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Li C, Zhu B, Zhang J, Guan P, Zhang G, Yu H, Yang X, Liu L. Epidemiology, health policy and public health implications of visual impairment and age-related eye diseases in mainland China. Front Public Health 2022; 10:966006. [PMID: 36438305 PMCID: PMC9682104 DOI: 10.3389/fpubh.2022.966006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 10/26/2022] [Indexed: 11/10/2022] Open
Abstract
The prevalence of visual impairment (VI) and age-related eye diseases has increased dramatically with the growing aging population in mainland China. However, there is limited comprehensive evidence on the progress of ophthalmic epidemiological research in mainland China to enhance our awareness of the prevention of eye diseases to inform public health policy. Here, we conducted a literature review of the population-based epidemiology of VI and age-related eye diseases in mainland China from the 1st of January 1946 to the 20th of October 2021. No language restrictions were applied. There was significant demographic and geographic variation in the epidemic of VI and age-related eye diseases. There are several factors known to be correlated to VI and age-related eye diseases, including age, gender, family history, lifestyle, biological factors, and environmental exposures; however, evidence relating to genetic predisposition remains unclear. In addition, posterior segment eye diseases, including age-related macular degeneration and diabetic retinopathy, are amongst the major causes of irreversible visual impairments in the senile Chinese population. There remains a significant prevention gap, with only a few individuals showing awareness and achieving optimal medical care with regards to age-related eye diseases. Multiple challenges and obstacles need to be overcome, including the accelerated aging of the Chinese population, the lack of structured care delivery in many underdeveloped regions, and unequal access to care. Despite the progress to date, there are few well-conducted multi-center population-based studies following a single protocol in mainland China, which findings can hopefully provide valuable cues for governmental decision-making and assist in addressing and halting the incidence of VI and age-related eye diseases in China.
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Affiliation(s)
- Cong Li
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China,School of Medicine, South China University of Technology, Guangzhou, China
| | - Bo Zhu
- Cancer Hospital of China Medical University/Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Jie Zhang
- Department of Retina, Weifang Eye Hospital, Weifang, China
| | - Peng Guan
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Guisen Zhang
- Department of Retina, Inner Mongolia Chaoju Eye Hospital, Hohhot, China
| | - Honghua Yu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China,*Correspondence: Honghua Yu
| | - Xiaohong Yang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China,Xiaohong Yang
| | - Lei Liu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China,Lei Liu
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Chariwala RA, Shah SP, Patel D, Chaudhari SP, Gajiwala UR. Rapid Assessment of Avoidable Blindness and Willingness to Pay for Cataract Surgery in Tribal Region of Surat District of Gujarat State, India. Ophthalmic Epidemiol 2020; 28:152-159. [PMID: 32673143 DOI: 10.1080/09286586.2020.1792939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AIM To estimate prevalence and causes of avoidable blindness among people ≥50 years and to assess willingness to pay (WTP) for cataract surgery in tribal region of south Gujarat, India. METHODS A cross-sectional population based survey was conducted with 44 randomly selected clusters each having 50 people aged ≥50 years selected by probability proportional to size of sampling. Adults identified with cataract causing visual loss (<6/18) in any eye were interviewed to assess their WTP for surgery. RESULTS Total of 2137 examined out of 2200 people enumerated (response rate 97.1%). The prevalence of blindness (Presenting Visual Acuity (PVA)<3/60 in better eye) was 2.23% (95% CI: 2.95%-1.51%). Cataract was main cause of blindness (67.3%) followed by corneal scarring (8.2%). Major barrier to cataract surgery cited by bilaterally blind people was lack of escort to the surgical facility (34.3%). Cataract surgical coverage (CSC) was 84.9% (eyes) and 92% (persons). Of the 492 people interviewed to assess WTP for their surgery, only 36.4% people were willing to pay. CONCLUSION The tribal population has a high poverty profile in India. Within this group, cataract remains the main treatable cause of blindness despite a high CSC. Assessment of barriers suggested that a well-coordinated outreach programme with free transport facilities to the surgical facility is required along with strategies to improve accessibility and prioritising cataract blind in the community. One-third of people were willing to pay for their surgeries implying that cross subsidization or tier system could be feasible for eye care programme sustainability.
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Affiliation(s)
- Rohan A Chariwala
- Department of Public Health and Research in Eye Care, Tejas Eye Hospital, Divyajyoti Trust, Mandvi, Gujarat, India
| | - Shaheen P Shah
- Department of Ophthalmology, Queensland Children's Hospital, Brisbane, QLD, Australia
| | - Daksha Patel
- International Center for Eye Health (ICEH), London School of Hygiene and Tropical Medicine (LSHTM), London, UK
| | - Sheetal P Chaudhari
- Department of Public Health and Research in Eye Care, Tejas Eye Hospital, Divyajyoti Trust, Mandvi, Gujarat, India
| | - Uday R Gajiwala
- Department of Public Health and Research in Eye Care, Tejas Eye Hospital, Divyajyoti Trust, Mandvi, Gujarat, India
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Shen W, Cun Q, Zhong H, Pan CW, Li J, Chen Q. Ethnic variation in prevalence, self-reported barriers and outcome of cataract surgery in a rural population in southwestern China: the Yunnan minority eye study. BMC Public Health 2020; 20:893. [PMID: 32517668 PMCID: PMC7285510 DOI: 10.1186/s12889-020-09009-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 05/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND As a part of the Yunnan Minority Eye Studies, the purpose of this study was to determine the prevalence, barriers and visual acuity outcomes of cataract surgery in a multiethnic adult population in rural areas of southwestern China. METHODS A population-based cross-sectional survey was conducted with participants of Bai, Yi, and Han ethnicity aged ≥50 years in Yunnan. A detailed eye examination was performed. Information on the date, setting, type, and complications of cataract surgery were recorded in the examination of cataract-operated eyes. RESULTS Of 6546 subjects (2133 Bai ethnicity, 2208 Yi ethnicity and 2205 Han ethnicity), the prevalence of cataract surgery was 6.0%, with 4.6% in Bai, 7.0% in Yi, and 6.4% in Han ethnicity. Cataract Surgical coverage (CSC) among those with presenting visual acuity (PVA) < 20/200 in both eyes because of cataract was 53.3%, with 52.8% in Bai, 64.4% in Yi, and 45.3% in Han ethnicity. CSC was associated with Yi ethnicity, younger age, and higher education level, while unoperated cataract was associated with Han ethnicity, older age, and illiterate. The main barrier to cataract surgery was lack of awareness and knowledge, cost, and fear. Among the 525 cataract-operated eyes, PVA and best-corrected visual acuity (BCVA) of 20/63 or better was 44.5 and 67.2%, respectively, with 48.1 and 65.9% in Bai, 47.8 and 75.4% in Yi, 39.1 and 59.9% in Han ethnicity. Han ethnicity, aphakia, earlier year of surgery, lower-level surgical hospital and illiterate were associated with postoperative visual impairment defined by PVA, while Han ethnicity, aphakia, and illiterate were associated with that defined by BCVA. The principal causes of postoperative visual impairment were retinal disorders (26.8%), posterior capsule opacification (25.1%), refractive error(22.7%), and glaucoma (9.3%). CONCLUSIONS Han ethnicity had a lower CSC and relatively poor visual outcomes compared with ethnic minorities. Further effective effort to remove barriers and provide sight restoration is warranted.
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Affiliation(s)
- Wei Shen
- Department of Ophthalmology, the Fourth Affiliated Hospital of Kunming Medical University (the Second People's Hospital of Yunnan Province), Yunnan Eye Institute, Key Laboratory of Yunnan Province for the Prevention and Treatment of Ophthalmology, Kunming, 650032, People's Republic of China
| | - Qing Cun
- Department of Ophthalmology, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Hua Zhong
- Department of Ophthalmology, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Chen-Wei Pan
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Jun Li
- Department of Ophthalmology, the Fourth Affiliated Hospital of Kunming Medical University (the Second People's Hospital of Yunnan Province), Yunnan Eye Institute, Key Laboratory of Yunnan Province for the Prevention and Treatment of Ophthalmology, Kunming, 650032, People's Republic of China
| | - Qin Chen
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210000, People's Republic of China.
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He Y, Nie A, Pei J, Ji Z, Jia J, Liu H, Wan P, Ji M, Zhang C, Zhu Y, Wang X. Prevalence and causes of visual impairment in population more than 50 years old: The Shaanxi Eye Study. Medicine (Baltimore) 2020; 99:e20109. [PMID: 32443320 PMCID: PMC7253703 DOI: 10.1097/md.0000000000020109] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 03/29/2020] [Accepted: 03/30/2020] [Indexed: 11/13/2022] Open
Abstract
To assess the prevalence and causes of visual impairment (VI) in the elderly Chinese rural population in Shaanxi Province.A population-based, cross-sectional study design was used to determine the extent of VI in Chinese people over the age of 50 years in Shaanxi Province. Visual acuity and best-corrected visual acuity were measured using the logarithm of minimum angle of resolution chart. Blindness and low vision were defined according to WHO criteria. The major cause of VI was identified for all participants who were visually impaired.A total of 1912 residents completed a standard questionnaire and underwent a detailed eye examination, and the response rate was 90%. The overall prevalence of blindness and low vision were 1.5% and 8.2%. There was no statistically significant differences between genders in the prevalence of blindness and low vision (P > .05). The prevalence of blindness and low vision was higher among older individuals (P < .05) and lower (P < .05) among those with the highest education level. Cataract, corneal opacity, and glaucoma were considered as the main causes of blindness, which accounted for 67.9%, 10.7%, and 7.1%, respectively. Cataract, refractive error, and age-related macular degeneration were always considered as the leading causes of low vision, which accounted for 66%, 14.7%, and 5.8%, respectively.Cataract, corneal opacity, and glaucoma were the main causes of blindness and low vision in the population aged 50 years or more. The prevalence of these diseases that causes blindness and low vision was higher than that reported in other studies.
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Wang J, Leng F, Li Z, Tang X, Qian H, Li X, Zhang Y, Chen X, Du H, Liu P. Retinal vascular abnormalities and their associations with cardiovascular and cerebrovascular diseases: a Study in rural southwestern Harbin, China. BMC Ophthalmol 2020; 20:136. [PMID: 32252694 PMCID: PMC7137258 DOI: 10.1186/s12886-020-01407-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 03/27/2020] [Indexed: 11/11/2022] Open
Abstract
Background Limited data is available on retinal vessel morphology in the north China. The study aimed to evaluate the prevalence of retinal vascular abnormalities (RVAs) and investigate their associations with the self-reported diagnosis of cardiovascular and cerebrovascsular diseases (CCVds) in a rural adult population of northeast China. Methods A population-based, cross-sectional study was conducted, using the cluster random sampling method. One eye of each participant was photographed with a non-mydriatic fundus camera. RVAs including focal and general arteriolar narrowing (FAN and GAN), arteriovenous nicking (AVN), arteriolar sheathing (AS), and retinopathy were evaluated. Data on self-reported diagnosis of cardiovascular and cerebrovascular diseases and status of smoking and alcohol drinking were obtained from questionnaires. Results Among the 6267 participants with an age ≥ 50 years, photographs were obtained of 99.2%, with quality sufficient to perform retinal evaluations in 82.5%. The prevalence of FAN, AVN, AS, retinopathy and GAN were 9.1, 8.9, 5.0, 6.6 and 6.2%, respectively. All the retinal lesions were associated with hypertension (all P < 0.01). After adjusting for age, gender, and left/right eyes, hypertension, hyperlipidaemia, diabetes mellitus, habits of past or current smoking and alcohol consumption, AVN was strongly associated with the self-reported diagnosis histories of coronary heart diseases(CHD) (OR, 1.44; 95% CI, 1.09, 1.89) and retinopathy was significantly associated with a self-reported diagnosis of stroke (OR, 2.05; 95% CI, 1.18, 3.57). Conclusions The overall prevalence of retinal microvascular abnormalities in this population was relatively higher than that reported in other regions of the world. Retinopathy is associated with the self-reported diagnosis of stroke while AVN was associated with the self-reported diagnosis of CHD, but the remaining retinal lesions were not consistently associated with CCVds. Thus, an examination of retinal microvascular characteristics may offer clues to CCVds and could be a potentially novel biomarkers for CCVds risk.
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Affiliation(s)
- Junwei Wang
- Eye Hospital, First Affiliated Hospital, Harbin Medical University, Harbin, 150001, China
| | - Fei Leng
- Eye Hospital, First Affiliated Hospital, Harbin Medical University, Harbin, 150001, China
| | - Zhijian Li
- Eye Hospital, First Affiliated Hospital, Harbin Medical University, Harbin, 150001, China
| | - Xianling Tang
- Eye Hospital, First Affiliated Hospital, Harbin Medical University, Harbin, 150001, China
| | - Hua Qian
- Department of Pharmacology, College of Pharmacy, Harbin Medical University, Harbin, China
| | - Xiaoguang Li
- Department of Pharmacology, College of Pharmacy, Harbin Medical University, Harbin, China
| | - Yi Zhang
- Eye Hospital, First Affiliated Hospital, Harbin Medical University, Harbin, 150001, China
| | - Xuedong Chen
- Eye Hospital, First Affiliated Hospital, Harbin Medical University, Harbin, 150001, China
| | - Haitao Du
- Eye Hospital, First Affiliated Hospital, Harbin Medical University, Harbin, 150001, China
| | - Ping Liu
- Eye Hospital, First Affiliated Hospital, Harbin Medical University, Harbin, 150001, China.
