State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China.
Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China.
Br J Ophthalmol. 2023 Aug;107(8):1190-1196. doi: 10.1136/bjophthalmol-2021-320892. Epub 2022 Apr 22.
To report the 6-year incidence, causes and risk factors for vision loss (visual impairment (VI) and blindness), among elderly adults in rural southern China.
Population-based, cohort study. Initiated in 2014, the study recruited participants aged 50 and older using random cluster sampling from Yangxi County. All eligible participants were invited to attend interviews and comprehensive eye examinations at the 6-year follow-up between November 2020 and March 2021. The WHO categories of vision loss were used to define incident cases of VI (3/60≤VA <6/12), moderate-to-severe VI (MSVI) (3/60≤VA<6/18) and blindness (VA <3/60) in the better-seeing eye.
Among the 5825 baseline participants, 3187 (64.4%) of 4946 surviving subjects participated in the 6-year follow-up. Based on presenting and best-corrected VA, respectively, the crude incidence rate of blindness was 0.8% (95% CI 0.5% to 1.1%) vs 0.3% (95% CI 0.1% to 0.5%), for MSVI 6.7% (95% CI 5.7% to 7.6%) vs 4.6% (95% CI 3.8% to 5.4%) and for any VI 16.1% (95% CI 14.5% to 17.6%) vs 12.9% (95% CI 11.6% to 14.1%). Cataract (48.3%) and refractive errors (44.4%) were the most common causes of vision loss. Factors significantly associated with greater incident vision loss were older age, female sex, less education, living alone and longer axial length (all p<0.05).
Substantial work is still required to reduce avoidable vision loss in rural China. Screening outreach and efforts to improve awareness which target the poorer and less educated are urgently needed to reduce the growing unmet need for eye care due to ageing.
报告中国南方农村地区老年人在 6 年内视力丧失（视力障碍（VI）和失明）的发生率、原因和危险因素。
基于人群的队列研究。该研究于 2014 年启动，采用随机聚类抽样从阳西县招募 50 岁及以上的参与者。所有符合条件的参与者均被邀请在 2020 年 11 月至 2021 年 3 月的 6 年随访期间参加访谈和全面眼部检查。使用世界卫生组织（WHO）视力丧失类别来定义在较好眼视力中 VI（3/60≤VA<6/12）、中度至重度 VI（MSVI）（3/60≤VA<6/18）和失明（VA<3/60）的新发病例。
在 5825 名基线参与者中，4946 名存活受试者中有 3187 名（64.4%）参加了 6 年随访。基于就诊时和最佳矫正视力，失明的粗发生率分别为 0.8%（95%CI 0.5%至 1.1%）和 0.3%（95%CI 0.1%至 0.5%），MSVI 分别为 6.7%（95%CI 5.7%至 7.6%）和 4.6%（95%CI 3.8%至 5.4%），任何 VI 分别为 16.1%（95%CI 14.5%至 17.6%）和 12.9%（95%CI 11.6%至 14.1%）。白内障（48.3%）和屈光不正（44.4%）是视力丧失的最常见原因。与视力丧失发生率较高显著相关的因素是年龄较大、女性、受教育程度较低、独居和眼轴较长（均 p<0.05）。
在中国农村地区，仍需要开展大量工作来减少可避免的视力丧失。迫切需要开展筛查外展和提高意识的工作，以针对贫困人口和教育程度较低的人群，减少由于人口老龄化而导致的日益增长的未满足的眼保健需求。
