力损害和失明的解剖部位,并将结果与马拉维以往盲人学校研究的结果进行比较。
2011年9月,使用世界卫生组织/基层保健眼科学标准检查记录,对马拉维一所盲人综合学校的儿童进行了检查。使用标准化的世界卫生组织报告表对较好眼的视力进行分类。
检查了55名6至19岁的学生,其中39名(71%)为男性,16名(29%)为女性。38名(69%)失明,8名(15%)严重视力损害,8名(15%)视力损害,1名(1.8%)无视力损害。视力丧失的主要解剖部位是视神经(16%)和视网膜(16%),其次是晶状体/白内障(15%)、角膜(11%)和全眼球病变(11%)、葡萄膜病变(6%)和皮质盲(2%)。大多数儿童视力损害或失明的确切病因无法确定。白化病占视力损害的13%(7/55)。24%的病例被认为是潜在可避免的:人工晶状体眼患者的屈光性弱视和角膜瘢痕。
视神经萎缩、视网膜疾病(主要是白化病)和白内障是马拉维一所盲人综合学校中儿童严重视力损害和失明的主要原因。与35年前是最常见原因相比,角膜瘢痕现在是视力损害的第四大原因。先天性白内障及其术后结果是视力损害最常见的补救原因。