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Deng Y, Liang Y, Lin S, Wen L, Li J, Zhou Y, Shen M, Zheng J, Feng K, Sun Y, Robert KW, Qu J, Lu F. Design and baseline data of a population-based metabonomics study of eye diseases in eastern China: the Yueqing Ocular Diseases Investigation. EYE AND VISION 2020; 7:8. [PMID: 31988968 PMCID: PMC6969972 DOI: 10.1186/s40662-019-0170-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 12/23/2019] [Indexed: 01/20/2023]
Abstract
Background China is undergoing a massive transition toward an urban and industrial economy. These changes will restructure the demographics and economy which will eventually influence the future patterns of disease. The risk factors of vision-impairing eye diseases remain ambiguous and poorly understood. Metabolomics is an ideal tool to understand and shed light on the ocular disease mechanisms for earlier treatment. This article aims to describe the design, methodology and baseline data of the Yueqing Ocular Diseases Investigation (YODI), a developed county population-based study to determine the prevalence and primary causes of visual impairment; also with metabonomics analysis we aimed to identify, predict and suggest some preventive biomarkers that cause blindness. Methods A population-based, cross-sectional study. Randomized clustering sampling was used to identify adults aged 50 years and older in Xiangyang Town, Yueqing county-level City. The interviews covered demographic, behavioral, ocular risk factors and mental health state. The ocular examination included visual acuity, autorefraction, intraocular pressure, anterior and posterior segment examinations, fundus photography, retinal tomography and angiography, and visual field testing. Anthropometric measurements included height and weight, waist and hip circumference, blood pressure, pulse rate, electrocardiogram, and abdominal ultrasound scan. A venous blood sample was collected for laboratory tests and metabonomics studies. Results Of the 5319 individuals recruited for the YODI, 4769 (89.7%) subjects were enrolled for analyses. The median age was 62.0 years, and 45.6% were male. The educational level of illiteracy or semi-illiteracy, primary, middle and high school or above was 29.8%, 45.5%, 20.1%, and 3.3%, respectively. Majority of the participants were female, younger, and less educated when compared with nonparticipants. The average body mass index and waist-hip ratios were 24.4 ± 3.4 kg/m2 and 0.9 ± 0.1 respectively. Blood sample collection reached a sample size of 1909 (479 from subjects with self-reported diabetes and 1430 from one-third of the 4290 subjects without self-reported diabetes). Conclusions The YODI provides population-based data with a high response rate (89.7%) on the prevalence and primary causes of major vision-impairing eye diseases in developed county areas in eastern China. Metabonomics analysis from YODI will provide further association of metabolic characteristics with the visual impairment eye diseases. The risk prediction model could be created and has the potential to be generalized to developed eastern areas in China for prevention.
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Affiliation(s)
- Yuxuan Deng
- 1Clinical and Epidemiological Research Center, Eye Hospital of Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027 Zhejiang China.,2School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027 Zhejiang China.,3Qingdao Municipal Hospital, 5 Donghai Middle Road, Qingdao, 266071 Shandong China
| | - Yuanbo Liang
- 1Clinical and Epidemiological Research Center, Eye Hospital of Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027 Zhejiang China.,2School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027 Zhejiang China
| | - Sigeng Lin
- 1Clinical and Epidemiological Research Center, Eye Hospital of Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027 Zhejiang China.,2School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027 Zhejiang China.,Wuhu First People's Hospital, 1 Chizhushandong Road, Wuhu, 241000 Anhui China
| | - Liang Wen
- Eye Hospital of Fushun City, 1 Hupo Road, Fushun, 113006 Liaoning China
| | - Jin Li
- 2School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027 Zhejiang China
| | - Yue Zhou
- 2School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027 Zhejiang China
| | - Meixiao Shen
- 2School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027 Zhejiang China
| | - Jingwei Zheng
- 1Clinical and Epidemiological Research Center, Eye Hospital of Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027 Zhejiang China
| | - Kemi Feng
- 1Clinical and Epidemiological Research Center, Eye Hospital of Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027 Zhejiang China
| | - Yanting Sun
- 6Qilu Hospital of Shandong University (Qingdao), 758 Hefei Road, Qingdao, 266035 Shandong China
| | - Kwapong Willaim Robert
- 2School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027 Zhejiang China
| | - Jia Qu
- 2School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027 Zhejiang China
| | - Fan Lu
- 2School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027 Zhejiang China
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Wei S, Sun Y, Li SM, Hu J, Cao K, Du J, An W, Liang X, Guo J, Li H, Wang N. Visual Impairment and Spectacle Use in University Students in Central China: The Anyang University Students Eye Study. Am J Ophthalmol 2019; 206:168-175. [PMID: 31078530 DOI: 10.1016/j.ajo.2019.04.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 04/12/2019] [Accepted: 04/23/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE To investigate the prevalence and associations of visual impairment and spectacle use in university students in central China. DESIGN Cross-sectional study. METHODS This study included students aged 16-26 years in China. Study subjects from 2 universities underwent distance visual acuity (VA) assessment in both eyes with a logarithm of the minimum angle of resolution chart and their refractions were measured by cycloplegic autorefraction. Blindness was defined as presenting VA less than three-sixtieth in the better eye (World Health Organization definition), and visual impairment was defined as presenting VA less than six-twelfths. RESULTS Overall, 9710 undergraduates were enumerated, 7704 (79.3%) subjects were included in this study. The prevalence of uncorrected VA less than six-twelfths and less than three-sixtieth in the better eye were 69.9% and 0.9%, respectively. Only 77.0% (4148/5388) of subjects with uncorrected VA in the better eye of less than six-twelfths wore glasses. For presenting VA, the prevalence of mild (VA <6/12 to 6/18), moderate (VA <6/18 to 6/60), and severe (VA <6/60 to 3/60) visual impairment was 6.3%, 11.2%, and 0.7%, respectively. Overall, 71.7% (4300/6001) of students with myopia (spherical equivalent ≤-0.5 diopters) wore spectacles. In multiple logistic regression analysis, visual impairment was associated with female sex (P < .001) and lower year level of education (P = .006) when presenting with VA. CONCLUSIONS This study has documented a relatively high prevalence of visual impairment and relatively low spectacle coverage in Chinese university students. Given the potential impact of visual impairment, target education and accessible refraction services are highly important to solve the problem.
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Affiliation(s)
- Shifei Wei
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University and Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Yunyun Sun
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University and Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Shi-Ming Li
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University and Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Jianping Hu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University and Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Kai Cao
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University and Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Jialing Du
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University and Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Wenzai An
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University and Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Xintong Liang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University and Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | | | - He Li
- Anyang Eye Hospital, Anyang, China
| | - Ningli Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University and Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China.
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Dai WW, Gao JM, He P, Ma Z, Tian XX, Zheng XY. The association between socioeconomic status and visual disability among older adults in China. Int J Ophthalmol 2019; 12:106-113. [PMID: 30662849 DOI: 10.18240/ijo.2019.01.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 11/07/2018] [Indexed: 10/27/2022] Open
Abstract
AIM To investigate the association between socioeconomic status (SES) and visual disability (VD) among older Chinese adults. METHODS We obtained data from the Second National Sample Survey on Disability, conducted in China in 2006. A total number of 192 375 older adults (aged≥65y) were screened for suspected VD via interviews with trained examiners. Those who screened positively for VD were referred to ophthalmologists to obtain a final diagnosis. RESULTS VD was prevalent among 7.29% of Chinese adults aged 65 and older, and was higher in rural areas (8.71%) than in urban areas (4.82%). After adjusting for SES indicators and covariates, we found that less-educated older adults were more likely to suffer from VD, with an odds ratio (OR) of 2.50 (95%CI: 2.26-2.82) for illiterates, compared with those who graduated from senior high school or above. Older adults who were in the lowest income quintile were more at risk of VD, with an OR of 1.81 (95%CI: 1.68-2.95), compared with adults in the highest income quintile. In urban areas, when compared with adults who graduated from senior high school or above, those who did not continue their education after junior high school, primary school, or those who were illiterate, were more likely to suffer from VD, with an OR of 1.35 (95%CI: 1.51-1.59), 1.84 (95%CI: 1.60-2.12), and 2.63 (95%CI: 2.27-3.04), respectively. Lower levels of income were statistically significant when associated with VD. In rural areas, adults who were illiterate had an OR of 2.21 (95%CI: 1.75-2.79) when compared to adults with senior high school or above education level. Per capita, household income remained significantly associated with VD. Older adults who were ≥85, female, single, and residing in rural areas were associated with higher risks of VD. CONCLUSION Individual-level SES among the elderly, in the form of education and income, is associated with VD among elderly Chinese adults in both urban and rural areas; however, the association is stronger in rural areas. Further studies are still required to explore the mechanism behind the relationships.
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Affiliation(s)
- Wan-Wei Dai
- Institute of Population Research, APEC Health Science Academy (HeSAY), Peking University, Beijing 100891, China.,The Third Hospital, Peking University, Beijing 100191, China
| | - Jia-Min Gao
- Institute of Population Research, APEC Health Science Academy (HeSAY), Peking University, Beijing 100891, China.,Guanghua School of Management, Institute of Strategic Research, Peking University, Beijing 100891, China
| | - Ping He
- Institute of Population Research, APEC Health Science Academy (HeSAY), Peking University, Beijing 100891, China.,China Center for Health Development Studies, Peking University, Beijing 100891, China
| | - Zheng Ma
- Institute of Population Research, APEC Health Science Academy (HeSAY), Peking University, Beijing 100891, China
| | - Xiao-Xiao Tian
- Institute of Population Research, APEC Health Science Academy (HeSAY), Peking University, Beijing 100891, China
| | - Xiao-Ying Zheng
- Institute of Population Research, APEC Health Science Academy (HeSAY), Peking University, Beijing 100891, China
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Jiachu D, Jiang F, Luo L, Zheng H, Duo J, Yang J, Nima Y, Ling J, Xiao B, Bassett K. Blindness and eye disease in a Tibetan region of China: findings from a Rapid Assessment of Avoidable Blindness survey. BMJ Open Ophthalmol 2018; 3:e000209. [PMID: 30539152 PMCID: PMC6257377 DOI: 10.1136/bmjophth-2018-000209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 10/06/2018] [Accepted: 10/16/2018] [Indexed: 11/17/2022] Open
Abstract
Introduction The only population-based survey of blindness and visual impairment of a Tibetan population was conducted in the Tibet Autonomous Region in 1999. Methods and analysis The Rapid Assessment of Avoidable Blindness methodology was used to conduct a survey of Kandze Tibetan Autonomous Prefecture, Sichuan Province of China in the Fall 2017. Using the 2010 census, 100 clusters of 50 participants aged 50 years or older were randomly sampled using probability proportionate to size. Results Among the 5000 people enumerated, 4763 were examined (95.3% response). The age-adjusted and sex-adjusted prevalence of blindness, severe visual impairment, moderate visual impairment and early visual impairment (EVI) were 1.6% (95% CI: 1.08 to 2.38)), 0.9% (95% CI:0.7 to 1.5), 5.1% (95% CI:4.4 to 5.7), and 7.45% (95% CI:6.67 to 8.2), respectively. The prevalence of blindness among Tibetans was significantly higher than that among Han Chinese (2.2% (95% CI:1.8 to 2.6) and 0.6 (95% CI:0.2 to 1.7), respectively, p<0.05). Women bore a significant excess burden of EVI compared with men (8.5% (95% CI:7.5 to 9.6) and 6.1% (95% CI:5.1 to 7.2), respectively, p<0.05). Cataract was the primary cause of blindness (39.4%) followed by macular degeneration (10.6%) and corneal opacity (5.3%). Conclusion Blindness and visual impairment in Kandze Tibetan Autonomous Prefecture is substantially less than an earlier study of a Tibetan region and now resembles other regions of China. About 58% of blindness and 67% of SVIwere avoidable, primarily by providing cataract services. Eighty-three percent of EVI was avoidable by providing refractice services throughout the region.
