Risk, causes, and outcomes of visual impairment after loss of vision in the non-amblyopic eye: a population-based study
Risk, causes, and outcomes of visual impairment after loss of vision in the non-amblyopic eye: a population-based study
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DOI：
10.1016/s0140-6736(02)09782-9
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发表时间：
2002-08-24
期刊：
影响因子：
168.9
通讯作者：
Taylor, D
中科院分区：
文献类型：
--
作者：
Rahi, JS;Logan, S;Taylor, D
许多国家在儿童早期进行弱视背景筛查，以确保在关键时期发现并治疗受影响的儿童，使弱视眼达到一定的视力水平，以便在日后非弱视眼视力丧失时能发挥作用。我们旨在调查非弱视眼视力丧失导致的视力损害的风险、原因和结果。
方法 从1997年7月起的24个月内，在英国进行全国性监测，以确定所有单眼弱视（视力低于6/12）且非弱视眼新近出现视力丧失，导致视力低于6/12或视野受限无法驾驶的个体。在就诊时和1年后获取参与者的信息。根据世界卫生组织的分类标准，参与者被归类为具有社会显著视力损害、视力损害、严重视力损害或失明。
结果 在370名符合条件的个体中，就诊时104人（28%）有社会显著视力损害，180人（49%）有视力损害，86人（23%）有严重视力损害或失明。到95岁时永久性视力损害的最小风险为每10万总人口32.9例（95%置信区间29.1 - 36.9）。弱视个体预计一生视力丧失的风险至少为1.2%（95%置信区间1.1 - 1.4）。先前有带薪工作的102人当中只有36人（35%）能够继续工作。
解释 在英国，弱视筛查正在接受审查，非弱视眼出现严重视力丧失的风险及其后果比之前设想的要大。因此，除了提高弱视眼视力的益处外，儿童时期治疗弱视是一种潜在的有价值的策略，可预防日后致残性视力丧失。
Background Screening for amblyopia in early childhood is done in many countries to ensure that affected children are detected and treated within the critical period, and achieve a level of vision in their amblyopic eye that would be useful should they lose vision in their non-amblyopic eye later in life. We aimed to investigate the risk, causes, and outcomes of visual impairment attributable to loss of vision in the non-amblyopic eye.Methods For 24 months from July, 1997, national surveillance was done to identify all individuals in the UK with unilateral amblyopia (acuity worse than 6/12) who had newly acquired vision loss in the non-amblyopic eye, resulting in acuity of worse than 6/12 or visual-field restriction precluding driving. Information about participants was obtained at presentation and 1 year later. Participants were categorised as having socially significant visual impairment, or visual impairment, severe visual impairment, or blindness, in accordance with WHO taxonomy.Findings Of 370 eligible individuals, at presentation 104 (28%) had socially significant visual impairment, 180 (49%) visual impairment, and 86 (23%) severe visual impairment or blindness. The minimum risk of permanent visual impairment by age 95 years was 32.9 (95% Cl 29.1-36.9) per 100 000 total population. The projected lifetime risk of vision loss for an individual with amblyopia was at least 1.2% (95% Cl 1.1-1.4). Only 36 (35%) of 102 people previously in paid employment were able to continue.Interpretation In the UK, where screening for amblyopia is under review, risk of serious vision loss affecting the nonamblyopic eye and its results are greater than that previously assumed. Thus, in addition to the-benefits of improved vision in the amblyopic eye, treatment of amblyopia during childhood is a potentially valuable strategy to prevent incapacitating vision loss later in life.