7 年随访中老年人的屈光状态变化：石牌眼病研究。

Changes in refractive status in an elderly Chinese population in a 7-year follow-up: The Shihpai Eye Study.

机构信息

Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC; Community Medicine Research Center and Institute of Public Health, National Yang Ming University, Taipei, Taiwan, ROC.

Department of Health Management, I-Shou University, Kaohsiung, Taiwan, ROC.

出版信息

J Chin Med Assoc. 2017 Oct;80(10):673-678. doi: 10.1016/j.jcma.2017.06.004. Epub 2017 Jul 14.

DOI:10.1016/j.jcma.2017.06.004

PMID:28716601

Abstract

BACKGROUND

Refractive error is the major cause of moderate and severe visual impairment. Visual impairment limits people's ability to perform daily tasks and affects their quality of life. Longitudinal data on the refractive status of the elderly was available only for whites and Africans. The purpose of this study was to report the 7-year incidence of myopia, hyperopia and refractive error change as well as their associated risk factors in a metropolitan elderly Chinese population.

METHODS

The Shihpai Eye Study 2006 included 460/824 (55.8%) subjects (age range 72-94 years old) of 1361 participants in the 1999 baseline survey for a follow-up eye examination. Incidences were calculated for those who had emmetropia (-0.50D < spherical equivalent (SE) <+0.50D) at baseline. Refractive error change at 7 year was defined as (SE at the 7-year visit - SE at baseline).

RESULTS

90 (26.4%) subjects were emmetropic, 61 (17.9%) were myopic and 190 (55.7%) hyperopic. The mean refractive error was 0.49 ± 2.19 D and the average change in refractive error was -0.13 ± 1.03 D. The incidence of myopia at seven-year was 26.8 % [95% Confidence interval (C.I.): 22.8%-30.9%] and the incidence of hyperopia was 19.7% (95% C.I.: 16.1%-23.3%). Nuclear sclerosis (>Grade 2 vs. ≤Grade 2) [p < 0.0001; relative risk (RR): 8.94; 95% C.I.: 4.40-18.2], anterior chamber depth (mm) [p = 0.05; RR: 0.43; 95% C.I.: 0.18-1.01] and lens thickness (mm) [p < 0.01; RR: 2.35; 95% C.I.: 1.17-2.73] were significantly associated with myopic shift. On the other hand, hyperopic shift was significantly associated with cortical opacity (>Grade 2 vs. ≤Grade 2) (p = 0.02; RR: 1.21; 95% C.I.: 1.02-3.54).

CONCLUSION

In this elderly Asian population, there was on average a slight myopic shift. The incidence of myopia was comparable to population-based studies of other ethnic groups, whereas the incidence of hyperopia was substantially higher.

摘要

背景

屈光不正（refractive error）是中重度视力损害的主要原因。视力损害限制了人们执行日常任务的能力，并影响了他们的生活质量。只有白人和非洲人有关于老年人屈光状态的纵向数据。本研究的目的是报告一个大都市老年华裔人群中近视、远视和屈光不正变化的 7 年发病率及其相关危险因素。

方法

石排眼研究 2006 年纳入了 1999 年基线调查中 1361 名参与者中有 460/824 名（55.8%）受试者（年龄 72-94 岁）进行后续眼部检查。对基线时为正视眼（-0.50D<球镜等效值（spherical equivalent，SE）<+0.50D）的患者计算发病率。7 年时的屈光不正变化定义为（7 年就诊时的 SE-基线时的 SE）。

结果

90 名（26.4%）患者为正视眼，61 名（17.9%）为近视，190 名（55.7%）为远视。平均屈光误差为 0.49 ± 2.19 D，平均屈光误差变化为-0.13 ± 1.03 D。7 年时近视的发病率为 26.8%[95%置信区间（confidence interval，CI）：22.8%-30.9%]，远视的发病率为 19.7%（95% CI：16.1%-23.3%）。核硬化症（>Grade 2 级比≤Grade 2 级）[p<0.0001；相对风险（relative risk，RR）：8.94；95% CI：4.40-18.2]、前房深度（mm）[p=0.05；RR：0.43；95% CI：0.18-1.01]和晶状体厚度（mm）[p<0.01；RR：2.35；95% CI：1.17-2.73]与近视漂移显著相关。另一方面，远视漂移与皮质混浊（>Grade 2 级比≤Grade 2 级）显著相关（p=0.02；RR：1.21；95% CI：1.02-3.54）。