Klein R, Klein B E, Lee K E
Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison, USA.
Ophthalmology. 1996 Aug;103(8):1169-78. doi: 10.1016/s0161-6420(96)30526-5.
To describe the change in visual acuity over a 5-year period in persons participating in a large population-based study.
Best-corrected visual acuity was measured, after refraction, with logMAR charts using a modification of the Early Treatment Diabetic Retinopathy Study protocol in 3684 persons living in Beaver Dam, Wisconsin, who ranged in age from 43 to 86 years at the time of a baseline examination from 1988 to 1990, and at a follow-up examination from 1993 to 1995.
The change in the number of letters read correctly over the 5-year period varied from 0.4 +/- 4.9 (mean +/- standard deviation) in people between 43 and 54 years of age to -5.2 +/- 15.4 in people 75 years of age or older at baseline. Over the 5-year period, vision became impaired (20/40 or worse in the better eye) in 2.9% of the population and severely impaired (20/200 or worse in the better eye) in 0.3%. The visual angle doubled in 1.7% of the population, and 2.4% had improved vision. People 75 years of age or older at baseline were 12.5 times (95% confidence interval [Cl], 8.6-18.2; P < 0.001) more likely to have impaired vision, 9.7 times (95% Cl, 5.9-16.0; P < 0.001) more likely to have doubling of the visual angle, and 78 times more likely (95% Cl, 9.9-614.1; P < 0.001) to have severe visual impairment than people younger than 75 years of age at baseline. People 75 years of age or older who were living in nursing homes or group homes were 3.8 times more likely to have impaired vision, 3.3 times more likely to have severely impaired vision, and 5.7 times more likely to have a doubling of the visual angle than those not residing in a nursing home or a group home.
These data provide precise population-based estimates of incidence of visual loss over a wide spectrum of ages and show that decreased visual acuity in people 75 years of age is a common finding, especially in those who are in nursing homes or group homes.
描述参与一项大型人群研究的人员在5年期间视力的变化情况。
采用改良的早期糖尿病视网膜病变研究方案，使用对数最小分辨角对数视力表，在威斯康星州比弗戴尔的3684名年龄在43至86岁之间的人群中测量最佳矫正视力。这些人在1988年至1990年进行基线检查时测量视力，在1993年至1995年进行随访检查时再次测量视力。
在5年期间，43至54岁人群正确读出字母数的变化为0.4±4.9（平均值±标准差），而基线时75岁及以上人群的变化为-5.2±15.4。在5年期间，2.9%的人群视力受损（较好眼视力为20/40或更差），0.3%的人群视力严重受损（较好眼视力为20/200或更差）。1.7%的人群视角翻倍，2.4%的人群视力有所改善。基线时75岁及以上的人群视力受损的可能性是75岁以下人群的12.5倍（95%置信区间[CI]，8.6-18.2；P<0.001），视角翻倍的可能性是75岁以下人群的9.7倍（95%CI，5.9-16.0；P<0.001），严重视力损害的可能性是75岁以下人群的78倍（95%CI，9.9-614.1；P<0.001）。与不住在养老院或集体宿舍的75岁及以上人群相比，住在养老院或集体宿舍的75岁及以上人群视力受损的可能性高3.8倍，视力严重受损的可能性高3.3倍，视角翻倍的可能性高5.7倍。
这些数据提供了基于人群的、涵盖广泛年龄范围的视力丧失发病率的精确估计，并表明75岁人群视力下降是常见现象，尤其是在住在养老院或集体宿舍的人群中。
