Klaver C C, Wolfs R C, Vingerling J R, Hofman A, de Jong P T
Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands.
Arch Ophthalmol. 1998 May;116(5):653-8. doi: 10.1001/archopht.116.5.653.
To study the prevalence and causes of blindness and visual impairment in various age categories of a large population-based study.
For the study, 6775 subjects aged 55 years or older underwent an extensive ophthalmologic screening examination, including measurements of visual acuity and the visual field and fundus photography. The causes of blindness or visual impairment were determined using all screening information and medical records.
The prevalence of blindness, according to World Health Organization criteria, ranged from 0.1% in subjects aged 55 to 64 years to 3.9% in subjects aged 85 years or older; the prevalence of visual impairment ranged from 0.1% to 11.8%. For persons younger than 75 years, myopic degeneration and optic neuropathy were the most important causes of impaired vision. For persons aged 75 years or older, age-related macular degeneration was the major cause of the increased prevalence of blindness, whereas age-related cataract predominantly caused the increased prevalence of visual impairment.
The hierarchy of causes of blindness and visual impairment is highly determined by age. As yet, little can be done to reduce the exponential increase of blindness; however, adequate implementation of surgery to treat cataract could reduce visual impairment by one third. Underuse of ophthalmologic care is a prominent cause of the high frequency of untreated cataracts among the elderly.
在一项基于大规模人群的研究中，研究不同年龄组失明和视力损害的患病率及病因。
在该研究中，6775名55岁及以上的受试者接受了全面的眼科筛查检查，包括视力、视野测量和眼底照相。利用所有筛查信息和病历确定失明或视力损害的病因。
根据世界卫生组织标准，失明患病率在55至64岁受试者中为0.1%，在85岁及以上受试者中为3.9%；视力损害患病率在0.1%至11.8%之间。对于75岁以下的人，近视性变性和视神经病变是视力受损的最重要原因。对于75岁及以上的人，年龄相关性黄斑变性是失明患病率增加的主要原因，而年龄相关性白内障主要导致视力损害患病率增加。
失明和视力损害的病因层级很大程度上由年龄决定。目前，几乎无法减少失明人数的指数增长；然而，充分实施白内障手术可将视力损害降低三分之一。眼科护理利用不足是老年人白内障未治疗率高的一个突出原因。
