臺東縣金峯鄉排灣族平地山胞之翼狀片疫學的調查成績

Prevalence of Pterygia among Plain Aborigines of Paiwan Tribe of Chin-Fong-Hsian, Tai-Tong-Shien

陳振武(C. W. Chen) ； 莊雪霞(S. S. Chuang)

《中華民國眼科醫學會會刊》 15卷 (1976/05) Pp. 27-34

https://doi.org/10.30048/ACTASOS.197605.0006

並列摘要

A survey of pterygia was carried out among the plain aborigines of Paiwan tribe living in Ching-Fong-Hsian, Tai-Tong-Hsien. Among a population of 3246, were examined 268 cases including both sex and all age groups. A method of notation and classification of pterygia reported by Chen was applied with a modification. With this method symbols P, T, A, V, O, were used to represent five elements of clinical findings of pterygia to meet the needs of statistical analysis and clinical evaluation. The symbols represent respectively stages of growth, thickness and vascularity, the angle composed by the upper and lower borders, the distance of vascularization into the cornea, and the grayish opacity beyond the vascular apex on the cornea.
The results were summarized as follows:
1. Pterygia were found only among those over the age of 20 years. Among 268 examined, pterygia were found in 41.42%. When adjusted according to the age distribution of population, the expected prevalence rate was 19.04% for the total population.
2. The rate of prevalence increased in accordance with the age ranging from 14.28% among the age 20 to 29 years to 65.45% of 40 to 49 years. Over the age 50 years, it did not show accumulative increase.
3. The growth in size and thickness, and in relation to the corneal involvement of the pterygium showed a tendency of self-limitation when the age reached over 50 years and the growth to certain size. The distance of the corneal involvement measured from the limbus was rarely longer than 2mm. In 67.71%, the pterygia were small leaving the semilunar fold uninvolved (P1) and in 31.25%, the pterygium involved the semilunar fold resulting in its deformity.
4. The tendency of growth and self-limitation of pterygium in relation to age and its own size suggests the important role played by the endogenous factors innately related to age. The exogenous factors, however, such as exposure to sunlight, particularly ultra-violet rays, dryness, wind and dusts have been emphasized. The conjunctival tissue reactivity to proliferate in response to external irritation of exposure to sunlight, wind and dust seems to diminish as age grows over 50 years.
5. The pterygia were found in the nasal side of the cornea in 85.42% of all counted among 111 affected persons.
6. Pterygia were found only in single eye in 49.55% and in both eyes in 50.45%.
7. The most common type of distribution of pterygia within the eyes was a single nasal pterygium in one eye (46.85%). The binasal pterygia occupied 27.93%. The combination of binasal and a temporal pterygia occupied 10.81%. The combination of bitemporal and a nasal pterygia was as less common as that of binasal combined with bitemporal ones. Each of them was found in 5.40%.
Attention was called to the adequate management of the body and base of the pterygium in its surgery. Most of the methods of surgery usually emphasize the importance to neatly remove the tissues on the cornea and limbal sclera. Failure to remove the subconjunctival tissues of base of the growth that reached beyond the semilunar fold may become one of the important factors which result in higher rate of relapse after surgery.