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Affiliation(s)
- Danba Jiachu
- Kham Eye Centre, Kandze Prefecture People`s Hospital, Dartsedo, China
| | - Feng Jiang
- Kham Eye Centre, Kandze Prefecture People`s Hospital, Dartsedo, China
| | - Li Luo
- Kham Eye Centre, Kandze Prefecture People`s Hospital, Dartsedo, China
| | - Hong Zheng
- Kham Eye Centre, Kandze Prefecture People`s Hospital, Dartsedo, China
| | - Ji Duo
- Kham Eye Centre, Kandze Prefecture People`s Hospital, Dartsedo, China
| | - Jing Yang
- Kham Eye Centre, Kandze Prefecture People`s Hospital, Dartsedo, China
| | - Yongcuo Nima
- Kham Eye Centre, Kandze Prefecture People`s Hospital, Dartsedo, China
| | - Jin Ling
- Department of Preventive Ophthalmology, Zhongshan Ophthalmic Center of Sun Yat-sen University, Guangzhou, China
| | - Baixiang Xiao
- Department of Preventive Ophthalmology, Zhongshan Ophthalmic Center of Sun Yat-sen University, Guangzhou, China
| | - Ken Bassett
- British Columbia Center for Epidemiology & International Ophthalmology and Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada
- Seva Canada, Vancouver, Canada
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Song P, Wang H, Theodoratou E, Chan KY, Rudan I. The national and subnational prevalence of cataract and cataract blindness in China: a systematic review and meta-analysis. J Glob Health 2018. [PMID: 29977532 PMCID: PMC6005639 DOI: 10.7189/jogh.08-010804] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background Cataract is the second leading cause of visual impairment and the first of blindness globally. However, for the most populous country, China, much remains to be understood about the scale of cataract and cataract blindness. We aimed to investigate the prevalence of cataract and cataract blindness in China at both the national and subnational levels, with projections till 2050. Methods In this systematic review and meta-analysis, China National Knowledge Infrastructure (CNKI), Wanfang, Chinese Biomedicine Literature Database (CBM-SinoMed), PubMed, Embase, and Medline were searched using a comprehensive search strategy to identify all relevant articles on the prevalence of cataract or cataract blindness in Chinese population published from January 1990 onwards. We fitted a multilevel mixed-effects meta-regression model to estimate the prevalence of cataract, and a random-effects meta-analysis model to pool the overall prevalence of cataract blindness. The United Nations Population Division (UNPD) data were used to estimate and project the number of people with cataract and cataract blindness from 1990 to 2050. According to different demographic and geographic features in the six geographic regions in China, the national numbers of people with cataract in the years 2000 and 2010 were distributed to each region. Results In males, the prevalence of any cataract (including post-surgical cases) ranged from 6.71% (95% CI = 5.06-8.83) in people aged 45-49 years to 73.01% (95% CI = 65.78-79.2) in elderly aged 85-89 years. In females, the prevalence of any cataract increased from 8.39% (95% CI = 6.36-10.98) in individuals aged 45-49 years to 77.51% (95% CI = 71.00-82.90) in those aged 85-89 years. For age-related cataract (ARC, including post-surgical cases), in males, the prevalence rates ranged from 3.23% (95% CI = 1.51-6.80) in adults aged 45-49 years to 65.78% (95% CI = 46.72-80.82) in those aged 85-89 years. The prevalence of ARC in females was 4.72% (95% CI = 2.22-9.76) in the 45-49 years age group and 74.03% (95% CI = 56.53-86.21) in the 85–89 years age group. The pooled prevalence rate of cataract blindness (including post-surgical cases) by best corrected visual acuity (BCVA)<0.05 among middle-aged and older Chinese was 2.30% (95% CI = 1.72-3.07), and those of cataract blindness by BCVA<0.10 and cataract blindness by presenting visual acuity (PVA)<0.10 were 2.56% (95% CI = 1.94-3.38) and 4.51% (95% CI = 3.53-5.75) respectively. In people aged 45-89 years, the number of any cataract cases was 50.75 million (95% CI = 42.17-60.37) in 1990 and 111.74 million (95% CI = 92.94-132.84) in 2015, and that of ARC rose from 35.77 million (95% CI = 19.81-59.55) in 1990 to 79.04 million (95% CI = 44.14-130.85) in 2015. By 2050, it is projected that the number of people (45-89 years of age) affected by any cataract will be 240.83 million (95% CI = 206.07-277.35), and that of those with ARC will be 187.26 million (95% CI = 113.17-281.23). During 2000 and 2010, South Central China consistently owed the most cases of any cataract, whereas Northwest China the least. Conclusions The prevalence of cataract and cataract blindness in China was unmasked. In the coming decades, cataract and cataract blindness will continue to be a leading public-health issue in China due to the ageing population. Future work should be prioritized to the promotion of high-quality epidemiological studies on cataract.
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Affiliation(s)
- Peige Song
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - He Wang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Evropi Theodoratou
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - Kit Yee Chan
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - Igor Rudan
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, United Kingdom
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11
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Song P, Wang H, Theodoratou E, Chan KY, Rudan I. The national and subnational prevalence of cataract and cataract blindness in China: a systematic review and meta-analysis. J Glob Health 2018. [PMID: 29977532 DOI: 10.7189/jogh.08‐010804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background Cataract is the second leading cause of visual impairment and the first of blindness globally. However, for the most populous country, China, much remains to be understood about the scale of cataract and cataract blindness. We aimed to investigate the prevalence of cataract and cataract blindness in China at both the national and subnational levels, with projections till 2050. Methods In this systematic review and meta-analysis, China National Knowledge Infrastructure (CNKI), Wanfang, Chinese Biomedicine Literature Database (CBM-SinoMed), PubMed, Embase, and Medline were searched using a comprehensive search strategy to identify all relevant articles on the prevalence of cataract or cataract blindness in Chinese population published from January 1990 onwards. We fitted a multilevel mixed-effects meta-regression model to estimate the prevalence of cataract, and a random-effects meta-analysis model to pool the overall prevalence of cataract blindness. The United Nations Population Division (UNPD) data were used to estimate and project the number of people with cataract and cataract blindness from 1990 to 2050. According to different demographic and geographic features in the six geographic regions in China, the national numbers of people with cataract in the years 2000 and 2010 were distributed to each region. Results In males, the prevalence of any cataract (including post-surgical cases) ranged from 6.71% (95% CI = 5.06-8.83) in people aged 45-49 years to 73.01% (95% CI = 65.78-79.2) in elderly aged 85-89 years. In females, the prevalence of any cataract increased from 8.39% (95% CI = 6.36-10.98) in individuals aged 45-49 years to 77.51% (95% CI = 71.00-82.90) in those aged 85-89 years. For age-related cataract (ARC, including post-surgical cases), in males, the prevalence rates ranged from 3.23% (95% CI = 1.51-6.80) in adults aged 45-49 years to 65.78% (95% CI = 46.72-80.82) in those aged 85-89 years. The prevalence of ARC in females was 4.72% (95% CI = 2.22-9.76) in the 45-49 years age group and 74.03% (95% CI = 56.53-86.21) in the 85-89 years age group. The pooled prevalence rate of cataract blindness (including post-surgical cases) by best corrected visual acuity (BCVA)<0.05 among middle-aged and older Chinese was 2.30% (95% CI = 1.72-3.07), and those of cataract blindness by BCVA<0.10 and cataract blindness by presenting visual acuity (PVA)<0.10 were 2.56% (95% CI = 1.94-3.38) and 4.51% (95% CI = 3.53-5.75) respectively. In people aged 45-89 years, the number of any cataract cases was 50.75 million (95% CI = 42.17-60.37) in 1990 and 111.74 million (95% CI = 92.94-132.84) in 2015, and that of ARC rose from 35.77 million (95% CI = 19.81-59.55) in 1990 to 79.04 million (95% CI = 44.14-130.85) in 2015. By 2050, it is projected that the number of people (45-89 years of age) affected by any cataract will be 240.83 million (95% CI = 206.07-277.35), and that of those with ARC will be 187.26 million (95% CI = 113.17-281.23). During 2000 and 2010, South Central China consistently owed the most cases of any cataract, whereas Northwest China the least. Conclusions The prevalence of cataract and cataract blindness in China was unmasked. In the coming decades, cataract and cataract blindness will continue to be a leading public-health issue in China due to the ageing population. Future work should be prioritized to the promotion of high-quality epidemiological studies on cataract.
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Affiliation(s)
- Peige Song
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - He Wang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Evropi Theodoratou
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - Kit Yee Chan
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - Igor Rudan
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, United Kingdom
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12
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Song P, Wang H, Theodoratou E, Chan KY, Rudan I. The national and subnational prevalence of cataract and cataract blindness in China: a systematic review and meta-analysis. J Glob Health 2018; 8:010804. [DOI: 10.7189/jogh.08.010804] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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13
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A Study on the Awareness of Cataract Disease and Treatment Options in Patients who Need Surgery in a Rural Area of Eastern China. Eur J Ophthalmol 2018; 18:544-50. [DOI: 10.1177/112067210801800407] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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14
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Xie X, Xu L, Jonas J, Wang Y. Prevalence of Diabetic Retinopathy among Subjects with Known Diabetes in China: The Beijing Eye Study. Eur J Ophthalmol 2018; 19:91-9. [PMID: 19123155 DOI: 10.1177/112067210901900114] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose To evaluate the prevalence of diabetic retinopathy and risk factors among patients with self-reported diabetes mellitus in China. Methods The Beijing Eye Study, a population-based study on inhabitants aged 40+ years, included 4439 subjects. Fundus photographs of the worse eye from participants with self-reported diabetes were graded. Results Fundus photographs ready for evaluation and a filled out questionnaire were available for 4127 (93.0%) subjects. The prevalence of self-reported diabetes was 235/4127 (5.7%). Among the subjects with a self-reported diagnosis of diabetes, diabetic retinopathy was detected on the fundus photographs of 86 (37.1%) subjects, with macular edema in 12 (5.2%) subjects, clinically significant macular edema in 6 (2.6%) subjects, and a vision-threatening stage of the retinopathy in 12 (5.2%) subjects. Diabetic retinopathy was associated with rural region (p=0.004), longer duration of diabetes (p=0.009), use of diabetic medications (p=0.02), and lower education background (p=0.003). Conclusions Prevalence of diabetic retinopathy among Chinese patients aged 40+ years with a self-reported diagnosis of diabetes is about 37%, with a vision-threatening stage of the retinopathy detected in 5% of the subjects. About 5.7% of the adult Chinese population report on a known diagnosis of diabetes mellitus, with about 15% of these subjects knowing about the presence of diabetic retinopathy. The frequency of known diabetes mellitus is lower in rural regions than in urban regions, while diabetic retinopathy overall and macular edema among the subjects with known diabetes mellitus were significantly more common in the rural group.
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Affiliation(s)
- X.W. Xie
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University - China
| | - L. Xu
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University - China
| | - J.B. Jonas
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University - China
- Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University of Heidelberg, Mannheim - Germany
| | - Y.X. Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University - China
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Tsai IL, Woung LC, Tsai CY, Kuo LL, Liu SW, Lin S, Wang IJ. Trends in Blind and Low Vision Registrations in Taipei City. Eur J Ophthalmol 2018; 18:118-24. [PMID: 18203096 DOI: 10.1177/112067210801800120] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose To determine the overall reported incidence and causes of registrable blindness and low vision in Taipei, Taiwan, that have occurred in the previous 10 years. Methods Study data were obtained from disability identification registration forms completed between January 1995 and December 2004. Definitions of low vision and blindness were defined by WHO criteria: low vision included visual acuity worse than 6/18 (20/60) to a lower limit of 3/60 (20/400). Blindness was defined as visual acuity worse than 3/60 (20/400) in the better eye with best possible correction. Results There were 3151 registrations for visual impairment during the study period. A total of 239 registrations were excluded due to insufficient data. Of the remaining 2912 (1518 males and 1394 females), 640 males and 647 females were legally blind (44.20%). A total of 878 males and 747 females were partially sighted. The six leading causes of low vision and blindness, in decreasing frequency, were glaucoma, optic neuropathy, diabetic retinopathy, retinitis pigmentosa, age-related macular degeneration, and myopic macular degeneration. Conclusions The proportions of new registrations owing to glaucoma, diabetic retinopathy, age-related macular degeneration, and myopic macular degeneration have changed significantly since 2000; the proportion due to diabetic retinopathy has increased.
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Affiliation(s)
- I.-L. Tsai
- Department of Ophthalmology, Zhongxing Branch, Taipei City Hospital, Taipei, Taiwan
| | - L.-C. Woung
- Department of Ophthalmology, Jen-Ai Branch, Taipei City Hospital, Taipei - Taiwan - RP China
| | - C.-Y. Tsai
- Department of Ophthalmology, Zhongxing Branch, Taipei City Hospital, Taipei, Taiwan
| | - L.-L. Kuo
- Department of Ophthalmology, Zhongxing Branch, Taipei City Hospital, Taipei, Taiwan
| | - S.-W. Liu
- Department of Ophthalmology, Zhongxing Branch, Taipei City Hospital, Taipei, Taiwan
| | - S. Lin
- Department of Ophthalmology, School of Medicine, University of California, San Francisco - USA
| | - I.-J. Wang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei - Taiwan - RP China
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Zhao J, Xu X, Ellwein LB, Cai N, Guan H, He M, Liu P, Lv J, Sheng X, Yang P, Yi J, Yang M, Zhang R, Ding X, Du L, Li F, Lu H, Shao W, Wang J, Yuan Y, Zhou R, Zhuang W, An L. Prevalence of Vision Impairment in Older Adults in Rural China in 2014 and Comparisons With the 2006 China Nine-Province Survey. Am J Ophthalmol 2018; 185:81-93. [PMID: 29102607 DOI: 10.1016/j.ajo.2017.10.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 10/18/2017] [Accepted: 10/23/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE To estimate the prevalence of vision impairment and blindness in 2014 among older adults in rural China with comparisons with the 2006 Nine-Province Survey. DESIGN Population-based, cross-sectional study. METHODS Geographical cluster sampling was used in randomly selecting residents from a rural county or semi-rural district within 9 provinces: Beijing, Jiangsu, Guangdong, Heilongjiang, Jiangxi, Hebei, Ningxia, Chongqing, and Yunnan. Persons 50 years of age or older were enumerated through household visits and invited to examination sites for visual acuity testing and examination. Vision impairment and blindness in 2014 was compared with data from the 2006 survey. RESULTS Among 51 310 examined persons, the prevalence of presenting vision impairment (<20/63 to ≥20/400) in the better-seeing eye ranged from 6.05% to 15.3% across the 9 study sites, with presenting blindness (<20/400) ranging from 0.66% to 5.35%. With best-corrected visual acuity, the prevalence of vision impairment ranged from 1.96% to 8.74%, and blindness from 0.47% to 5.01%. Vision impairment was associated with older age, female sex, and little or no education. The overall prevalence of presenting vision impairment and blindness decreased during the 2006-2014 interval by 6.31% and 29.0%, respectively; and by 16.1% and 38.0%, respectively, after standardization of 2006 prevalence rates to the 2014 population. CONCLUSIONS Substantial progress has been made in the reduction of vision impairment in rural China. Nevertheless, vision impairment remains an important public health problem with substantial geographic disparities and with older age, female sex, and illiteracy as risk factors.
