Klein R, Wang Q, Klein B E, Moss S E, Meuer S M
Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison.
Invest Ophthalmol Vis Sci. 1995 Jan;36(1):182-91.
To investigate the relationship of age-related maculopathy, cataract, and glaucoma to visual acuity in the population-based Beaver Dam Eye Study.
A cross-sectional, population-based study was performed in people 43 through 86 years of age residing in Beaver Dam, Wisconsin, who were identified between 1987 and 1988 and examined (n = 4926) between 1988 and 1990. Of those who participated, 99.4% were white. Visual acuity was measured (n = 4886) using a modification of the Early Treatment Diabetic Retinopathy Study protocol. Stereoscopic color fundus photographs and slit lamp and retroillumination photographs of the lens were graded in a masked fashion using standardized protocols to determine the presence of age-related maculopathy and central cataract.
Fifty-seven percent of those who were legally blind had late age-related maculopathy in both eyes. The frequency of visual acuity of 20/200 or worse was not significantly different in eyes with exudative macular degeneration (48%) than in eyes with pure geographic atrophy (42%). While controlling for other factors (age, central cataract, and glaucoma) in participants with both gradable age-related maculopathy and visual acuity measurable in at least one eye (n = 4716), investigators found that each of the early age-related maculopathy lesions was associated with a decrease in visual acuity of approximately two letters or fewer when compared to eyes without these lesions. Late age-related maculopathy was associated with a decrease of approximately seven lines of letters read correctly.
These data demonstrate that exudative macular degeneration and pure geographic atrophy are the most important causes of legal blindness in this population and that early age-related maculopathy, central cataract, and glaucoma had a small effect on visual acuity.
在基于人群的比弗代姆眼研究中，调查年龄相关性黄斑病变、白内障和青光眼与视力之间的关系。
对居住在威斯康星州比弗代姆、年龄在43至86岁之间的人群进行了一项横断面、基于人群的研究。这些人于1987年至1988年被确定，并于1988年至1990年接受检查（n = 4926）。参与研究的人中，99.4%为白人。使用改良的早期糖尿病视网膜病变研究方案测量视力（n = 4886）。立体彩色眼底照片以及晶状体的裂隙灯和后照法照片采用标准化方案进行盲法分级，以确定年龄相关性黄斑病变和中心性白内障的存在情况。
法定盲患者中有57%双眼患有晚期年龄相关性黄斑病变。渗出性黄斑变性患者的眼睛（48%）视力为20/200或更差的频率与单纯地图样萎缩患者的眼睛（42%）相比，无显著差异。在年龄相关性黄斑病变可分级且至少一只眼睛视力可测量的参与者中（n = 4716），在控制其他因素（年龄、中心性白内障和青光眼）后，研究人员发现，与没有这些病变的眼睛相比，每种早期年龄相关性黄斑病变均与视力下降约两个字母或更少相关。晚期年龄相关性黄斑病变与正确读出的字母行数减少约七行相关。
这些数据表明，渗出性黄斑变性和单纯地图样萎缩是该人群法定盲的最重要原因，并表明早期年龄相关性黄斑病变、中心性白内障和青光眼对视力的影响较小。
