Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, India; Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute Banjara Hills, Hyderabad, India; University of Rochester, School of Medicine and Dentistry, Rochester, New York, USA.
Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, India; Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute Banjara Hills, Hyderabad, India.
Am J Ophthalmol. 2021 Mar;223:322-332. doi: 10.1016/j.ajo.2020.09.035. Epub 2020 Sep 29.
To report 15-year incidence rate of visual loss (blindness and visual impairment [VI]), causes, and risk factors for participants in Andhra Pradesh Eye Disease Study III (APEDS III).
Population-based cohort study.
From 2012 to 2016, all rural participants were interviewed and underwent a comprehensive eye examination, including dilated fundus examination and imaging. Presenting visual acuity (PVA) and best-corrected visual acuity (BCVA) were measured using a standard logarithm of Minimum Angle of Resolution chart at 3 meters. World Health Organization (WHO) and United States of America (USA) categories of VI and blindness were used. Incident visual loss was defined as the development of or worsening of visual loss of one or more categories.
In APEDS I, 7,771 rural participants were examined using stratified, random-cluster systematic sampling; in APEDS III, 5,395 participants (69.4% of rural or 52.4% of total participants) were re-examined. Using WHO categories, the crude incidence rate of any visual loss based on PVA and BCVA were 14.6 (95% confidence interval [CI]:13.6-15.7) and 6.3 (95% CI: 6.1-6.4) per 100 person-years, respectively. Using USA criteria, the values were 22.6 (95% CI: 22.3-23.0) and 10.6 (95% CI: 10.3-10.8) per 100 person-years, respectively. More than 90% of visual loss was attributable to cataract and uncorrected refractive error. Using WHO categories, significant independent risk factors for the incident visual loss were increasing age, female gender, illiteracy, past or current smoker, and current use of alcohol. Using the USA definition, an additional risk factor was lower level of education.
The high incidence likely reflects poor access to eye care in this population, which needs to be taken into account when planning eye care programs.
报告安得拉邦眼病研究 III（APEDS III）参与者 15 年的视力丧失（失明和视力障碍[VI]）发生率、原因和危险因素。
基于人群的队列研究。
2012 年至 2016 年，对所有农村参与者进行访谈并进行全面眼科检查，包括眼底散瞳检查和影像学检查。使用标准的最小角分辨率对数图表在 3 米处测量眼前视力（PVA）和最佳矫正视力（BCVA）。使用世界卫生组织（WHO）和美国（USA）的 VI 和失明分类。新发视力丧失定义为一个或多个类别视力丧失的发展或恶化。
在 APEDS I 中，使用分层、随机聚类系统抽样检查了 7771 名农村参与者；在 APEDS III 中，5395 名参与者（农村的 69.4%或总参与者的 52.4%）接受了重新检查。使用 WHO 分类，基于 PVA 和 BCVA 的任何视力丧失的粗发生率分别为 14.6（95%置信区间[CI]：13.6-15.7）和 6.3（95%CI：6.1-6.4）每 100 人年。使用美国标准，相应的值分别为 22.6（95%CI：22.3-23.0）和 10.6（95%CI：10.3-10.8）每 100 人年。超过 90%的视力丧失归因于白内障和未经矫正的屈光不正。使用 WHO 分类，视力丧失新发的独立危险因素为年龄增长、女性、文盲、过去或现在的吸烟者以及当前饮酒者。使用美国定义，另一个危险因素是较低的教育水平。
发病率高可能反映了该人群获得眼保健的机会有限，在规划眼保健计划时需要考虑到这一点。