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Association Between Hay Fever and High Myopia in United States Adolescents and Adults. Eye Contact Lens 2017; 43:186-191. [PMID: 26974535 DOI: 10.1097/icl.0000000000000251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To investigate the relationship between hay fever and refractive error in a representative sample of adolescents and adults in the United States. METHODS This cross-sectional study included 5,744 participants aged ≥12 years from the 2005 to 2006 National Health and Nutrition Examination Survey who participated in the allergy questionnaire, completed objective refraction and keratometry in both eyes, and had immunoglobulin E (IgE) serology. The primary predictor variable, refractive error, was classified as emmetropia (-0.99 to +0.99 diopters [D]), low myopia (-1.00 to -2.99 D), moderate myopia (-3.00 to -5.99 D), high myopia (≥-6.00 D), or hyperopia (≥1.00 D). Covariates included age, gender, race, asthma, eczema, total serum IgE ≥120 kU/L, corneal steepness, and corneal astigmatism. The primary outcome was hay fever. RESULTS The study population's mean age was 41.7 years; 48.8% of subjects were men and 51.2% were women. The prevalence of hay fever was 12.1% overall. High myopes had 2.7 times higher odds of hay fever compared to emmetropes (OR 2.67, CI, 1.57-4.51, P=0.001), which was independent of demographics, atopic conditions, IgE serology, and keratometry measurements. CONCLUSIONS The association between hay fever and high myopia identified in this large cross-sectional study remains speculative and was not mediated through corneal steepness or corneal astigmatism. Further prospective studies may help elucidate the directionality of the association between hay fever and high myopia.
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Prevalence and causes of low vision and blindness in a Chinese population with type 2 diabetes: the Dongguan Eye Study. Sci Rep 2017; 7:11195. [PMID: 28894238 PMCID: PMC5593882 DOI: 10.1038/s41598-017-11365-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 08/22/2017] [Indexed: 01/19/2023] Open
Abstract
To assess the prevalence and causes of low vision and blindness in type 2 diabetes patients, a population-based cross-sectional study including 8952 rural-dwelling residents aged 40 years or older from Hengli Town in Southern China was conducted. Participants underwent standard interviews, physical measurements, laboratory tests, and comprehensive eye examinations. Low vision and blindness were defined based on WHO criteria. Visual acuity data were available for 1348 (89.9%) of the 1500 subjects with type 2 diabetes. Age-standardized prevalence of bilateral low vision and blindness assessed in the better-seeing eye was 2.9% (95% confidence interval [CI]: 2.0–3.8) and 0.7% (95% CI: 0.2–1.1) based on best-corrected visual acuity (BCVA). Cataracts were the primary cause of low vision and blindness. Visual impairment was associated with age (odds ratio [OR]: 3.73, 95% CI: 2.39–5.83), education level (OR: 3.21, 95% CI: 1.63–6.29), duration of diabetes (OR: 1.14, 95% CI: 1.04–1.25) and body mass index (OR: 0.86, 95% CI: 0.77–0.95). Our data suggest that approximately 70% of visual impairment in this diabetic population could be eliminated with appropriate cataract surgery or spectacle correction. Greater consideration should be given to older type 2 diabetes patients with a level of lower education.
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Zhang X, Li EY, Leung CKS, Musch DC, Tang X, Zheng C, He M, Chang DF, Lam DSC. Prevalence of visual impairment and outcomes of cataract surgery in Chaonan, South China. PLoS One 2017; 12:e0180769. [PMID: 28797099 PMCID: PMC5552304 DOI: 10.1371/journal.pone.0180769] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 06/21/2017] [Indexed: 11/21/2022] Open
Abstract
Purpose To estimate the prevalence and causes of blindness and visual impairment (VI), and report the outcomes of cataract surgery in Chaonan Region, Guangdong Province, southern China Design Cross-sectional population-based survey Participants A total of 3484 participants including 1397 men (40.1%) and 2087 women (59.9%) aged ≥50 years were examined (94.2% response rate). Method A two-stage cluster sampling procedure was used to select 3700 participants aged ≥50 years from 74 clusters of Chaonan Region. Participants were examined according to the Rapid Assessment of Avoidable Blindness (RAAB) method. Blindness and visual impairment (VI) were defined by the World Health Organization criteria. Participants with visual acuity (VA) < 6/18 in either eye were examined by ophthalmologists. The primary causes of blindness and VI were reported with reference to the participant’s better eye. Main outcome measures Prevalence and main causes of blindness, severe visual impairment (SVI), VI and the outcomes of cataract surgery Results The standardized prevalence rates of blindness, SVI, and VI were 2.4% (95% confidence interval [CI], 1.9–2.9%), 1.0% (95% CI, 0.7–1.4%), and 6.4% (95% CI, 5.6%– 7.1%), respectively. The principal cause of blindness and SVI was cataract, accounting for 67.1% and 67.6% respectively, and the principal cause of VI was refractive error (46.9%). One hundred and fifty five out of 3484 (4.4%) people (211 eyes) had cataract surgery. Of the 211 eyes that had cataract surgery, 96.7% were pseudophakic. 67.2% of the 211 operated eyes had a presenting visual acuity (PVA) of 6/18 or better. Conclusions The prevalence of blindness, SVI, and VI was high among rural residents in Chaonan. Cataract remained the leading cause of avoidable blindness. Outcomes of cataract surgery performed in rural private clinics were suboptimal. Quality-control initiatives such as hands-on training program should be introduced to improve cataract surgery outcomes.
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Affiliation(s)
- Xiujuan Zhang
- Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong, Hong Kong, China
- Tianjin Eye Hospital, Tianjin, China
| | - Emmy Y. Li
- Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong, Hong Kong, China
- Project Vision Charitable Foundation, Hong Kong, China
- Hong Kong Eye Hospital, Kowloon, Hong Kong, China
| | | | - David C. Musch
- Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
| | - Xin Tang
- Tianjin Eye Hospital, Tianjin, China
| | | | - Mingguang He
- State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, China
| | - David F. Chang
- The University of California, San Francisco, California, United States of America
| | - Dennis Shun-Chiu Lam
- Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong, Hong Kong, China
- Project Vision Charitable Foundation, Hong Kong, China
- State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, China
- * E-mail:
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Darge HF, Shibru G, Mulugeta A, Dagnachew YM. The Prevalence of Visual Acuity Impairment among School Children at Arada Subcity Primary Schools in Addis Ababa, Ethiopia. J Ophthalmol 2017; 2017:9326108. [PMID: 28706737 PMCID: PMC5494567 DOI: 10.1155/2017/9326108] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 04/02/2017] [Accepted: 04/26/2017] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Visual impairment and blindness are major public health problems in developing countries where there is no enough health-care service. OBJECTIVE To determine the prevalence of visual impairment among school children. MATERIALS AND METHODS A school-based cross-sectional study was conducted between 15 June 2015 and 30 November 2015 at Arada subcity primary schools, Addis Ababa, Ethiopia. Two schools were selected randomly, and 378 students were screened from grades 1 to 8 using systematic random sampling method. Snellen chart was used for visual acuity test. Students who had visual acuity of ≤6/12 were further examined by an ophthalmologist to diagnose the reason for low vision. Data was analyzed using SPSS version 20. RESULTS A total of 378 students were screened, and 192 (50.8%) were females and the remaining 186 (49.2%) were males. The prevalence of visual impairment (VA) of ≤6/12 on either eye was 5.8%, VA < 6/18 on either eye was 1.1%, and VA < 6/18 on the better eye was 0.53%. In this study, color blindness [OR: 19.65, 95% CI (6.01-64.33)] was significantly associated with visual acuity impairment. CONCLUSION The prevalence of visual impairment among school children in the study area was 5.8% and school screening is recommended.
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Affiliation(s)
- Haile Fentahun Darge
- Department of Medical Physiology, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Getahun Shibru
- Department of Medical Physiology, College of Health Sciences, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abiy Mulugeta
- Department of Ophthalmology, College of Health Sciences, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yinebeb Mezgebu Dagnachew
- Department of Medical Physiology, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
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Salomão SR, Furtado JM, Berezovsky A, Cavascan NN, Ferraz AN, Cohen JM, Muñoz S, Belfort R. The Brazilian Amazon Region Eye Survey: Design and Methods. Ophthalmic Epidemiol 2017; 24:257-264. [DOI: 10.1080/09286586.2016.1276199] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Solange R. Salomão
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - João Marcello Furtado
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
- Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - Adriana Berezovsky
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - Nívea N. Cavascan
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - Alberto N. Ferraz
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - Jacob M. Cohen
- Divisão de Oftalmologia, Departamento de Cirurgia, Faculdade de Medicina da Universidade Federal do Amazonas, Manaus, AM, Brasil
- Instituto de Olhos de Manaus, Manaus, AM, Brasil
| | - Sergio Muñoz
- Departamento de Salud Publica, Universidad de La Frontera, Temuco, Chile
| | - Rubens Belfort
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
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Sugnanam KKN, Ma S, Kreis A, Correia M, Verma N, Dirani M. Prospective Study of Eye Disease in Timor-Leste: The East Timor Eye Program. Asia Pac J Ophthalmol (Phila) 2016; 5:349-53. [PMID: 27213765 DOI: 10.1097/apo.0000000000000164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSE This study aimed to present the methodology of the East Timor Eye Program and report the prevalence of eye disease seen at the National Eye Centre during a 3-month sample period between June and August 2012. DESIGN Two hundred ninety-three new patients aged 17 years or older were assessed at the National Eye Centre in Dili, Timor-Leste. METHODS All participants received a comprehensive dilated eye examination that included distance visual acuity measurements, indirect fundoscopy, and a complete slit lamp assessment including gonioscopy and intraocular pressure measurement. Each patient completed an interview-administered general questionnaire, and information on general health, ocular history, and medication was obtained. Anthropometric measurements were also taken and recorded. RESULTS A total of 293 patients, 183 males (62.5%) and 110 females (37.5%), aged between 17 and 88 years (mean, 47.66 years) were recruited and examined. The 3 most common clinical eye presentations were conjunctival disorders (60.41%), followed by lens disorders (48.12%) and scleral, corneal, iris, and ciliary body disorders (46.42%). The 3 most common conditions causing blindness (visual acuity less than 3/60 as defined by the World Health Organization) were lens disorders (45.9%), choroidal and retinal disorders (18.9%), and other disorders of the eye and adnexa (13.5%). CONCLUSIONS The East Timor Eye Program is an effective program that has enabled the management and treatment of various eye conditions in residents of Timor-Leste. The program set high standards for stringent and accurate data collection and ophthalmic diagnoses in a low-resource setting. Lens disorders and choroidal and retinal disorders were the most common conditions causing blindness.
