Thapa Raba, Bajimaya Sanyam, Paudyal Govinda, Khanal Shankar, Tan Stevie, Thapa Suman S, van Rens G H M B
Vitreo-retina Service, Tilganga Institute of Ophthalmology, P O Box 561, Kathmandu, Nepal.
Central Department of Statistics, Tribhuvan University, Kirtipur, Nepal.
BMC Ophthalmol. 2018 Feb 13;18(1):42. doi: 10.1186/s12886-018-0710-9.
This study aims to explore the prevalence and causes of low vision and blindness focused on retinal disease in a population above 60 years in Nepal.
Two thousand one hundred subjects were enrolled in a population-based cross-sectional study. History, presenting and best corrected visual acuity after subjective refraction, anterior and posterior segment examinations was obtained in detail.
Among the total subjects, 1860 (88.57%) had complete information. Age varies from 60 to 95 (mean age: 69.64 ± 7.31) years. Low vision and blindness in both eyes at presentation was found in 984 (52.90%, 95% confidence interval (CI): 50.60-55.19) and 36 (1.94%, 95% CI: 1.35-2.66) subjects respectively. After best correction, bilateral low vision and blindness was found in 426 (22.92%, 95% CI: 21.01-24.88), and 30 (1.61%, 95% CI: 0.10-2.30) subjects respectively. As compared to 60-69 years old, risk of visual impairment was four times higher (95% CI:3.26-5.58) in the 70-79 year olds and 14 times higher (95% CI: 9.72-19.73) in the age group 80 years and above. Major causes of bilateral low vision were cataract (68.07%), followed by retinal disorders (28.64%), and for blindness; retinal disorders (46.66%), followed by cataract (43.33%). Illiteracy was significantly associated with visual impairment.
Among the elderly population, prevalence of visual impairment was high. Refractive error, cataract and retinal disorders were the major cause of low vision. Screening the population at the age 60 years and above, focused on cataract and posterior segment diseases, providing glasses and timely referral can help reduce visual impairment.
本研究旨在探讨尼泊尔60岁以上人群中以视网膜疾病为主的低视力和失明的患病率及病因。
2100名受试者参与了一项基于人群的横断面研究。详细记录了病史、主观验光后的现患视力和最佳矫正视力、眼前节和眼后节检查情况。
在所有受试者中，1860名（88.57%）有完整信息。年龄范围为60至95岁（平均年龄：69.64±7.31岁）。初诊时双眼低视力和失明的受试者分别有984名（52.90%，95%置信区间（CI）：50.60 - 55.19）和36名（1.94%，95% CI：1.35 - 2.66）。最佳矫正后，双眼低视力和失明的受试者分别有426名（22.92%，95% CI：21.01 - 24.88）和30名（1.61%，95% CI：0.10 - 2.30）。与60 - 69岁人群相比，70 - 79岁人群视力损害风险高4倍（95% CI：3.26 - 5.58），80岁及以上年龄组高14倍（95% CI：9.72 - 19.73）。双眼低视力的主要病因是白内障（68.07%），其次是视网膜疾病（28.64%）；失明的主要病因是视网膜疾病（46.66%），其次是白内障（43.33%）。文盲与视力损害显著相关。
在老年人群中，视力损害患病率较高。屈光不正、白内障和视网膜疾病是低视力的主要原因。对60岁及以上人群进行筛查，重点关注白内障和眼后节疾病，提供眼镜并及时转诊有助于降低视力损害。
