Thapa Raba, Bajimaya Sanyam, Paudyal Govinda, Khanal Shankar, Tan Stevie, Thapa Suman S, van Rens Ger
Vitreo-retina Service, Tilganga Institute of Ophthalmology, Kathmandu.
Central Departments of Statistics, Tribhuvan University, Kirtipur, Nepal.
Clin Ophthalmol. 2017 May 22;11:963-972. doi: 10.2147/OPTH.S132338. eCollection 2017.
This study aimed to explore the prevalence of and risk factors for age-related macular degeneration (AMD) in an elderly population in Nepal.
This is a population-based, cross-sectional study. A sample size of 2,100 was calculated. A total of 1,860 (88.6%) subjects aged >60 years were enrolled for the study from 30 clusters in the district. Detailed history, visual acuity, and anterior segment and posterior segment examinations were performed. AMD was graded according to the International ARM Epidemiological Study Group.
Among the total study population, 659 subjects had any AMD (35.43%; 95% confidence interval [CI]: 33.25-37.65), 484 had mild dry AMD (26.02%; 95% CI: 24.04-28.08), 143 had intermediate dry AMD (7.69%; 95% CI: 6.52-8.99), 19 had geographic atrophy (1.02%; 95% CI: 0.61-1.59), and 13 had wet AMD (0.70%; 95% CI: 0.37-1.19). The overall prevalence of early and late AMD was 33.71% and 1.72%, respectively. Among subjects with dry and wet AMD, 36.53% and 46.1% had visual impairment, while 2.78% and 23.08% were blind, respectively. In multivariate analysis, AMD was significantly higher in subjects with an increased number of cigarettes smoked per day (odds ratio [OR] 1.02, 95% CI: 1.01-1.04; =0.007) and in subjects with pseudophakia (OR 1.45, 95% CI: 1.12-1.87; =0.005).
One-third of the population aged ≥60 years have some form of AMD. There was a significant association with the number of cigarettes consumed and with previous cataract surgery.
本研究旨在探讨尼泊尔老年人群中年龄相关性黄斑变性（AMD）的患病率及危险因素。
这是一项基于人群的横断面研究。计算得出样本量为2100。从该地区的30个群组中纳入了总共1860名（88.6%）年龄大于60岁的受试者进行研究。进行了详细的病史询问、视力检查以及眼前节和眼后节检查。AMD根据国际年龄相关性黄斑变性流行病学研究组的标准进行分级。
在整个研究人群中，659名受试者患有任何类型的AMD（35.43%；95%置信区间[CI]：33.25 - 37.65），484名患有轻度干性AMD（26.02%；95% CI：24.04 - 28.08），143名患有中度干性AMD（7.69%；95% CI：6.52 - 8.99），19名患有地图样萎缩（1.02%；95% CI：0.61 - 1.59），13名患有湿性AMD（0.70%；95% CI：0.37 - 1.19）。早期和晚期AMD的总体患病率分别为33.71%和1.72%。在干性和湿性AMD受试者中，分别有36.53%和46.1%存在视力损害，而失明者分别为2.78%和23.08%。在多因素分析中，每天吸烟数量增加的受试者患AMD的比例显著更高（比值比[OR] 1.02，95% CI：1.01 - 1.04；P = 0.007），以及人工晶状体植入者患AMD的比例也显著更高（OR 1.45，95% CI：1.12 - 1.87；P = 0.005）。
三分之一的60岁及以上人群患有某种形式的AMD。吸烟数量及既往白内障手术与之存在显著关联。
