Jiachu Danba, Jiang Feng, Luo Li, Zheng Hong, Duo Ji, Yang Jing, Nima Yongcuo, Ling Jin, Xiao Baixiang, Bassett Ken
Kham Eye Centre, Kandze Prefecture People`s Hospital, Dartsedo, China.
Department of Preventive Ophthalmology, Zhongshan Ophthalmic Center of Sun Yat-sen University, Guangzhou, China.
BMJ Open Ophthalmol. 2018 Nov 17;3(1):e000209. doi: 10.1136/bmjophth-2018-000209. eCollection 2018.
The only population-based survey of blindness and visual impairment of a Tibetan population was conducted in the Tibet Autonomous Region in 1999.
The Rapid Assessment of Avoidable Blindness methodology was used to conduct a survey of Kandze Tibetan Autonomous Prefecture, Sichuan Province of China in the Fall 2017. Using the 2010 census, 100 clusters of 50 participants aged 50 years or older were randomly sampled using probability proportionate to size.
Among the 5000 people enumerated, 4763 were examined (95.3% response). The age-adjusted and sex-adjusted prevalence of blindness, severe visual impairment, moderate visual impairment and early visual impairment (EVI) were 1.6% (95% CI: 1.08 to 2.38)), 0.9% (95% CI:0.7 to 1.5), 5.1% (95% CI:4.4 to 5.7), and 7.45% (95% CI:6.67 to 8.2), respectively. The prevalence of blindness among Tibetans was significantly higher than that among Han Chinese (2.2% (95% CI:1.8 to 2.6) and 0.6 (95% CI:0.2 to 1.7), respectively, p<0.05). Women bore a significant excess burden of EVI compared with men (8.5% (95% CI:7.5 to 9.6) and 6.1% (95% CI:5.1 to 7.2), respectively, p<0.05). Cataract was the primary cause of blindness (39.4%) followed by macular degeneration (10.6%) and corneal opacity (5.3%).
Blindness and visual impairment in Kandze Tibetan Autonomous Prefecture is substantially less than an earlier study of a Tibetan region and now resembles other regions of China. About 58% of blindness and 67% of SVIwere avoidable, primarily by providing cataract services. Eighty-three percent of EVI was avoidable by providing refractice services throughout the region.
1999年在西藏自治区开展了唯一一项基于人群的藏族失明和视力损害调查。
2017年秋季，采用可避免失明快速评估方法对中国四川省甘孜藏族自治州进行了一项调查。利用2010年人口普查数据，采用按规模大小成比例的概率抽样方法，随机抽取了100个群组，每个群组有50名50岁及以上的参与者。
在被调查的5000人中，4763人接受了检查（应答率为95.3%）。经年龄和性别调整后的失明、严重视力损害、中度视力损害和早期视力损害（EVI）患病率分别为1.6%（95%可信区间：1.08至2.38）、0.9%（95%可信区间：0.7至1.5）、5.1%（95%可信区间：4.4至5.7）和7.45%（95%可信区间：6.67至8.2）。藏族的失明患病率显著高于汉族（分别为2.2%（95%可信区间：1.8至2.6）和0.6（95%可信区间：0.2至1.7），p<0.05）。与男性相比，女性的EVI负担明显过重（分别为8.5%（95%可信区间：7.5至9.6）和6.1%（95%可信区间：5.1至7.2），p<0.05）。白内障是失明的主要原因（39.4%），其次是黄斑变性（10.6%）和角膜混浊（5.3%）。
甘孜藏族自治州的失明和视力损害情况比早期对一个藏族地区的研究结果有显著改善，现在与中国其他地区类似。约58%的失明和67%的严重视力损害是可以避免的，主要通过提供白内障服务。通过在整个地区提供验光配镜服务，83%的早期视力损害是可以避免的。
