Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China; Myopia Key Laboratory of the Health Ministry, and Visual Impairment and Reconstruction Key Laboratory of Shanghai, Shanghai, China.
State Key Laboratory of Genetic Engineering and MOE Key Laboratory of Contemporary Anthropology, Collaborative Innovation Center for Genetics and Development, School of Life Sciences and Institutes of Biomedical Sciences, Fudan University, Shanghai, China; Fudan-Taizhou Institute of Health Sciences, Taizhou, China.
Ophthalmology. 2015 Jul;122(7):1480-8. doi: 10.1016/j.ophtha.2015.03.022. Epub 2015 May 16.
To study the current prevalence and causes of low vision and blindness in an adult Chinese population.
Population-based, cross-sectional study.
We used a random cluster sampling method and evaluated 10 234 eligible subjects ≥45 years old (response rate, 78.1%) in the Taizhou Eye Study.
Examinations were performed from July 2012 through December 2013. Participants underwent a detailed examination, including uncorrected visual acuity, best-corrected visual acuity (BCVA), intraocular pressure, axial length, slit-lamp, and fundus examinations to evaluate the prevalence and primary causes of visual impairment (VI).
We defined low vision and blindness according to the World Health Organization (WHO) criteria (low vision: BCVA, <20/63-≥20/400; blindness: BCVA, <20/400 in the better eye) and United States criteria (low vision: BCVA, <20/40-≥20/200; blindness: BCVA, <20/200 in the better eye).
Using the WHO BCVA criteria, the standardized prevalence of bilateral low vision and blindness were 5.1% and 1.0%, respectively. Using the United States BCVA criteria, the standardized prevalence were 12.8% and 1.5%, respectively. Using the WHO criteria, the primary causes of bilateral low vision and blindness were cataract (59.1% and 48.5%, respectively), myopic macular degeneration (17.6% and 17.2%, respectively), and age-related macular degeneration (11.6% and 10.1%, respectively). The primary causes of monocular low vision were cataract (55.6%), age-related macular degeneration (12.6%), and myopic macular degeneration (8.9%), whereas those of monocular blindness were cataract (46.8%), atrophy of eyeball or prosthetic eye (10.2%), and cornea opacity (7.3%). A further analysis revealed that in adults 45-59 years old, myopic macular degeneration (59.6% and 27.2%, respectively) and cataract (13.8% and 23.4%, respectively) were the leading causes of bilateral and monocular VI. In adults ≥60 years old, cataract (66.8% and 61.2%, respectively) and age-related macular degeneration (12.6% and 11.8%, respectively) were the primary causes of bilateral and monocular VI.
The prevalence of low vision and blindness in Chinese adults remains a severe public health problem. In the Taizhou Eye Study, cataract was the leading cause of low vision and blindness. Myopic macular degeneration and cataract were the primary causes of VI in adults 45-59 years and ≥60 years old, respectively.
研究中国成年人群中低视力和盲的当前患病率和病因。
基于人群的横断面研究。
我们使用了随机聚类抽样方法，评估了台州眼病研究中 10234 名≥45 岁的合格受试者（应答率为 78.1%）。
检查于 2012 年 7 月至 2013 年 12 月进行。参与者接受了详细检查，包括未矫正视力、最佳矫正视力（BCVA）、眼压、眼轴、裂隙灯和眼底检查，以评估视力障碍（VI）的患病率和主要病因。
我们根据世界卫生组织（WHO）标准（低视力：BCVA，<20/63-≥20/400；盲：BCVA，<20/400 在较好的眼睛）和美国标准（低视力：BCVA，<20/40-≥20/200；盲：BCVA，<20/200 在较好的眼睛）定义低视力和盲。
使用 WHO 的 BCVA 标准，双侧低视力和盲的标准化患病率分别为 5.1%和 1.0%。使用美国的 BCVA 标准，标准化患病率分别为 12.8%和 1.5%。使用 WHO 标准，双侧低视力和盲的主要病因是白内障（分别为 59.1%和 48.5%）、近视性黄斑变性（分别为 17.6%和 17.2%）和年龄相关性黄斑变性（分别为 11.6%和 10.1%）。单眼低视力的主要病因是白内障（55.6%）、年龄相关性黄斑变性（12.6%）和近视性黄斑变性（8.9%），而单眼盲的主要病因是白内障（46.8%）、眼球萎缩或义眼（10.2%）和角膜混浊（7.3%）。进一步分析显示，在 45-59 岁的成年人中，近视性黄斑变性（分别为 59.6%和 27.2%）和白内障（分别为 13.8%和 23.4%）是双眼和单眼 VI 的主要病因。在≥60 岁的成年人中，白内障（分别为 66.8%和 61.2%）和年龄相关性黄斑变性（分别为 12.6%和 11.8%）是双眼和单眼 VI 的主要病因。
中国成年人的低视力和盲患病率仍然是一个严重的公共卫生问题。在台州眼病研究中，白内障是低视力和盲的主要原因。在 45-59 岁和≥60 岁的成年人中，近视性黄斑变性和白内障分别是 VI 的主要病因。
