Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China.
Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China.
Acta Ophthalmol. 2021 Mar;99(2):e136-e143. doi: 10.1111/aos.14523. Epub 2020 Jun 29.
To estimate the prevalence, causes and risk factors of bilateral visual impairment in rural areas of Tianjin, China.
A large population-based, cross-sectional study. A stratified random cluster sampling method was used to investigate 12 233 participants in all age groups living in rural Tianjin. Participants completed questionnaires and received professional ophthalmology examinations.
According to World Health Organization best-corrected visual acuity (BCVA) criteria, the crude prevalence of bilateral visual impairment (BCVA < 20/63), bilateral low vision (BCVA < 20/63 to ≥20/400) and bilateral blindness (BCVA < 20/400) was 2.53%, 2.40% and 0.14% (age- and gender-standardized prevalence was 1.86%, 1.76% and 0.11%). The prevalence increased with age and was higher in women than men. The most common causes of bilateral visual impairment in the total population were cataract (48.39%), refractive error/amblyopia (17.74%), age-related macular degeneration (AMD) (10.00%), diabetic retinopathy (5.81%) and glaucoma (3.87%). For participants younger than 50 years, refractive error/amblyopia was the leading cause of low vision and blindness, while cataract was the major cause in the participants over 50. Female gender, older age and self-reported diabetes were associated with increased risks of visual impairment.
The age- and gender-standardized prevalence of low vision, especially in the older group (50+), was higher in this study compared with previous studies in China. Refractive error/amblyopia was the leading cause of bilateral visual impairment in younger group, while cataract was the primary cause in the older group. These findings will provide useful information for planning comprehensive eye healthcare programmes in China.
估计中国天津市农村地区双侧视力损害的患病率、病因和危险因素。
这是一项大型基于人群的横断面研究。采用分层随机聚类抽样方法，调查了天津市农村地区所有年龄段的 12233 名参与者。参与者完成了问卷调查并接受了专业的眼科检查。
根据世界卫生组织最佳矫正视力（BCVA）标准，双侧视力损害（BCVA<20/63）、双侧低视力（BCVA<20/63 至≥20/400）和双侧盲（BCVA<20/400）的粗患病率分别为 2.53%、2.40%和 0.14%（年龄和性别标准化患病率分别为 1.86%、1.76%和 0.11%）。患病率随年龄增长而增加，女性高于男性。总人群中双侧视力损害的最常见病因是白内障（48.39%）、屈光不正/弱视（17.74%）、年龄相关性黄斑变性（AMD）（10.00%）、糖尿病视网膜病变（5.81%）和青光眼（3.87%）。对于 50 岁以下的参与者，屈光不正/弱视是低视力和失明的主要原因，而白内障是 50 岁以上参与者的主要原因。女性、年龄较大和自我报告的糖尿病与视力损害风险增加相关。
与中国以前的研究相比，本研究中年龄和性别标准化的低视力患病率，尤其是在年龄较大的（50+）组中更高。在年轻组中，屈光不正/弱视是双侧视力损害的主要原因，而在老年组中，白内障是主要原因。这些发现将为中国规划全面的眼保健计划提供有用信息。
