Sun Ruizhu, Huang Dan, Liu Zhenxing, Zhu Tingting, Gu Zheyao, Ma Ge, Wang Yun, Zhang Chunyuan, Luo Xiangying, Tang Zhigang, Xi Ting, Xie Fangfei
Department of Ophthalmology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, 242 Guangji Road, Suzhou, Jiangsu 215008, China.
Physical Examination Center, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, 242 Guangji Road, Suzhou, Jiangsu 215008, China.
J Ophthalmol. 2022 Dec 20;2022:2885738. doi: 10.1155/2022/2885738. eCollection 2022.
To evaluate the prevalence, causes, and risk factors of presenting visual impairment (PVI) and presenting blindness among adults in Suzhou, China.
A total of 43927 subjects were included in this cross-sectional study. Each subject underwent ophthalmic examinations, including presenting visual acuity (PVA), intraocular pressure (IOP), slit-lamp examination, and fundus examination under the small pupils of each eye.
Using the World Health Organization (WHO) definition, the prevalence of bilateral PVI, bilateral presenting blindness, monocular PVI, and monocular presenting blindness was 1.59% (95% CI, 1.51-1.67), 0.002% (95% CI, 0.0019-0.0021), 3.87% (95% CI, 3.68-4.06), and 0.19% (95% CI, 0.18-0.20), respectively. Using the United States (US) definition, the prevalence of bilateral PVI, bilateral presenting blindness, monocular PVI, and monocular presenting blindness was 5.83% (95% CI, 5.54-6.12), 0.04% (95% CI, 0.038-0.042), 7.43% (95% CI, 7.06-7.80), and 0.45% (95% CI, 0.43-0.47), respectively. The prevalence of PVI was higher in females (WHO criteria, 2.06%, 95% CI, 1.96-2.16; US criteria, 7.27%, 95% CI, 6.91-7.63) than in males (WHO criteria, 1.2%, 95 CI%, 1.14-1.26; US criteria, 4.65%, 95% CI, 4.42-4.89). The leading cause of PVI is an uncorrected refractive error, followed by cataracts and age-related macular degeneration (AMD). Multivariate analysis proved that the prevalence of visual impairment (PVA, better eye, WHO criteria) increased significantly with older age, higher mean arterial pressure (MAP), higher globulin level, and higher fasting blood glucose (FBG). In addition, it also increased significantly with lower hemoglobin, a lower body mass index (BMI), and a lower arterial stiffness index. In this study, serum creatinine, blood urea nitrogen, uric acid, triglycerides, and the systemic immune-inflammation index (SII) showed no association with visual impairment.
The leading causes of PVI in Suzhou were uncorrected refractive error and cataracts. The prevalence of PVI increased with females, older age, higher MAP, higher FBG, higher globulin, lower hemoglobin, lower BMI, and lower arterial stiffness index.
评估中国苏州成年人中现患视力损害（PVI）和现患失明的患病率、病因及危险因素。
本横断面研究共纳入43927名受试者。每位受试者均接受眼科检查，包括每只眼睛小瞳孔下的现患视力（PVA）、眼压（IOP）、裂隙灯检查和眼底检查。
采用世界卫生组织（WHO）的定义，双眼PVI、双眼现患失明、单眼PVI和单眼现患失明的患病率分别为1.59%（95%CI，1.51 - 1.67）、0.002%（95%CI，0.0019 - 0.0021）、3.87%（95%CI，3.68 - 4.06）和0.19%（95%CI，0.18 - 0.20）。采用美国（US）的定义，双眼PVI、双眼现患失明、单眼PVI和单眼现患失明的患病率分别为5.83%（95%CI，5.54 - 6.12）、0.04%（95%CI，0.038 - 0.042）、7.43%（95%CI，7.06 - 7.80）和0.45%（95%CI，0.43 - 0.47）。女性PVI的患病率（WHO标准，2.06%，95%CI，1.96 - 2.16；US标准，7.27%，95%CI，6.91 - 7.63）高于男性（WHO标准，1.2%，95%CI，1.14 - 1.26；US标准，4.65%，95%CI，4.42 - 4.89）。PVI的主要病因是未矫正的屈光不正，其次是白内障和年龄相关性黄斑变性（AMD）。多因素分析证明，视力损害（PVA，较好眼，WHO标准）的患病率随年龄增长、平均动脉压（MAP）升高、球蛋白水平升高和空腹血糖（FBG）升高而显著增加。此外，它还随血红蛋白降低、体重指数（BMI）降低和动脉僵硬度指数降低而显著增加。在本研究中，血清肌酐、血尿素氮、尿酸、甘油三酯和全身免疫炎症指数（SII）与视力损害无关联。
苏州PVI的主要病因是未矫正的屈光不正和白内障。PVI的患病率随女性、年龄增长、MAP升高、FBG升高、球蛋白升高、血红蛋白降低、BMI降低和动脉僵硬度指数降低而增加。