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Affiliation(s)
- Kirthi Kumar Naidu Sugnanam
- From the *East Timor Eye Program, Royal Australasian College of Surgeons, East Melbourne, Victoria, Australia; †Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia; ‡Department of Ophthalmology, University Hospitals of Geneva, Geneva, Switzerland; §Sentru Matan Nasional, Hospital Nacional Guido Valadares, Bidau, Dili, Timor-Leste; and ¶School of Medicine, University of Tasmania, Tasmania, Australia
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Zhu RR, Shi J, Yang M, Guan HJ. Prevalences and causes of vision impairment in elderly Chinese: a socioeconomic perspective of a comparative report nested in Jiangsu Eye Study. Int J Ophthalmol 2016; 9:1051-6. [PMID: 27500116 DOI: 10.18240/ijo.2016.07.19] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 11/19/2015] [Indexed: 10/21/2022] Open
Abstract
AIM To survey the prevalence and causes of visual impairment/blindness among elderly Chinese from different socioeconomic status in community-based design. METHODS Cluster-sampling randomly selected residents from Binhu and Funing District, two areas representing different socioeconomic levels in China with Binhu in an advanced status and Funing in less-developed area. The participants subjected to ophthalmic examination. The presenting visual acuity (PVA) and best-corrected visual acuity (BCVA) were recorded. Visual impairment and blindness were defined according to World Health Organization criteria. The causes of visual impairment/blindness were identified by ophthalmic examination and/or questionnaire. The socioeconomic status included the per capita gross domestic product, numbers of hospital with ophthalmic service and the number of ophthalmologists per 1 million residents. RESULTS We successfully included 12 867 participants form 2 areas in this study. The prevalence of PVA impairment (<20/63 to ≥20/400) in the better eye was 5.4% in Binhu and 23.6% in Funing, while the prevalence of blindness (<20/400) was 0.9% in Binhu and 2.3% in Funing. With BCVA, the prevalence of visual impairment was 2.4% in Binhu and 6.4% in Funing, while the prevalence of blindness was 0.8% in Binhu and 1.6% in Funing. The participants with older age and female gender had higher prevalence in visual impairment and blindness. The highest prevalences of vision impairment and blindness evaluated by BCVA at >80y age group reached 20.4% and 6.3% respectively. The prevalences of vision impairment and blindness evaluated by BCVA were 3.5% and 1.0% in male and 5.0% and 1.3% in female. The above differences were statistically significant (P<0.05). The predominant causes of visual impairment and blindness were cataract, retinal disorders and uncorrected refractive error in both areas. The socioeconomic status was associated with visual impairment and blindness. CONCLUSION This community-based study build a sufficient sample size for an ophthalmic survey. Our data show the disparities on socioeconomic development and genders in visual impairment and blindness in China. Special emphasis of ophthalmic service should be placed on females and less-developed area.
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Affiliation(s)
- Rong-Rong Zhu
- Eye Institute, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Jian Shi
- Eye Institute, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Mei Yang
- Eye Institute, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Huai-Jin Guan
- Eye Institute, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
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Cheng F, Shan L, Song W, Fan P, Yuan H. Distance- and near-visual impairment in rural Chinese adults in Kailu, Inner Mongolia. Acta Ophthalmol 2016; 94:407-13. [PMID: 26289905 DOI: 10.1111/aos.12808] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 06/16/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE To investigate the prevalence and causes of distance-visual impairment and near-vision impairment in a rural Chinese population in Inner Mongolia. METHODS A population-based, cross-sectional study design was used to identify visual impairment in the Chinese aged 40 years and older living in Kailu County, Inner Mongolia. Low vision, blindness and near-visual impairment (NVI) were defined according to World Health Organization (WHO) criteria. RESULTS The overall prevalence of blindness and visual impairment based on the presenting visual acuity (VA) was 2.2% (95% CI: 1.8-2.6) and 9.8% (95% CI: 8.9-10.6), respectively, and was adjusted to 0.9% (95% CI: 0.6-1.2) and 4.7% (95% CI: 4.1-5.3) using best-corrected visual acuity (BCVA), respectively. Taking the presenting VA into consideration, the leading cause of visual impairment and blindness was cataract (40.3%, 40.9%), followed by uncorrected refractive error (26.6%, 28.2%). According to the BCVA, the main cause of visual impairment and blindness was cataract (48.3%, 41.3%) followed by glaucoma (19.0%, 23.9%). Among the examined subjects, 80.3% had NVI, and 51.7% had presbyopia. Major barriers reported by NVI persons without near correction were lack of money to purchase prescription glasses and poor quality of the available ones (43.2%). CONCLUSION Visual impairment is a serious public health problem, and the main causes leading to visual impairment are treatable and preventable in the rural Chinese population in Inner Mongolia. Presbyopia, together with the low rate of spectacles and lack of appropriate refractive and presbyopia spectacles, is highly prevalent in rural China.
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Affiliation(s)
- Fang Cheng
- Department of Ophthalmology; the 2nd Affiliated Hospital; Harbin Medical University; Harbin China
| | - Li Shan
- Department of Ophthalmology; the 2nd Affiliated Hospital; Harbin Medical University; Harbin China
| | - Wulian Song
- Department of Ophthalmology; the 2nd Affiliated Hospital; Harbin Medical University; Harbin China
| | - Pan Fan
- Department of Ophthalmology; the 2nd Affiliated Hospital; Harbin Medical University; Harbin China
| | - Huiping Yuan
- Department of Ophthalmology; the 2nd Affiliated Hospital; Harbin Medical University; Harbin China
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Meng Q, Cui Y, Zhang M, Zhang L, Zhang L, Zhang J, Kuang J, Liu Q, Zheng Y, Luo Z, Liu H, Zhu G, Cai J, Zhang G, Wen X, Guo H. Design and baseline characteristics of a population-based study of eye disease in southern Chinese people: the Dongguan Eye Study. Clin Exp Ophthalmol 2016; 44:170-80. [PMID: 26468890 DOI: 10.1111/ceo.12670] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 09/24/2015] [Accepted: 10/05/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND To describe the study design, methodology and baseline characteristics of the Dongguan Eye Study. DESIGN Population-based, cross-sectional study PARTICIPANTS A total of 8952 rural-dwelling residents aged 40 years or older in Hengli, Dongguan. METHODS The Dongguan Eye Study was conducted from September 2011 to February 2012. The interview covered demographic data, socio-economic status and health- and vision-related quality of life. Physical measurements included height, weight, waist and hip circumference, heart rate and blood pressure. Laboratory tests included fasting blood glucose, haemoglobin A1c, oral glucose tolerance, serum total cholesterol, triglycerides, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, serum creatinine, blood urea nitrogen and uric acid. Ophthalmic examinations included visual acuity and autorefraction testing, intraocular pressure measurement, slit-lamp examination, ocular biometry, gonioscopy, fundus photography, retinal nerve fibre layer imaging and visual field testing. MAIN OUTCOME MEASURES Prevalence and risk factors for visual impairment, blindness, eye diseases and their associations with systemic medical indicators or health-related lifestyles, as well as epidemiological data on diabetic subjects. Methodology, response rates and baseline characteristics are presented. RESULTS Of the 11 357 individuals eligible for the Dongguan Eye Study, 8952 (78.82%) subjects participated. All participants were self-identified Han Chinese. The average age was 54.0 years, 59.9% were female, 48.4% were farmers and 77.2% had elementary or junior middle school educational levels. The average body mass index and waist-hip ratio were 24.6 ± 3.9 kg/m(2) and 0.9 ± 0.2. CONCLUSIONS Data from the Dongguan Eye Study provide information concerning the prevalence, risk factors and impacts of eye diseases in rural residents undergoing urbanization in southern China.
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Affiliation(s)
- Qianli Meng
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Ying Cui
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Min Zhang
- Department of Ophthalmology, Dongguan People's Hospital, Dongguan, Guangdong, China
| | - Lixin Zhang
- Department of Ophthalmology, Hengli Hospital, Dongguan, Guangdong, China
| | - Liang Zhang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Jinxin Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jian Kuang
- Department of Endocrinology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Qingyang Liu
- Department of Ophthalmology, Dongguan People's Hospital, Dongguan, Guangdong, China
| | - Yang Zheng
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Eye Institute, Chongqing Key Laboratory of Ophthalmology, Chongqing, China
| | - Zhongling Luo
- Department of Ophthalmology, Hengli Hospital, Dongguan, Guangdong, China
| | - Huikun Liu
- Department of Ophthalmology, Hengli Hospital, Dongguan, Guangdong, China
| | - Guoping Zhu
- Department of Ophthalmology, Hengli Hospital, Dongguan, Guangdong, China
| | - Jingjing Cai
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Guanrong Zhang
- Health Management Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Xingxuan Wen
- Department of Epidemiology and Health Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Haike Guo
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.,Henan Aier Eye Hospital, Aier School of Ophthalmology, Central South University, Changsha, China
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Wang M, Zuo Y, Lin X, Ling Y, Lin X, Li M, Lamoureux E, Zheng Y. Willingness to Pay for Cataract Surgery Provided by a Senior Surgeon in Urban Southern China. PLoS One 2015; 10:e0142858. [PMID: 26575284 PMCID: PMC4648520 DOI: 10.1371/journal.pone.0142858] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 10/27/2015] [Indexed: 11/18/2022] Open
Abstract
Purpose To study willingness to pay for cataract surgery and surgical service provided by a senior cataract surgeon in urban Southern China. Methods This study was a cross-sectional willingness-to-pay (WTP) interview using bidding formats. Two-hundred eleven persons with presenting visual impairment in either eye due to cataract were enrolled at a tertiary eye hospital. Participants underwent a comprehensive eye examination and a WTP interview for both surgery and service provided by a senior surgeon. Demographic information, socioeconomic status and clinical data were recorded. Results Among 211 (98% response rate) persons completing the interview, 53.6% were women and 80.6% were retired. About 72.2% had a monthly income lower than 1000 renminbi (US $161). A total of 189 (89.6%) were willing to pay for cataract and the median amount of WTP was 6000 renminbi (US$968). And 102 (50.7%) were willing to pay additional fees for surgery performed by a senior surgeon, and the median amount of WTP was 500 renminbi (US$81). In regression models adjusting for age and gender, persons with preexisting eye diseases other than cataract, were more likely to pay for cataract surgery and service provided by a senior surgeon (P = 0.04 for both). Conclusions In urban China, cataract patients, especially those with preexisting eye conditions, are willing to pay additional fees for a senior surgeon. Moving to a system where the price of cataract surgery is proportional to the consultant’ skill and expertise is possible and may have a potential impact on waiting list and quality of eye care. Further studies are needed to examine the impact of such pricing system on attitudes and choices of cataract patients.
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Affiliation(s)
- Mei Wang
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yajing Zuo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xianhua Lin
- Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China
| | - Yunlan Ling
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xiaofeng Lin
- Shantou Central Hospital, Affiliated Shantou Hospital of Sun Yat-sen University, Shantou, China
| | - Mingge Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Ecosse Lamoureux
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
- Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
| | - Yingfeng Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- * E-mail:
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Ren XT, Snellingen T, Gu H, Assanangkornchai S, Zou YH, Chongsuvivatwong V, Lim A, Jia W, Liu XP, Liu NP. Use of cataract surgery in urban Beijing: a post screening follow-up of the elderly with visual impairment due to age-related cataract. ACTA ACUST UNITED AC 2015; 30:1-6. [PMID: 25837353 DOI: 10.1016/s1001-9294(15)30001-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To understand the perception for the use of cataract surgical services in a population of acceptors and non-acceptors of cataract surgery in urban Beijing. METHODS From a community-based screening program a total of 158 patients with presenting visual acuity of less than 6/18 on either eye due to age-related cataract were informed about the possibility of surgical treatment. These patients were interviewed and re-examined 36 to 46 months after initial screening. The main reasons for not accepting surgery were obtained using a questionnaire. Vision function and vision-related quality of life scores were assessed in those who received and did not receive surgery. RESULTS At the follow-up examination 116 of the 158 patients were available and 36 (31.0%) had undergone cataract surgery. Cases who chose surgery had higher education level than those who did not seek surgery (OR=2.64, 95% CI: 1.08-6.63, P=0.02). There were no significant differences in vision function (P=0.11) or quality of life scores (P=0.16) between the surgery group and the non-surgery group. Main reasons for not having surgery included no perceived need (50.0%), feeling of being "too old" (19.2%), and worry about the quality of surgery (9.6%). Cost was cited by 1 (1.9%) subject as the main reason for not seeking surgery. CONCLUSIONS The data suggest that in China's capital urban center for patients with moderate visual impairment there is a relative low acceptance rate of cataract surgery, mainly due to people's perception of marginal benefits of surgery. Cost is not a determining factor as barrier to undergo surgery and patients with poorer education are less likely to undertake surgery.
