Visual impairment and blindness caused by retinal diseases: A nationwide register-based study.
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Zhou Chuandi, Li Shu, Ye Luyao, Chen Chong, Liu Shu, Yang Hongxia, Zhuang Peng, Liu Zengye, Jiang Hongwen, Han Jing, Jiang Yiping, Zhou Liqin, Zhou Xiyuan, Xiao Jun, Zhang Cangxia, Wen Lihui, Lan Changjun, Wang Yuqing, Sun Tao, Jiang Li, Xie Peipei, Chen Fan, Liang Ge, Fu Dongdong, Zhang Tianzi, Shi Xuetao, Song Zhengyu, Liu Xinghong, Li Shanshan, Li Pengcheng, Xu Xiangzhou, Wei Qinfeng, Wang Weibang, Huang Xionggao, De Zhen, Deng Aijun, Ding Lin, Pan Xiuhong, Wen Haiyan, Zhang Zhongchen, Lv Hongbin, Zhang Jian, Tian Xuemin, Deng Zhen, Wang Hua, Wang Fang, Wang Yu, Zhao Hongchao, Fang Yanhong, Wu Yuyu, Wu Yufeng, Shen Nian, Li Bo, Li Xiaorong, Dai Hong, Zhao Naiqing, Sun Xiaodong, Zheng Zhi, Liu Kun, Xu Xun
Аннотация
METHODS: A nationwide register-based study of vitreoretinal disease covering all 31 provinces (51 treating centres) of mainland China. A total of 28 320 adults diagnosed with retinal diseases were included. Participants underwent standardised ocular examinations, which included best-corrected visual acuity (BCVA), dilated-fundus assessments, and optical coherence tomography. Visual impairment and blindness are defined using BCVA according to the World Health Organization (WHO) (visual impairment: <20/63-≥20/400; blindness: <20/400) and the United States (visual impairment: <20/40-≥20/200; blindness: <20/200) definitions. The risk factors of vision loss were explored by logistic regression analyses.
RESULTS: Based on the WHO definitions, the proportions for unilateral visual impairment and blindness were 46% and 18%, respectively, whereas those for bilateral visual impairment and blindness were 31% and 3.3%, respectively. Diabetic retinopathy (DR) accounts for the largest proportion of patients with visual impairment (unilateral visual impairment: 32%, bilateral visual impairment: 60%) and blindness (unilateral blindness: 35%; bilateral blindness: 64%). Other retinal diseases that contributed significantly to vision loss included age-related macular degeneration, myopic maculopathy, retinal vein occlusion, and rhegmatogenous retinal detachment and other macular diseases. Women (bilateral vision loss: P = 0.011), aged patients (unilateral vision loss: 45-64 years: P < 0.001, ≥65 years: P < 0.001; bilateral vision loss: 45-64 years: P = 0.003, ≥65 years: P < 0.001 (reference: 18-44 years)) and those from Midwest China (unilateral and bilateral vision loss: both P < 0.001) were more likely to suffer from vision loss.
CONCLUSIONS: Retinal disorders cause substantial visual burden among patients with retinal diseases in China. DR, the predominant retinal disease, is accountable for the most prevalent visual disabilities. Better control of diabetes and scaled-up screenings are warranted to prevent DR. Specific attention should be paid to women, aged patients, and less developed regions.