Age-related Prevalence and Met Need for Correctable and Uncorrectable Near Vision Impairment in a Multi-country Study

作者：He, Mingguang^*; Abdou, Amza; Ellwein, Leon B.; Naidoo, Kovin S.; Sapkota, Yuddha D.; Thulasiraj, R. D.; Varma, Rohit; Zhao, Jialiang; Kocur, Ivo; Congdon, Nathan G.

来源：Ophthalmology, 2014, 121(1): 417-422.

DOI：10.1016/j.ophtha.2013.06.051

• QUALITY-OF-LIFE
• FUNCTIONAL PRESBYOPIA
• POPULATION
• INDIA
• EYE

Purpose: To estimate the prevalence, potential determinants, and proportion of met need for near vision impairment (NVI) correctable with refraction approximately 2 years after initial examination of a multi-country cohort.
Design: Population-based, prospective cohort study.
Participants: People aged 35 years examined at baseline in semi-rural (Shunyi) and urban (Guangzhou) sites in China; rural sites in Nepal (Kaski), India (Madurai), and Niger (Dosso); a semi-urban site (Durban) in South Africa; and an urban site (Los Angeles) in the United States. Methods: Near visual acuity (NVA) with and without current near correction was measured at 40 cm using a logarithm of the minimum angle of resolution near vision tumbling E chart. Participants with uncorrected binocular NVA 20/ 40 were tested with plus sphere lenses to obtain best-corrected binocular NVA. Main Outcome Measures: Prevalence of total NVI (defined as uncorrected NVA 20/ 40) and NVI correctable and uncorrectable to > 20/ 40, and current spectacle wearing among those with bilateral NVA 20/ 63 improving to > 20/ 40 with near correction (met need).
Results: Among 13 671 baseline participants, 10 533 (77.2%) attended the follow-up examination. The prevalence of correctable NVI increased with age from 35 to 50e60 years and then decreased at all sites. Multiple logistic regression modeling suggested that correctable NVI was not associated with gender at any site, whereas more educated persons aged > 54 years were associated with a higher prevalence of correctable NVI in Nepal and India. Although near vision spectacles were provided free at baseline, wear among those who could benefit was < 40% at all but 2 centers (Guangzhou and Los Angeles).
Conclusions: Prevalence of correctable NVI is greatest among persons of working age, and rates of correction are low in many settings, suggesting that strategies targeting the workplace may be needed.

• 出版日期2014-1
• 单位中山大学; 中国医学科学院北京协和医院; 北京协和医学院; 眼科学国家重点实验室