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Affiliation(s)
- Xue-tao Ren
- Sekwa Eye Hospital, Beijing 100088, China; Epidemiology Unit, Faculty of Science and Technology, Prince of Songkla University, Songkhla 90110, Thailand
| | | | - Hong Gu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Beijing Ophthalmology and Visual Sciences, Beijing 100730, China
| | - Sawitri Assanangkornchai
- Epidemiology Unit, Faculty of Science and Technology, Prince of Songkla University, Songkhla 90110, Thailand
| | - Yan-hong Zou
- Department of Ophthalmology, First Hospital of Tsinghua University, Beijing 100016, China
| | - Virasakdi Chongsuvivatwong
- Epidemiology Unit, Faculty of Science and Technology, Prince of Songkla University, Songkhla 90110, Thailand
| | - Apiradee Lim
- Department of Mathematics and Computer Science, Faculty of Science and Technology, Prince of Songkla University, Songkhla 90110, Thailand
| | - Wei Jia
- Sekwa Eye Hospital, Beijing 100088, China
| | - Xi-pu Liu
- Sekwa Eye Hospital, Beijing 100088, China;Department of Ophthalmology, First Hospital of Tsinghua University, Beijing 100016, China
| | - Ning-pu Liu
- Sekwa Eye Hospital, Beijing 100088, China; Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Beijing Ophthalmology and Visual Sciences, Beijing 100730, China
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Qiu M, Wang SY, Singh K, Lin SC. Racial disparities in uncorrected and undercorrected refractive error in the United States. Invest Ophthalmol Vis Sci 2014; 55:6996-7005. [PMID: 25249602 DOI: 10.1167/iovs.13-12662] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To identify risk factors for inadequately corrected refractive error in the United States. METHODS This cross-sectional study included 12,758 participants 12 years of age and older from the 2005 to 2008 National Health and Nutrition Examination Survey. The primary outcome was the proportion of individuals with inadequate refractive correction for whom refractive correction would result in a visual acuity of 20/40 or better. The primary predictor was race/ethnicity. Secondary predictors included age, sex, annual household income, education, insurance, type of refractive error, current corrective lens use, presenting and best corrected visual acuity, cataract surgery, glaucoma, and age-related macular degeneration. RESULTS Overall, 50.6% of subjects had a refractive error which was correctable to 20/40 or better with refraction. The percentage of subjects with correctable refractive error who were inadequately corrected was 11.7%. Odds of inadequate refractive correction were significantly greater in Mexican Americans and non-Hispanic blacks than in their non-Hispanic white counterparts in all age groups, with the greatest disparity in the 12- to 19-year-old group. Other risk factors associated with inadequate refractive correction in adults but not in teenagers included low annual household income, low education, and lack of health insurance. CONCLUSIONS Racial disparities in refractive error correction were most pronounced in those under 20 years of age, as well as in adults with low annual household income, low education level, and lack of health insurance. Targeted efforts to provide culturally appropriate education, accessible vision screening, appropriate refractive correction, and routine follow-up to these medically underserved groups should be pursued as a public health strategy.
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Affiliation(s)
- Mary Qiu
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States
| | - Sophia Y Wang
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States
| | - Kuldev Singh
- Department of Ophthalmology, Stanford University, Stanford, California, United States
| | - Shan C Lin
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States
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Li Z, Song Z, Wu S, Xu K, Jin D, Wang H, Liu P. Outcomes and Barriers to Uptake of Cataract Surgery in Rural Northern China: The Heilongjiang Eye Study. Ophthalmic Epidemiol 2014; 21:161-8. [DOI: 10.3109/09286586.2014.903499] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Zhijian Li
- Department of Ophthalmology, the First Affiliated Hospital of Harbin Medical University HarbinChina
| | - Zhen Song
- Department of Ophthalmology, the First Affiliated Hospital of Harbin Medical University HarbinChina
| | - Shubin Wu
- Department of Ophthalmology, the First Affiliated Hospital of Harbin Medical University HarbinChina
| | - Keke Xu
- Department of Ophthalmology, the First Affiliated Hospital of Harbin Medical University HarbinChina
| | - Di Jin
- Department of Ophthalmology, the First Affiliated Hospital of Harbin Medical University HarbinChina
| | - Haijing Wang
- Department of Ophthalmology, the First Affiliated Hospital of Harbin Medical University HarbinChina
| | - Ping Liu
- Department of Ophthalmology, the First Affiliated Hospital of Harbin Medical University HarbinChina
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Chen H, Fan YC, He QH, Wu XY, Wei M, Eichner JE, Farris BK, Hildebrand PL, Lei CT, Wu SH, Yang JY. Changed trends of major causes of visual impairment in Sichuan, China from 1987 to 2006. Int J Ophthalmol 2014; 7:139-44. [PMID: 24634880 DOI: 10.3980/j.issn.2222-3959.2014.01.26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 10/29/2013] [Indexed: 09/26/2022] Open
Abstract
AIM To study the trends of major causes of visual impairment (VI) in adults in Sichuan, China and evaluate the effect of aging on the trends. METHODS We used data from the National Sample Survey on Disabilities (NSSD) in Sichuan province conducted in 1987 and 2006. The age-adjusted prevalence of major causes of VI and the prevalence stratified by age in each cause were calculated and compared. The association between age and each cause of VI was also analyzed. RESULTS Retinal disease increased and became the second leading cause of VI in 2006 while blinding trachoma decreased markedly. Cataract and non-trachomatous corneal diseases were among the leading causes of VI in both years. We found associations between age and causes of VI, with age showing the strongest association with cataract and relatively lower associations with other causes. CONCLUSION In the last two decades, dramatic changes occurred in the major causes of VI with significantly increased retinal disease and decreased blinding trachoma. Aging of the population might be an important factor accounting for the changed trends of VI. Understanding the prevalence of VI, its major causes and trends over time can assist in prioritizing and developing effective interventional strategies and monitoring their impact.
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Affiliation(s)
- Hui Chen
- Department of Ophthalmology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan Province, China ; Institute of Laboratory Animals, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan 610072, China, Luzhou 646000, Sichuan Province, China
| | - Ying-Chuan Fan
- Institute of Laboratory Animals, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan 610072, China, Luzhou 646000, Sichuan Province, China
| | - Qi-Hong He
- Department of Ophthalmology, Luzhou People's Hospital of Sichuan Province, Luzhou 646000, Sichuan Province, China
| | - Xiao-Yun Wu
- Department of Medical Records and Statistics, Shenzhen People's Hospital, Shenzhen 518020, Guangdong Province, China
| | - Min Wei
- Department of Ophthalmology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan Province, China
| | - June E Eichner
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, OK 73104, USA
| | - Bradley K Farris
- Department of Ophthalmology, University of Oklahoma School of Medicine, Oklahoma City, OK 73104, USA ; Dean A. McGee Eye Institute, Department of Ophthalmology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - P Lloyd Hildebrand
- Department of Ophthalmology, University of Oklahoma School of Medicine, Oklahoma City, OK 73104, USA ; Dean A. McGee Eye Institute, Department of Ophthalmology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Chun-Tao Lei
- Department of Ophthalmology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan Province, China
| | - Shu-Hua Wu
- Department of Emergency and Critical Care, the Second Affiliated Hospital of Soochow University, Suzhou 215004, Jiangsu Province, ,China
| | - Jing-Yun Yang
- Methodology Center, College of Health and Human Development, Pennsylvania State University, State College, PA 16801, USA
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Huang W, Ye R, Liu B, Chen Q, Huang G, Liu Y, Friedman DS, Congdon NG, Ling J, He M. Visual outcomes of cataract surgery performed by supervised novice surgeons during training in rural China. Clin Exp Ophthalmol 2014; 41:463-70. [PMID: 23078185 DOI: 10.1111/ceo.12021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Accepted: 09/16/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND To assess the outcomes of cataract surgery performed by novice surgeons during training in a rural programme. DESIGN : Retrospective study. PARTICIPANTS Three hundred thirty-four patients operated by two trainees under supervision at rural Chinese county hospitals. METHODS Two trainees performed surgeries under supervision. Visual acuity, refraction and examinations were carried out 3 months postoperatively. MAIN OUTCOME MEASURES Postoperative uncorrected visual acuity, pinhole visual acuity, causes of visual impairment (postoperative uncorrected visual acuity < 6/18) RESULTS: Among 518 operated patients, 426 (82.2%) could be contacted and 334 (64.4% of operated patients) completed the examinations. The mean age was 74.1 ± 8.8 years and 62.9% were women. Postoperative uncorrected visual acuity was available in 372 eyes. Among them, uncorrected visual acuity was ≥6/18 in 278 eyes (74.7%) and <6/60 in 60 eyes (16.1%), and 323 eyes (86.8%) had pinhole visual acuity ≥ 6/18 and 38 eyes (10.2%) had pinhole visual acuity < 6/60. Main causes of visual impairment were uncorrected refractive error (63.9%) and comorbid eye disease (24.5%). Comorbid eye diseases associated with pinhole visual acuity < 6/60 (n = 23, 6.2%) included glaucoma, other optic nerve atrophy, vitreous haemorrhage and retinal detachment. CONCLUSIONS The findings suggest that hands-on training remains safe and effective even when not implemented in centralized training centres. Further refinement of the training protocol, providing postoperative refractive services and more accurate preoperative intraocular lens calculations, can help optimize outcomes.
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Affiliation(s)
- Wenyong Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
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Zhou JB, Guan HJ, Zhu DQ, Sang AM, Gu HY, Fan XQ, Ge SF. Improvement in visual function and quality of life following a blindness prevention surgery program in a rural area of Eastern China. Exp Ther Med 2013; 5:1725-1731. [PMID: 23837062 PMCID: PMC3702720 DOI: 10.3892/etm.2013.1037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Accepted: 03/18/2013] [Indexed: 11/06/2022] Open
Abstract
The aim of this study was to assess the changes in visual function (VF) and quality of life (QOL) among patients following blindness prevention surgery in a rural area of Eastern China. The prospective study selected cataract patients via mobile eye screening camps. VF and QOL questionnaires originally developed by Fletcher et al were completed prior to and 6 months after surgery. Small-incision cataract surgery (SICS) with posterior chamber intraocular lens (IOL) implantation was performed on patients by a blindness prevention surgery group. The VF and QOL scores of 178 cataract patients preoperatively were 48.58±31.18 and 65.97±26.77, respectively. The scores decreased in proportion to decreasing vision status. The VF and QOL scale scores were significantly correlated with the vision grade of the patient (rVF=-17.2093, t=-10.87, P<0.001, rQOL=-13.1399, t=-8.87, P<0.001) and age (rVF=-0.6505, t=-3.87, P<0.001, rQOL=- 0.3309, t=-2.10, P=0.037). A total of 131 patients responded to the second survey, VF and QOL scores increased significantly over a six-month postoperative period (VF=83.21±16.40, P<0.001; QOL=86.53±16.33, P<0.001). The VF scale scores were correlated with the grade of vision and residence area, the QOL scale scores were correlated with the grade of vision and gender. The VF and QOL of patients were significantly improved by performing SICS with posterior chamber IOL implantation collectively in a short period in rural areas of Eastern China. It is important to follow-up cataract patients postoperatively as untreated complications of the surgery may affect the stability of VF and QOL postoperatively.
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Affiliation(s)
- Ji-Bo Zhou
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai 200011; ; Department of Ophthalmology, Affiliated Hospital, Nantong University, Nantong, Jiangsu 226001
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Zhu M, Tong X, Zhao R, He X, Zhao H, Liu M, Zhu J. Visual impairment and spectacle coverage rate in Baoshan district, China: population-based study. BMC Public Health 2013; 13:311. [PMID: 23566106 PMCID: PMC3626875 DOI: 10.1186/1471-2458-13-311] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Accepted: 03/25/2013] [Indexed: 11/10/2022] Open
Abstract
Background To investigate the prevalence and risk factors of visual impairment associated with refractive error and the unmet need for spectacles in a special suburban senior population in Baoshan District of Shanghai, one of several rural areas undergoing a transition from rural to urban area, where data of visual impairment are limited. Methods The study was a population based survey of 4545 Chinese aged (age: >60 years or older ) at Baoshan, Shanghai, in 2009. One copy of questionnaire was completed for each subject. Examinations included a standardized refraction and measurement of presenting and best corrected visual acuity (BCVA) as well as tonometry, slit lamp biomicroscopy, and fundus photography. Results The prevalence of mild (6/12 to 6/18), moderate (6/18 to 6/60) and severe visual impairment was 12.59%, 8.38% and 0.44%, respectively, and 5.26%, 3.06% and 0.09% with refractive correction. Visual impairment was associated with age, gender, education and career, but not insurance . The prevalence of correctable visual impairment was 5.81% (using 6/18 cutoff) and 13.18% (using 6/12 cutoff). Senior people and women were significantly at a higher risk of correctable visual impairment, while the well-educated on the contrary. The prevalence of undercorrected refractive error (improves by 2 or more lines with refraction) was 24.84%, and the proportion with undercorrected refractive error for mild, moderate , severe and no visual impairment was 61.54%, 67.98%, 60.00% and 14.10%, respectively. The spectacle coverage rate was 44.12%. Greater unmet need for spectacles was observed among elderly people, females, non-peasant, and subjects with less education and astigmatism only. Conclusions High prevalence of visual impairment, visual impairment alleviated by refractive correction, and low spectacle coverage existed among the senior population in Baoshan District of Shanghai. Education for the public of the importance of regular examination and appropriate and accessible refraction service might be helpful to solve the problem.
