Zhang Y, Jin S S, Wang J, Wang N L
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing 100730, China.
Zhonghua Yan Ke Za Zhi. 2024 Oct 11;60(10):813-821. doi: 10.3760/cma.j.cn112142-20231021-00180.
To investigate the changes in prevalence and causes of blindness and visual impairment over six years among rural populations aged 30 and above in Yongnian County, Handan City, Hebei Province, a pilot area in northern China for blindness prevention and treatment, and to study the incidence of common blinding eye diseases. This population-based prospective cohort study included a baseline survey conducted from 2006 to 2007 using stratified cluster sampling, targeting 6 830 Han Chinese individuals aged 30 and above, with a response rate of 90.4%, and a follow-up survey conducted from 2012 to 2013 with 5 394 participants, maintaining a response rate of 85.3%. Visual impairment was defined according to World Health Organization standards as visual acuity<20/60 but ≥20/400, and blindness as visual acuity<20/400. Age-and gender-standardized prevalence rates of blindness and visual impairment, along with their 95% confidence intervals (), were estimated. The six-year incidence rates of primary glaucoma, age-related macular degeneration, and myopic maculopathy, along with their 95%, were reported. At baseline, the standardized prevalence of bilateral blindness in individuals aged 30 and above was 0.6% (41/6 799) for presenting visual acuity and 0.5% (31/6 799) for best-corrected visual acuity. These rates were higher than those found in the follow-up survey, 0.5% (27/5 293) and 0.3% (17/5 276). Conversely, the standardized prevalence of bilateral visual impairment increased from 4.7% (361/6 799) and 1.0% (85/6 799) at baseline to 6.5% (355/5 293) and 1.4% (74/5 276) at follow-up, respectively. The leading cause of bilateral blindness was cataract in both baseline (13/31, 41.9%) and follow-up (7/17) surveys. Other major causes included myopic retinal degeneration (5/31, 16.1% at baseline; 2/17 at follow-up), glaucoma (3/31, 9.7% at baseline; 2/17 at follow-up), and corneal opacity (3/31, 9.7% at baseline; 2/17 at follow-up). Over six years, the incidence rates for primary glaucoma, early and late age-related macular degeneration, and myopic maculopathy in individuals aged 35 and above were 1.6% (95%: 1.2%-1.9%), 4.2% (95%: 3.8%-4.7%), 0.2% (95%: 0.2%-0.3%), and 0.1% (95%: 0.0%-0.2%), respectively. The prevalence of bilateral blindness in the rural population of Yongnian County, Handan City, Hebei Province, decreased over six years due to blindness prevention and treatment efforts but remained higher than in urban areas. Meanwhile, the prevalence of bilateral visual impairment increased since the baseline survey. Cataracts continued to be the primary cause of blindness, followed by myopic retinal degeneration, glaucoma, and corneal opacity.
为调查中国北方防盲治盲试点地区河北省邯郸市永年县30岁及以上农村人口6年间盲和视力损害的患病率及病因变化，并研究常见致盲眼病的发病率。这项基于人群的前瞻性队列研究包括2006年至2007年采用分层整群抽样法进行的基线调查，目标人群为6830名30岁及以上的汉族个体，应答率为90.4%；以及2012年至2013年进行的随访调查，有5394名参与者，应答率为85.3%。视力损害根据世界卫生组织标准定义为视力<20/60但≥20/400，盲为视力<20/400。估计了盲和视力损害的年龄及性别标准化患病率及其95%置信区间（）。报告了原发性青光眼、年龄相关性黄斑变性和近视性黄斑病变的6年发病率及其95%置信区间。基线时，30岁及以上个体双眼盲的标准化患病率，按就诊视力计算为0.6%（41/6799），按最佳矫正视力计算为0.5%（31/6799）。这些患病率高于随访调查中的患病率，分别为0.5%（27/5293）和0.3%（17/5276）。相反，双眼视力损害的标准化患病率分别从基线时的4.7%（361/6799）和1.0%（85/6799）增至随访时的6.5%（355/5293）和1.4%（74/5276）。双眼盲的主要病因在基线（13/31，41.9%）和随访（7/17）调查中均为白内障。其他主要病因包括近视性视网膜变性（基线时5/31，16.1%；随访时2/17）、青光眼（基线时3/31，9.7%；随访时2/17）和角膜混浊（基线时3/31，9.7%；随访时2/17）。6年间，35岁及以上个体原发性青光眼、早发性和迟发性年龄相关性黄斑变性以及近视性黄斑病变的发病率分别为1.6%（95%置信区间：1.2% - 1.9%）、4.2%（95%置信区间：3.8% - 4.7%）、0.2%（95%置信区间：0.2% - 0.3%）和0.1%（95%置信区间：0.0% - <0.2%）。河北省邯郸市永年县农村人口双眼盲患病率因防盲治盲工作在6年间有所下降，但仍高于城市地区。同时，自基线调查以来双眼视力损害患病率有所上升。白内障仍是致盲的主要原因，其次是近视性视网膜变性、青光眼和角膜混浊。
