Li Yanping, Yan Jianhua, Wang Zhonghao, Huang Wenyong, Huang Shengsong, Jin Ling, Zheng Yingfeng, Tan Xuhua, Yi Jinglin, Yip Jennifer, Xiao Baixiang
Outpatients Department, Affiliated Eye Hospital of Nanchang University, Nanchang, China.
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou City, China.
BMJ Open Ophthalmol. 2019 Feb 27;4(1):e000240. doi: 10.1136/bmjophth-2018-000240. eCollection 2019.
The aim of this study is to ascertain the prevalence and causes of childhood blindness and severe visual impairment (BL/SVI) in Huidong, South China.
This cross-sectional study was conducted in early 2017 in areas of 139 816 children at the age of 0-15 as the study subjects. We used the trained key informants (KIs) to do preliminary visual test in the communities and refer those children suspected with blindness or unable to count fingers with both eyes at 5 m to hospital for further examination by paediatric ophthalmologist for causes. The WHO's definition of BL/SVI was used, as blindness is best-corrected visual acuity worse than 0.05 in better eye and SVI is equal to or better than 0.05 but worse than 0.1 in better eye.
Three hundred and fourteen KIs were trained. In total, 42 children with BL/SVI were found, and among them over half (22, 52.4%) were due to posterior segment disorders by anatomic site and 18 (42.9%) children were potentially preventable; these included BL/SVI caused by factors at children's development in intrauterine and after birth. This established the prevalence of BL/SVI was at 0.31/1000 (95% CI 0.28 to 0.34/1000).
A low prevalence of childhood blindness was documented in this study. Establishment of surveillance system for disabled children including those with BL/SVI and better health education on eye care to the public according to the surveillance outcomes would help to reduce avoidable children's BL/SVI further in China.
本研究旨在确定中国南方惠东地区儿童失明及严重视力损害（BL/SVI）的患病率及病因。
这项横断面研究于2017年初在139816名0至15岁儿童所在地区开展，以这些儿童为研究对象。我们使用经过培训的关键信息提供者（KIs）在社区进行初步视力测试，将那些疑似失明或在5米处双眼无法数指的儿童转诊至医院，由儿科眼科医生进一步检查病因。采用世界卫生组织对BL/SVI的定义，即失明为最佳矫正视力在较好眼低于0.05，严重视力损害为最佳矫正视力在较好眼等于或优于0.05但低于0.1。
培训了314名关键信息提供者。总共发现42名患有BL/SVI的儿童，其中超过一半（22名，52.4%）按解剖部位归因于后段疾病，18名（42.9%）儿童的情况可能是可预防的；这些包括由宫内及出生后儿童发育相关因素导致的BL/SVI。由此确定BL/SVI的患病率为0.31/1000（95%可信区间0.28至0.34/1000）。
本研究记录了儿童失明的低患病率。建立包括患有BL/SVI儿童在内的残疾儿童监测系统，并根据监测结果对公众加强眼保健健康教育，将有助于进一步减少中国可避免的儿童BL/SVI。
