Department of Ophthalmology, Hohhot Chao Ju Eye Hospital, Hohhot, China.
Singapore National Eye Center, Singapore Eye Research Institute, Singapore.
Br J Ophthalmol. 2018 Dec;102(12):1653-1657. doi: 10.1136/bjophthalmol-2017-311633. Epub 2018 Feb 8.
To determine the prevalence and causes of visual impairment (VI), and to describe the characteristics of cataract surgery coverage and related barriers among adults aged ≥50 years residing in Hohhot, Inner Mongolia.
A population-based cross-sectional study was performed. Presenting visual acuity (PVA) was measured using the Rapid Assessment of Avoidable Blindness (RAAB) methodology. All VI cases were defined using the WHO definition, based on the PVA of the better-seeing eye. Details on history of cataract surgery and barriers to cataract surgery were also obtained using a standardised questionnaire.
Of 4500 eligible individuals, 3985 (88.6% response rate) were examined. The age-standardised prevalence of moderate VI (PVA <6/18 to ≥6/60) was 5.4% (95% CI 4.6% to 6.3%), and severe VI (PVA <6/60 to ≥3/60) was 0.9% (95% CI 0.6% to 1.3%). The age-standardised prevalence of blindness (PVA <3/60) was 1.2% (95% CI 0.8% to 1.6%). Uncorrected refractive error (40.1%) and cataract (37.9%) were the leading causes of overall VI. Cataract (34.9%) was the leading cause of blindness. Among individuals with blindness, cataract surgical coverage was 80.7%. Among individuals with blindness due to cataract, the main barriers to cataract surgery were lack of awareness (38.1%).
The age-standardised prevalence rate of blindness in Hohhot was lower compared with other RAAB studies in China. Cataract was the leading cause of blindness. These findings provide useful information for the planning of public healthcare services in Inner Mongolia.
本研究旨在确定呼和浩特市≥50 岁人群的视力损害（VI）患病率和病因，并描述白内障手术覆盖率及其相关障碍的特征。
本研究采用基于人群的横断面研究设计。采用快速性盲评估（RAAB）方法对受检者的最佳矫正视力（PVA）进行测量。根据更好眼的 PVA 值，采用世界卫生组织（WHO）定义来定义所有 VI 病例。还使用标准化问卷获取白内障手术史和白内障手术障碍的详细信息。
在 4500 名符合条件的个体中，有 3985 名（88.6%的应答率）接受了检查。经年龄标准化后，中度 VI（PVA <6/18 至≥6/60）的患病率为 5.4%（95%可信区间：4.6%至 6.3%），重度 VI（PVA <6/60 至≥3/60）的患病率为 0.9%（95%可信区间：0.6%至 1.3%）。经年龄标准化后，失明（PVA <3/60）的患病率为 1.2%（95%可信区间：0.8%至 1.6%）。未矫正屈光不正（40.1%）和白内障（37.9%）是 VI 总体发病的主要原因。白内障（34.9%）是失明的主要原因。在失明患者中，白内障手术覆盖率为 80.7%。在白内障致盲患者中，白内障手术的主要障碍是缺乏意识（38.1%）。
与中国其他 RAAB 研究相比，呼和浩特市经年龄标准化后的失明患病率较低。白内障是导致失明的主要原因。这些发现为内蒙古公共医疗服务规划提供了有用的信息。
