Racial variations in causes of vision loss in nursing homes: The Salisbury Eye Evaluation in Nursing Home Groups (SEEING) Study.
Racial variations in causes of vision loss in nursing homes: The Salisbury Eye Evaluation in Nursing Home Groups (SEEING) Study.
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DOI：
10.1097/01.ieb.0000150376.66176.d2
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发表时间：
2004-07
影响因子：
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通讯作者：
D. Friedman;S. West;B. Munoz;W. Park;James T. Deremeik;R. Massof;K. Frick;A. Broman;W. McGill
中科院分区：
文献类型：
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作者：
D. Friedman;S. West;B. Munoz;W. Park;James T. Deremeik;R. Massof;K. Frick;A. Broman;W. McGill
目的了解老年人低视力的患病率及原因。方法在马里兰州和特拉华州东岸的28家养老院进行了一项临床试验，以评估视力恢复/康复对养老院居民的影响。视觉敏锐度是通过识别图表和优先观察技术来测量的。一位眼科医生检查了所有视力较好的眼睛的视力低于20/40的居民，并确定了视力下降的主要原因。报告了视力较好的眼睛的结果。结果在2544名符合条件的居民中，1591人（63%）参加了测试，其中286人对视力测试没有反应。在其余1307名居民中，496名（37%）的最佳矫正视力低于视力较好的眼睛的20/40。412个科目的病因。非裔美国人受试者和白人受试者的低视力率相似（分别为39%和38%；年龄调整P = 0.18）。白内障是低视力的主要原因，占白人低视力的37%，占非裔美国人低视力的54%。白人受试者中有29%的低视力是由黄斑变性引起的，而非裔美国受试者中只有7%。青光眼导致4%的白人和10%的非裔美国人视力低下。屈光不正并不是养老院居民低视力的常见原因。结论：低视力在养老院居民中非常普遍，37%的老年人视力低于20/40。非裔美国人与白人受试者低视力的原因存在差异，其中非裔美国人更有可能因白内障（一种容易治疗的疾病）而丧失视力。对于在获得眼科护理服务方面面临重大障碍的养老院居民，适当的干预措施有可能改善这一高危老年人的生活质量。
OBJECTIVE To determine the prevalence and causes of low vision in a large sample of nursing home residents. METHODS Twenty-eight nursing homes on the Eastern Shore of Maryland and Delaware were enrolled in a clinical trial to assess the impact of vision restoration/rehabilitation on nursing home residents. Visual acuity was measured using both recognition charts and preferential looking techniques. An ophthalmologist examined all residents with visual acuity worse than 20/40 in the better-seeing eye and determined the primary cause for decreased vision. Results are reported for the better-seeing eye. RESULTS Of 2544 eligible residents, 1591 (63%) participated, but 286 residents were unable to respond to visual acuity testing. Of the remaining 1307 residents, 496 (37%) had best-corrected visual acuity worse than 20/40 in the better-seeing eye. Causes were ascribed for 412 subjects. Rates of low vision were similar between African American subjects and white subjects (39% and 38%, respectively; age-adjusted P =.18). Cataract was the leading cause of low vision, responsible for 37% of low vision among white subjects and 54% of low vision among African American subjects. Macular degeneration was responsible for 29% of low vision among white subjects but only 7% among African American subjects. Glaucoma caused low vision in 4% of white subjects and 10% of African American subjects. Refractive error was not a frequent cause of low vision in nursing home residents. CONCLUSIONS Low vision is highly prevalent among nursing home residents, with 37% having visual acuity worse than 20/40 in the better-seeing eye. Differences in causes of low vision between African American subjects and white subjects were noted, with African American subjects more likely to have vision loss on the basis of cataract, a readily treated condition. Appropriate interventions for nursing home residents, who face significant obstacles in accessing eye care services, have the potential to improve the quality of life of this at-risk older population.