上海市盲童学校学生视力状况及致盲原因调查分析

摘要

Objective To determine the causes of severe visual impairment and blindness (SVI/BL) among students in a school for the blind in Shanghai with a view to promote the control of childhood blindness and low vision.Methods A cross-sectional investigation of 163 students was conducted in April 2010.The data were included in the self-designed survey form from World Health Organization/Prevention of Blindness (WHO/PBL) eye examination record system,which includes classifications and etiological categories for visual impairment and blindness,and classifications of the affected anatomic sites of the eye involved in visual impairment and blindness.Distance uncorrected and corrected visual acuity were measured.Autorefraction and subjective refraction were performed if needed.The anterior segment was examined using a handheld slit lamp.The posterior segment was examined by ophthalmoscopy.Number were counted and measured with percentage.Results Of the 163 students,19.6％ were severe visual impairment,54.6％ were blindness,21.5％ had moderate visual impairment and 4.3％ were mildly impaired.The leading etiological causes of SVI/BL were congenital and hereditary factors (37.2％).The anatomical site for SVI/BL was the retina in 41.3％ of the students.The main disease causing SVI/BL was retinopathy of prematurity (ROP) (18.2％).Blinding disease was considered as "avoidable" in 64 studnets (52.9％),of which 29 cases (24.0％) were preventable,and 35 cases (28.9％) were treatable.The main treatable disease in moderate visual impairment was congenital cataract (15 cases,42.9％).Conclusion The pattern of childhood blindness in Shanghai is similar to that seen in other developed countries.It is recommended to move more quickly to establish a reliable ROP screening and treatment network,and vigorously promote low vision rehabilitation.%目的 调查上海市盲童学校(以下简称盲校)儿童视力状况及致盲原因,为防治儿童盲提 供依据.方法 横断面研究.根据世界卫生组织防盲计划(WHO/PBL)儿童盲与低视力检查记录表和工作手册自制调查表,于2010年4月对上海市盲校163名学生进行调查,采用标准对数视力表检查裸眼远视力和最佳矫正远视力,部分儿童辅以电脑验光和主觉验光；采用裂隙灯和眼底镜进行眼前段和眼底检查.数据录入后,按WHO/PBL标准定义进行视力损害分级,并分析盲和严重视力损害的原因.对数据进行分类计数,求百分比.结果 163名盲校儿童中,盲89人(54.6％),严重视力损害者32人(19.6％),一般视力损害者35人(21.5％),视力无损害者7人(4.3％).盲及严重视力损害儿童致盲主要原因为先天性和遗传性因素(37.2％),致盲首要解剖部位为视网膜(41.3％),首要病因是早产儿视网膜病变(ROP)(18.2％).可避免性盲64例(52.9％),其中可预防盲29例(24.0％),可治疗性盲35例(28.9％).导致一般视力损害的主要病因是先天性白内障(15例,42.9％).结论 上海市盲校儿童盲和严重视力损害儿童致盲原因构成已与其他发达国家和地区相似,ROP是主要致盲原因,建议加快建立健全ROP筛查与诊治网络,并大力推进低视力康复工作.