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印度北部克什米尔地区不可逆性盲的病因谱。

Etiological spectrum of irreversible blindness in Kashmir in North India.

机构信息

Department of Ophthalmology, Govt. Medical College, Srinagar, Jammu and Kashmir, India.

出版信息

Indian J Ophthalmol. 2021 Oct;69(10):2630-2636. doi: 10.4103/ijo.IJO_3818_20.

Abstract

PURPOSE

To determine the etiological spectrum of irreversible blindness in Kashmir Valley in India.

METHODS

Patients presenting to a tertiary care hospital in Kashmir, India, with unilateral or bilateral blindness from April 2019 to March 2020 were included in this cross-sectional study. Blindness was defined using the World Health Organization (WHO) criteria. All subjects had a complete ophthalmologic examination and information was gathered regarding their demographic profile, nature of ocular disorder whether primary or secondary and laterality, if the ocular involvement was unilateral.

RESULTS

248 patients were enrolled in the study. The mean age of the patients was 57.17 years. The male: female ratio was 2.17:1. The commonest cause of unilateral or bilateral blindness was glaucoma (22.58%) followed by diabetic retinopathy (DR) (17.74%). Unilateral blindness was seen in 78.62% of the patients. Unilateral blindness occurred mainly due to glaucoma (16.41%), DR (14.87%), age-related macular degeneration (13.33%), and trauma (pellet injury: 10.76%, non-pellet injury: 10.25%). The major causes of bilateral blindness were glaucoma (45.28%), DR (28.30%), and hereditary/congenital retinal diseases (16.98%). Socioeconomic status and educational status were significantly associated (P < 0.05 each) while age, gender, place of residence, and occupation were not significantly associated (P > 0.05 each) with the number of eyes affected by blindness.

CONCLUSION

Glaucoma and DR are the foremost causes of irreversible blindness in Kashmir. Public health plans aimed at encouraging good health education of patients should be developed in this region. Moreover, patients should be screened effectively for glaucoma and diabetes at the level of primary health care facilities.

摘要

目的

确定印度克什米尔山谷不可逆性失明的病因谱。

方法

本横断面研究纳入了 2019 年 4 月至 2020 年 3 月期间在印度克什米尔一家三级保健医院就诊的单侧或双侧失明患者。失明采用世界卫生组织(WHO)标准进行定义。所有患者均接受了全面的眼科检查,并收集了他们的人口统计学特征、眼部疾病的性质(原发性或继发性)以及单侧或双侧受累的情况。

结果

本研究共纳入 248 例患者。患者的平均年龄为 57.17 岁,男女比例为 2.17:1。单侧或双侧失明的最常见原因是青光眼(22.58%),其次是糖尿病视网膜病变(DR)(17.74%)。78.62%的患者出现单侧失明。单侧失明主要由青光眼(16.41%)、DR(14.87%)、年龄相关性黄斑变性(13.33%)和外伤(弹丸伤:10.76%,非弹丸伤:10.25%)引起。双侧失明的主要原因是青光眼(45.28%)、DR(28.30%)和遗传性/先天性视网膜疾病(16.98%)。社会经济地位和教育程度显著相关(P < 0.05),而年龄、性别、居住地和职业与失明眼数均无显著相关(P > 0.05)。

结论

青光眼和 DR 是克什米尔不可逆性失明的首要原因。应在该地区制定旨在鼓励患者进行良好健康教育的公共卫生计划。此外,应在初级卫生保健设施层面有效筛查青光眼和糖尿病患者。

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本文引用的文献

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The genetics of angle closure glaucoma.闭角型青光眼的遗传学。
Exp Eye Res. 2019 Dec;189:107835. doi: 10.1016/j.exer.2019.107835. Epub 2019 Oct 18.
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Immunosuppression for the Uveitides.葡萄膜炎的免疫抑制治疗。
Ophthalmology. 2018 Feb;125(2):193-202. doi: 10.1016/j.ophtha.2017.08.007. Epub 2017 Sep 20.
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Targets of Neuroprotection in Glaucoma.青光眼的神经保护靶点。
J Ocul Pharmacol Ther. 2018 Jan/Feb;34(1-2):85-106. doi: 10.1089/jop.2017.0041. Epub 2017 Aug 18.

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