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Affiliation(s)
- Mengjun Zhu
- Shanghai Eye Disease Prevention and Treatment Center, No.380, Kangding Road, Jingan, Shanghai 20040, China
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Prevalence and outcomes of cataract surgery in adult rural Chinese populations of the Bai nationality in Dali: the Yunnan minority eye study. PLoS One 2013; 8:e60236. [PMID: 23577095 PMCID: PMC3618447 DOI: 10.1371/journal.pone.0060236] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Accepted: 02/23/2013] [Indexed: 10/27/2022] Open
Abstract
PURPOSE To investigate the prevalence and visual acuity (VA) outcomes of cataract surgery in adults of the Bai Nationality populations in rural China. METHODS We conducted a population-based cross-sectional survey (from randomly selected block groups) of Chinese Bai Nationality aged ≥50 years in southwestern China. Presenting visual acuity (PVA), best corrected visual acuity (BCVA) were recorded and a detailed eye examination was carried out. For all aphakic and pseudophakic subjects identified, information on the date, setting, type, and complications of cataract surgery were recorded. In eyes with VA <20/63, the principal cause of visual impairment was identified. RESULTS Of 2133 (77.8% of 2742) subjects, 99 people (129 eyes) had undergone cataract surgery. The prevalence of cataract surgery was 4.6%. Surgical coverage among those with PVA <20/200 in both eyes because of cataract was 52.8%. Unoperated cataract was associated with older age. The main barrier to cataract surgery was lack of awareness and knowledge, cost, and fear. Among the 129 cataract-operated eyes, 22.5% had PVA of ≥20/32, 25.6% had PVA of 20/40 to 20/63, 23.3% had PVA <20/63 to 20/200, and 28.7% had PVA<20/200. With BCVA, the percentages were 42.6%, 23.3%, 10.9%, and 23.3%, respectively. Aphakia (odds ratio [OR], 8.49; P<0.001) and no education (OR, 10.18; P = 0.001) or less education (OR, 6.49; P = 0.014) were significantly associated with postoperative visual impairment defined by PVA, while aphakia (OR, 8.49; P<0.001) and female gender (OR, 4.19; P = 0.004) were significantly associated with postoperative visual impairment by BCVA. The main causes of postoperative visual impairment were refractive error, retinal disorders and glaucoma. CONCLUSIONS Half of those with bilateral visual impairment or blindness because of cataract remain in need of cataract surgery in Bai population. Surgical uptake and visual outcomes should be further improved in the future.
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Huang W, Ye R, Huang S, Wang D, Wang L, Liu B, Friedman DS, He M, Liu Y, Congdon NG. Perceived difficulty of various steps of manual small incision cataract surgery among trainees in rural China. Clin Exp Ophthalmol 2013; 41:668-73. [PMID: 23331340 DOI: 10.1111/ceo.12072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 12/25/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND The perceived difficulty of steps of manual small incision cataract surgery among trainees in rural China was assessed. DESIGN Cohort study. PARTICIPANTS Fifty-two trainees at the end of a manual small incision cataract surgery training programme. METHODS Participants rated the difficulty of 14 surgical steps using a 5-point scale, 1 (very easy) to 5 (very difficult). Demographic and professional information was recorded for trainees. MAIN OUTCOME MEASURE Mean ratings for surgical steps. RESULTS Questionnaires were completed by 49 trainees (94.2%, median age 38 years, 8 [16.3%] women). Twenty six (53.1%) had performed ≤50 independent cataract surgeries prior to training. Trainees rated cortical aspiration (mean score ± standard deviation = 3.10 ± 1.14) the most difficult step, followed by wound construction (2.76 ± 1.08), nuclear prolapse into the anterior chamber (2.74 ± 1.23) and lens delivery (2.51 ± 1.08). Draping the surgical field (1.06 ± 0.242), anaesthetic block administration (1.14 ± 0.354) and thermal coagulation (1.18 ± 0.441) were rated easiest. In regression models, the score for cortical aspiration was significantly inversely associated with performing >50 independent manual small incision cataract surgery surgeries during training (P = 0.01), but not with age, gender, years of experience in an eye department or total number of cataract surgeries performed prior to training. CONCLUSIONS Cortical aspiration, wound construction and nuclear prolapse pose the greatest challenge for trainees learning manual small incision cataract surgery, and should receive emphasis during training. Number of cases performed is the strongest predictor of perceived difficulty of key steps.
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Affiliation(s)
- Wenyong Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
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Li X, Zhou Q, Sun L, Wang Z, Han S, Wu S, Wang N. Prevalence of Blindness and Low Vision in a Rural Population in Northern China: Preliminary Results from a Population-Based Survey. Ophthalmic Epidemiol 2012; 19:272-7. [DOI: 10.3109/09286586.2012.700081] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Huang G, Crooms R, Chen Q, Congdon N, He M. Compliance with Follow-up after Cataract Surgery in Rural China. Ophthalmic Epidemiol 2012; 19:67-73. [DOI: 10.3109/09286586.2011.628777] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Ko F, Frick KD, Tzu J, He M, Congdon N. Willingness to pay for potential enhancements to a low-cost cataract surgical package in rural southern China. Acta Ophthalmol 2012; 90:e54-60. [PMID: 21801337 DOI: 10.1111/j.1755-3768.2011.02207.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess determinants of patients' willingness to pay (WTP) for potential components of a multi-tiered cataract surgical package offered by a non-governmental organization (NGO) in rural China. DESIGN Cross-sectional study. METHODS Demographic and clinical data were collected from 505 patients presenting for cataract screening or surgery in Yangjiang, China. Willingness to pay for potential enhancements to the current surgery package was assessed using a bidding format with random payment cards. RESULTS Among 426 subjects (84.4%) completing interviews, the mean age was 73.9 ± 7.3 years, 67.6% were women and 73% (n = 310) would pay for at least one offering, with 33-38% WTP for each item. Among those who would pay, the mean WTP for food was US$1.68 ± 0.13, transportation US$3.24 ± 0.25, senior surgeon US$50.0 ± 3.36 and US$89.4 ± 4.19 for an imported intra-ocular lens (IOL). The estimated total recovery from these enhancements under various assumptions would be US$20-50 (compared to the current programme price of US$65). In multivariate models, WTP for the senior surgeon increased with knowledge of a person previously operated for cataract (OR = 2.13, 95% CI 1.42-3.18, p < 0.001). Willingness to pay for the imported IOL increased with knowledge of a previously operated person (OR = 1.85, 95% CI 1.24-2.75, p < 0.01) and decreased with age >75 years (OR = 0.61, 0.40-0.93, p < 0.05). CONCLUSIONS Opportunities exist to increase cataract programme revenues through multi-tiered offerings in this setting, allowing greater subsidization of low-income patients. Personal familiarity with cataract surgery is important in determining WTP.
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Affiliation(s)
- Fang Ko
- Wilmer Eye Institute, Baltimore, Maryland, USA
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Zhang M, Wu X, Li L, Huang Y, Wang G, Lam J, Lam DSC, Gao Y, Griffiths S, Congdon N. Understanding Barriers to Cataract Surgery Among Older Persons in Rural China Through Focus Groups. Ophthalmic Epidemiol 2011; 18:179-86. [DOI: 10.3109/09286586.2011.580884] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Chen X, Chen C, Zhang Y, Yuan R, YE J. The effect of health insurance reform on the number of cataract surgeries in Chongqing, China. BMC Health Serv Res 2011; 11:67. [PMID: 21439077 PMCID: PMC3072314 DOI: 10.1186/1472-6963-11-67] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2010] [Accepted: 03/26/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cataracts are the leading cause of blindness in China, and poverty is a major barrier to having cataract surgery. In 2003, the Chinese government began a series of new national health insurance reforms, including the New Cooperative Medical Scheme (NCMS) and the Urban Resident Basic Health Insurance scheme (URBMI). These two programs, combined with the previously existing Urban Employee Basic Health Insurance (UEBMI) program, aimed to make it easier for individuals to receive medical treatment. This study reports cataract surgery numbers in rural and urban populations and the proportion of these who had health insurance in Chongqing, China from 2003 to 2008. METHODS The medical records of a consecutive case series, including 14,700 eyes of 13,262 patients who underwent age-related cataract surgery in eight hospitals in Chongqing from January 1, 2003, to December 31, 2008, were analysed retrospectively via multi-stage cluster sampling. RESULTS In the past six years, the total number of cataract surgeries had increased each year as had the number of patients with insurance. Both the number of surgeries and the number of insured patients were much higher in the urban group than in the rural group. The rate of increase in the rural group however was much higher than in the urban group, especially in 2007 and 2008. The odds ratios of having health insurance for urban vs. rural individuals were relatively stable from 2003 to 2006, but it decreased in 2007 and was significantly lower in 2008. CONCLUSIONS Health insurance appears to be an important factor associated with increased cataract surgery in Chongqing, China. With the implementation of health insurance, the number of Chongqing's cataract surgeries was increased year by year.
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Affiliation(s)
- Xiaofan Chen
- Department of Ophthalmology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, 400042, China
| | - Chunlin Chen
- Department of Ophthalmology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, 400042, China
| | - Yao Zhang
- Department of Epidemiology, College of Preventive Medicine, Third Military Medical University, Chongqing, 400038, China
| | - Rongdi Yuan
- Department of Ophthalmology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, 400042, China
| | - Jian YE
- Department of Ophthalmology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, 400042, China
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Huang W, Huang G, Wang D, Yin Q, Foster PJ, He M. Outcomes of cataract surgery in urban southern China: the Liwan Eye Study. Invest Ophthalmol Vis Sci 2011; 52:16-20. [PMID: 20688728 DOI: 10.1167/iovs.10-5382] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE The outcomes of cataract surgery have been well reported in rural China; however, the situation in the urban population remains unclear. This study assessed the outcomes of cataract surgery in urban southern China. METHODS Data were gathered from the Liwan Eye Study, a population-based, cross-sectional study conducted in people aged 50 years or more in the Liwan District of Guangzhou. Presenting and best corrected visual acuity and a detailed eye examination were performed. For all aphakic and pseudophakic participants identified, information on the date, setting, type, and complications of cataract surgery were recorded. RESULTS Of the 1405 participants, 62 people (90 eyes) had undergone cataract surgery. Of those, 54.4% underwent the phacoemulsification (Phaco) technique, 33.3% extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation, and 11.1% ECCE without IOL; 1 patient had intracapsular cataract extraction (ICCE). Presenting visual acuity (PVA) was >6/18 in 56 (62.2%) eyes, <6/18 to >6/60 in 20 (22.2%) eyes, <6/60 to >3/60 in 3 (3.3%) eyes, and <3/60 in 11(12.3%) eyes. Of the 34 eyes with PVA less than 6/18, the principal causes were 26.5% retinal abnormalities, 20.6% glaucoma, 35.3% uncorrected aphakia or refractive error, and 14.5% posterior capsule opacification (PCO). CONCLUSIONS ECCE or Phaco with IOL are the major surgical techniques used in urban southern China. More than half of the eyes with poor outcomes due to uncorrected aphakia, refractive error, or PCO are potentially treatable. This result suggests a pressing need for improved surgical training and postoperative care.
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Affiliation(s)
- Wenyong Huang
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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Schneider J, Leeder SR, Gopinath B, Wang JJ, Mitchell P. Frequency, course, and impact of correctable visual impairment (uncorrected refractive error). Surv Ophthalmol 2010; 55:539-60. [PMID: 20850856 DOI: 10.1016/j.survophthal.2010.02.004] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2009] [Revised: 02/15/2010] [Accepted: 02/19/2010] [Indexed: 11/24/2022]
Abstract
Uncorrected refractive error has been identified by the World Health Organization (WHO) as one of the priorities for Vision 2020 and a frequent cause of visual impairment. In the past, only the terms presenting visual impairment (PVI) and visual impairment after best refractive correction (BCVI) were used, so that PVI also included BCVI cases. In the more recent literature, visual impairment has been subdivided into two mutually exclusive entities: that which is correctable by refraction (which we now term correctable visual impairment, CVI) and that which cannot be corrected by refraction due to ocular or neurological disease (which we now term non-correctable visual impairment, NCVI, and which is identical to BCVI). PVI remains a useful concept as it includes both types of impairment. Although CVI is reported to be the major form of visual impairment worldwide, its impacts are not yet well understood. CVI has a higher prevalence among vulnerable groups such as older people, less well educated people and those living alone or in rural areas. Systematic data on barriers to refractive correction remain scant, but these may be present at the individual level, within the health service context, or at a social level. Our review indicates that research on CVI is at a relatively early stage and that more detailed research, particularly determining whether it has impacts on independent living and quality of life, is needed before CVI can be justifiably prioritized in health policy.
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Affiliation(s)
- Julie Schneider
- Menzies Centre for Health Policy, University of Sydney, Sydney, Australia
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Murthy GVS, Vashist P, John N, Pokharel G, Ellwein LB. Prevelence and causes of visual impairment and blindness in older adults in an area of India with a high cataract surgical rate. Ophthalmic Epidemiol 2010; 17:185-95. [PMID: 20642340 DOI: 10.3109/09286586.2010.483751] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The cataract surgical rate (CSR) in Gujarat, India is reported to be above 10,000 per million population. This study was conducted to investigate the prevalence and causes of vision impairment/blindness among older adults in a high CSR area. METHODS Geographically defined cluster sampling was used in randomly selecting persons >or= 50 years of age in Navsari district. Subjects in 35 study clusters were enumerated and invited for measurement of presenting and best-corrected visual acuity and an ocular examination. The principal cause was identified for eyes with presenting visual acuity < 20/32. RESULTS A total of 5158 eligible persons were enumerated and 4738 (91.9%) examined. Prevalence of presenting visual impairment < 20/63 to 20/200 in the better eye was 29.3% (95% confidence interval [CI]: 27.5-31.2) and 13.5% (95% CI: 12.0-14.9) with best correction. The prevalence of presenting bilateral blindness (< 20/200) was 6.9% (95% CI: 5.7-8.1), and 3.1% (95% CI: 2.5-3.7) with best correction. Presenting and best-corrected blindness were both associated with older age and illiteracy; gender and rural/urban residence were not significant. Cataract in one or both eyes was the main cause of bilateral blindness (82.6%), followed by retinal disorders (8.9%). Cataract (50.3%) and refractive error (35.4%) were the main causes in eyes with vision acuity < 20/63 to 20/200, and refractive error (86.6%) in eyes with acuity < 20/32 to 20/63. CONCLUSIONS Visual impairment and blindness is a significant problem among the elderly in Gujarat. Despite a reportedly high CSR, cataract remains the predominant cause of blindness.
