上海市新泾社区2型糖尿病患者盲和中重度视觉损伤的流行病学调查

摘要

目的 了解上海市新泾社区2型糖尿病人群盲和中重度视觉损伤的患病率及相关因素.方法 以人群为基础的横断面研究.2014年10月至2015年1月,对新泾社区2型糖尿病居民进行视力及眼部检查.采用整群随机抽样方法抽取22个基本抽样单位.正式现场调查之前先进行预试验.采用国际眼科学会理事会2002标准进行视力分级:中重度视觉损伤为最佳矫正视力＜0.3,且≥0.05,盲为最佳矫正视力＜0.05.并确定盲和中重度视觉损伤的主要原因.采用logistic回归分析盲和中重度视觉损伤的相关因素.结果 接受检查共2 216例.盲的患病率为0.7％(95％CI为0.35％～1.05％),中重度视觉损伤的患病率为5.2％(95％CI为4.28％～6.12％).高龄,女性,糖尿病起病年龄轻和较低的屈光力是盲和中重度视觉损伤的相关危险因素.盲166只眼,占总共4 432只眼的3.7％.白内障(39.8％)是主要的盲因,黄斑变性(18.0％)和眼球萎缩或缺失(11.4％)分列第二、第三位盲因.中重度视觉损伤376只眼,占总共4432只眼的8.5％.中重度视觉损伤首要原因为白内障(65.7％),其次为糖尿病性视网膜病变(9.8％)和黄斑变性(9.4％).结论 我国2型糖尿病人群的盲和中重度视觉损伤患病率仍较高.%Objective To investigate the prevalence,underlying causes and risk factors of moderate or severe visual impairment and blindness in a population with type 2 diabetes in Xinjing Town,Shanghai,China.Methods A cross-sectional survey among local Han adult residents,who were previously diagnosed as type 2 diabetes,was conducted between October 2014 and January 2015.The survey was preceded by a pilot study;operational methods were refined and quality assurance evaluation was carried out.The best corrected visual acuity was recorded and classified following the modified World Health Organization grading system.Assigned ophthalmic doctors assured the leading causes of every blind or visually impaired eye.Binary logistic regression analysis was used to determine the related factors of blindness and moderate or severe visual impairment.Results A total of 2 216 type 2 diabetic residents were enrolled,and 166 eyes (3.7％,166/4 432) were blind.Cataract was the leading cause of blindness (39.8％);macular degeneration (18.0％) and eyeball atrophy (11.4％) were the second and third leading causes of blindness,respectively.Moderate or severe visual impairment was found in 376 eyes (8.5％,376/4 432),and the most frequent cause was cataract (65.7％),followed by diabetic retinopathy (9.8％) and macular degeneration (9.4％).Older age,female gender,earlier onset diabetes and a lower spherical equivalent in the better eye were associated with best corrected visual acuity＜20/63 in the better eye.Conclusion The prevalences of moderate or severe visual impairment and blindness in our population with type 2 diabetes were high.