Department of Preventive Ophthalmology, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong, China.
Department of Surgery (Ophthalmology), Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia.
Br J Ophthalmol. 2018 Nov;102(11):1538-1542. doi: 10.1136/bjophthalmol-2017-311073. Epub 2018 Jan 24.
To investigate the prevalence and incidence of presbyopia in an urban Chinese population.
1817 subjects aged ≥35 years were identified by random cluster sampling in Yuexiu District, Guangzhou, China, at baseline in 2008, and all were invited for the follow-up examination in 2014. Distance and near visual acuity (VA) tests, as well as non-cycloplegic automated refraction were performed at each examination as per standardised protocol. Participants with presenting near VA ≤20/40 were further tested with add power at a standard distance of 40 cm to obtain their best-corrected near VA. Functional presbyopia was defined as near VA under presenting distance refraction correction of <20/50 and could be improved by at least one line with add power.
A total of 1191 (83.5% of the 2014 follow-up) participants were included in the current analysis with a mean (SD) age of 50.4 (9.7) years, and 52.9% were female. Prevalence of functional presbyopia at baseline was 25.2% (95% CI 21.5 to 28.9) and the 6-year incidence was 42.8% (95% CI 39.4 to 50.1). Older and more hyperopic subjects had both higher prevalence and incidence of presbyopia (P<0.001). Average presbyopic correction coverage (PCC) was 87.7% at baseline and was significantly lower in myopic participants (P=0.006).
Prevalence of functional presbyopia in urban China is relatively lower along with a higher PCC compared with previous population-based rural cohorts. We identified a high presbyopia incidence, and further studies are needed to understand longitudinal presbyopia progression as well as the urban-rural gap in presbyopia to throw light on future strategic planning.
调查中国城市人群中老视的患病率和发病率。
2008 年，采用随机整群抽样方法在广州市越秀区确定了 1817 名年龄≥35 岁的受试者作为基线人群，所有受试者均被邀请于 2014 年参加随访检查。每次检查均按照标准方案进行距离和近视力（VA）测试以及非睫状肌麻痹自动折射检查。对近 VA 表现值≤20/40 的患者，进一步在标准距离 40cm 处加光以获得最佳矫正近 VA。将近 VA 表现值在距离矫正下<20/50 且通过至少增加一行加光可提高的情况定义为功能性老视。
共有 1191 名（2014 年随访的 83.5%）参与者纳入本研究，平均（SD）年龄为 50.4（9.7）岁，52.9%为女性。基线时功能性老视的患病率为 25.2%（95%CI 21.5 至 28.9），6 年的发病率为 42.8%（95%CI 39.4 至 50.1）。年龄较大和远视度数较高的患者老视的患病率和发病率均较高（P<0.001）。基线时平均老视矫正覆盖率（PCC）为 87.7%，近视患者的 PCC 明显较低（P=0.006）。
与以前的基于人群的农村队列相比，中国城市人群中功能性老视的患病率较低，PCC 较高。我们发现老视的发病率较高，需要进一步研究来了解老视的纵向进展以及老视的城乡差距，为未来的战略规划提供依据。