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Zhao J, Ellwein LB, Cui H, Ge J, Guan H, Lv J, Ma X, Yin J, Yin ZQ, Yuan Y, Liu H. Prevalence and outcomes of cataract surgery in rural China the China nine-province survey. Ophthalmology 2010; 117:2120-8. [PMID: 20663565 DOI: 10.1016/j.ophtha.2010.03.005] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2009] [Revised: 01/14/2010] [Accepted: 03/02/2010] [Indexed: 11/15/2022] Open
Abstract
PURPOSE To investigate the prevalence and visual acuity (VA) outcomes of cataract surgery in rural populations throughout China. DESIGN Population-based, cross-sectional study. PARTICIPANTS Forty-five thousand seven hundred forty-seven adults 50 years of age and older. METHODS Geographically defined cluster sampling was used in randomly selecting a cross-section of residents from a representative rural county within each of 9 provinces in mainland China. Participants underwent VA measurements, refraction, and a slit-lamp examination at local examination sites; those with previous cataract surgery were queried as to the year and type of surgical facility. Surgical procedure and evidence of surgery complications were noted during the examination. The principal cause of visual impairment was identified for eyes with VA of 20/40 or worse. MAIN OUTCOME MEASURES Cataract surgery procedure, presenting and best-corrected distance VA, and causes of visual impairment. RESULTS Of 50 395 enumerated eligible persons, 45 747 (90.8%) were examined and tested for VA. The overall prevalence of cataract surgery was 2.09%. Surgical coverage among those with VA worse than 20/200 in both eyes because of cataract was 35.7%. Unoperated cataract was associated with older age, female gender, lack of education, and geographic area (province). Among the 1174 cataract-operated eyes, 31.1% had presenting VA of 20/32 or better, 15.4% had presenting VA of 20/40 to 20/63, 30.0% had presenting VA worse than 20/63 to 20/200, and 23.5% had presenting VA worse than 20/200. With best correction, the percentages were 57.6%, 6.2%, 18.5%, and 17.7%, respectively. Posterior capsule opacification, refractive error, and retinal disorders were the main causes in cataract-operated eyes with VA worse than 20/63. CONCLUSIONS Two thirds of those with bilateral visual impairment or blindness because of cataract remain in need of sight-restoring surgery. Posterior capsule opacification and refractive error, both readily amenable to treatment, were common in cataract-operated eyes. Sustained government efforts to provide access to affordable modern cataract surgery with a greater emphasis on postoperative follow-up and the quality of VA outcomes are needed. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Jialiang Zhao
- Chinese Academy of Medical Sciences, and Department of Ophthalmology, Peking Union Medical College Hospital, Beijing, China.
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Prevalence and causes of low vision and blindness in a rural Southwest Island of Japan: the Kumejima study. Ophthalmology 2010; 117:2315-21. [PMID: 20591485 DOI: 10.1016/j.ophtha.2010.03.043] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2009] [Revised: 03/16/2010] [Accepted: 03/17/2010] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To determine the prevalence and causes of low vision and blindness in an adult population on a rural southwest island of Japan. DESIGN Population-based, cross-sectional study. PARTICIPANTS All residents of Kumejima Island, Japan, 40 years of age and older. METHODS Of the 4632 residents 40 years of age and older, 3762 (response rate, 81.2%) underwent a detailed ocular examination including measurement of the best-corrected visual acuity (BCVA) with a Landolt ring chart at 5 m. The age- and gender-specific prevalence rates of low vision and blindness were estimated and causes were identified. MAIN OUTCOME MEASURES Low vision and blindness were defined, according to the definition of the World Health Organization, as a BCVA in the better eye below 20/60 to a lower limit of 20/400 and worse than 20/400, respectively. RESULTS The prevalence of bilateral low vision was 0.58% (95% confidence interval [CI], 0.38-0.89). The primary causes of low vision were cataract (0.11%), corneal opacity (0.08%), retinitis pigmentosa (RP; 0.06%), and diabetic retinopathy (0.06%). The prevalence of bilateral blindness was 0.39% (95% CI, 0.23-0.65). The primary causes of blindness were RP (0.17%) and glaucoma (0.11%). The primary causes of monocular low vision were cataract (0.65%), corneal opacity (0.16%), age-related macular degeneration (0.16%), and diabetic retinopathy (0.11%), whereas those of monocular blindness were cataract (0.29%), trauma (0.25%), and glaucoma (0.22%). Logistic analysis showed that female gender (P = 0.001; odds ratio [OR], 7.37; 95% CI, 2.20-24.71) and lower body weight (P = 0.015; OR, 0.94; 95% CI, 0.90-0.99) were associated significantly with visual impairment. CONCLUSIONS The prevalences of low vision and blindness in the adult residents of an island in southwest Japan were 1.5 to 3 times higher than the prevalences reported in an urban city on the Japanese mainland. The prevalence of visual impairment caused by RP on this island was much higher than on the mainland, suggesting a genetic characteristic of the population. Furthermore, the prevalence of visual impairment resulting from cataract and corneal opacity was higher than that on the mainland. The prevalence of visual impairment resulting from myopic macular degeneration was less.
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Lansingh VC, Resnikoff S, Tingley-Kelley K, Nano ME, Martens M, Silva JC, Duerksen R, Carter MJ. Cataract surgery rates in latin america: a four-year longitudinal study of 19 countries. Ophthalmic Epidemiol 2010; 17:75-81. [PMID: 20302429 DOI: 10.3109/09286581003624962] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To collect cataract surgery rates data in 19 Latin American countries over a 4-year period as data published to date have been limited. METHODS Cataract surgery rates were obtained from National Society of Ophthalmology, National VISION 2020/Prevention of Blindness Committee and Ministry of Health representatives for each country for 2005 to 2008. Economic (gross national income per capita) and other data were collected from publicly available databases. Linear and power correlations between gross national incomes and cataract surgery rates were calculated. RESULTS Over the study period, most countries increased their cataract surgery rates, with the largest increases observed for Venezuela (186%), Nicaragua (183%), Costa Rica (100%), Uruguay (97%), and Peru (88%). Mean cataract surgery rates for 2005, 2006, 2007, and 2008 for the ensemble of countries were 1545, 1684, 1660, and 1822 per million population, respectively, with a growth over the study period of 17.9%, concurrent with an increase of 57 million (11.5%) in the population. A good correlation between cataract surgery rate and gross national income per capita was found (P < .001). CONCLUSIONS Although progress is being made in the region, the cataract surgery rates represent only one parameter. When they are examined in the context of cataract surgical coverage it is clear that substantial proportions of bilaterally blind persons are still not receiving surgery.
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Affiliation(s)
- Van C Lansingh
- Fundacion Vision, Asuncion, Paraguay, Fundacion Hugo Nano, Buenos Aires, Argentina, and International Agency for the Prevention of Blindness/VISION 2020 LA office, Buenos Aires, Argentina
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Congdon NG, Aung T. A tale of two systems: health reform in China and the United States. Ophthalmology 2010; 117:407-8. [PMID: 20189031 PMCID: PMC7133675 DOI: 10.1016/j.ophtha.2010.01.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Accepted: 01/10/2010] [Indexed: 10/27/2022] Open
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Salomão SR, Mitsuhiro MRKH, Belfort R. Visual impairment and blindness: an overview of prevalence and causes in Brazil. AN ACAD BRAS CIENC 2010; 81:539-49. [PMID: 19722022 DOI: 10.1590/s0001-37652009000300017] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2008] [Accepted: 04/27/2009] [Indexed: 11/21/2022] Open
Abstract
Our purpose is to provide a summary overview of blindness and visual impairment on the context of recent Brazilian ocular epidemiologic studies. Synthesis of data from two cross-sectional population-based studies - the São Paulo Eye Study and the Refractive Error in School Children Study is presented. 3678 older adults and 2441 school children were examined between July 2004 and December 2005. Prevalence of blindness in older adults using presenting visual acuity was 1.51% decreasing to 1. 07% with refractive correction. The most common causes of blindness in older adults were retinal disorders, followed by cataract and glaucoma. In school children, the prevalence of uncorrected visual impairment was 4.82% decreasing to 0.41% with refractive correction. The most common cause of visual impairment in school children was uncorrected refractive error. Visual impairment and blindness in Brazil is an important public health problem. It is a significant problem in older Brazilians, reinforcing the need to implement prevention of blindness programs for elderly people with emphasis on those without schooling. In school-children cost-effective strategies are needed to address a readily treatable cause of vision impairment - prescription and provision of glasses.
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Affiliation(s)
- Solange R Salomão
- Instituto da Visão, Departamento de Oftalmologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
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Zhao J, Ellwein LB, Cui H, Ge J, Guan H, Lv J, Ma X, Yin J, Yin ZQ, Yuan Y, Liu H. Prevalence of vision impairment in older adults in rural China: the China Nine-Province Survey. Ophthalmology 2010; 117:409-16, 416.e1. [PMID: 20079923 DOI: 10.1016/j.ophtha.2009.11.023] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2009] [Revised: 10/03/2009] [Accepted: 11/13/2009] [Indexed: 10/19/2022] Open
Abstract
PURPOSE Describe the prevalence of visual impairment/blindness among older adults in rural populations in China. DESIGN Population-based, cross-sectional study. PARTICIPANTS We evaluated 45 747 adults > or =50 years of age. METHODS Geographically defined cluster sampling was used in randomly selecting a cross-section of residents from a representative rural county within each of 9 provinces in mainland China. Participants were enumerated through village registers followed by door-to-door household visits. Eligible persons were invited to local examination sites for visual acuity (VA) testing and eye examination. MAIN OUTCOME MEASURES Presenting and best-corrected distance VA. RESULTS Of 50 395 enumerated eligible persons, 45 747 (90.8%) were examined and tested for VA. The prevalence of presenting visual impairment <20/63 to > or =20/400 in the better eye was 10.8% and blindness (<20/400) was 2.29%. Across the 9 provinces, presenting visual impairment ranged from 6.89% to 15.8%, and blindness from 1.27% to 5.40%. With best-corrected VA, the prevalence of visual impairment was 5.30%, and 1.93% for blindness. The ranges across the 9 provinces were 3.13% to 9.51% for visual impairment and 0.74% to 4.95% for blindness. Visual impairment and blindness were associated with older age, female gender, lack of education, and geographic area (province) with both presenting and best-corrected VA. CONCLUSIONS Visual impairment and blindness are important public health problems in rural China, with significant regional variations in prevalence. Blindness prevention programs targeting the rural elderly should be expanded, particularly in areas with limited access and affordability of eye care services. Special emphasis should be given to reaching women and those without education. Greater attention should also be given to correction of refractive error.
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Affiliation(s)
- Jialiang Zhao
- Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China.
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Murthy GVS, Vashist P, John N, Pokharel G, Ellwein LB. Prevalence and vision-related outcomes of cataract surgery in Gujarat, India. Ophthalmic Epidemiol 2010; 16:400-9. [PMID: 19995206 DOI: 10.3109/09286580903315809] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Investigate the prevalence and vision-related outcomes of cataract surgery in an area of high cataract surgical rate. METHODS Cluster sampling was used in randomly selecting individuals > or = 50 years of age in 2007. Participants were queried regarding year and place of previous cataract surgery. Cataract surgical procedures and evidence of surgical complications were recorded. The principal cause was identified for eyes presenting with visual acuity (VA) < or = 20/40. RESULTS A total of 4,738 persons were examined and 834 (17.6%) had cataract surgery. Intra-ocular lenses (IOLs) were used in 84.1% of the 1,299 cataract-operated eyes, with more than half of these having manual small incision surgery. Surgical coverage among the cataract blind (visual acuity [VA] < 20/200) was estimated as 72.2%. Coverage was associated with older age, literacy, and urban residence; gender was not significant. Among cataract-operated eyes, 18.7% presented with VA > or = 20/32 and 18.0% were < 20/200. With best-corrected acuity, the corresponding percentages were 55.7% and 11.0%. Presenting and best-corrected VA > or = 20/63 were associated with young age, literacy, and IOL surgery; urban residence and surgery in non-governmental organizations (NGO)/private facilities were also significant for presenting VA; and recent surgery was significant for best-corrected VA. Refractive error was the main cause of vision impairment/blindness in cataract-operated eyes. CONCLUSIONS Refractive error and posterior capsule opacification, easily treatable causes of visual impairment, are common among the operated. A greater emphasis on the quality of visual acuity outcomes along with sustained efforts to provide access to affordable surgery is needed.
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Affiliation(s)
- Gudlavalleti V S Murthy
- International Center for Eye Health, London School of Hygiene & Tropical Medicine, London, UK.
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