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Community-Based Study on Prevalence and Causes of Visual Impairment among the Elderly in Taipei and Matsu
台北市與馬祖地區老人視力障礙盛行率與原因的社區性研究
摘要
目的：調查台灣台北市與馬祖地區65歲（含）以上老人視力障礙之盛行率及其原因，並比較兩地老人視力障礙現況之異同。 方法：本研究以台北市大同、中山區及連江縣南竿、北竿鄉地區65歲（含）以上老人為篩檢對象，進行視力檢查。如果表現視力低於0.5，則轉介做進一步眼科檢查。視力障礙定義為優眼最佳矯正視力低於0.50。 結果：共計有572位老人接受視力篩檢，其中台北市有367位，馬祖地區有205位。受檢者雙眼表現視力均低於0.5的比例為19.2%（其中台北市為8.0%，馬祖地區為39.1%）。受檢者視力障礙之比率為2.80%（其中台北市為1.91%，馬祖地區為4.39%)。本研究老人視力障礙最常見的原因是白內障及其相關疾病(70.5%)，其次是視網膜及其相關疾病(40.9%)。其中視網膜及其相關疾病與老人視力障礙有極明顯的相關性。在視力障礙原因的分佈上，台北市與馬祖地區並無差異。 結論：白內障及其相關疾病是台北市與馬祖地區65歲（含）以上老人視力障礙最常見的原因，其次是視網膜及其相關疾病。而視網膜及其相關疾病與視力障礙有極明顯的相關性。馬祖地區老人視力障礙比例明顯高於台北市。
關鍵字
無資料並列摘要
Purpose: This study was conducted to investigate and compare the prevalence and causes of visual impairment of the elderly people in the urban (Taipei) and rural (Matsu) areas. Methods: People of the age of 65 or older were enrolled for interviews and ophthalmic examinations in a visual health care survey in Taipei and Matsu. The clinical examination included visual acuity testing, slit-lamp and dilated retinal examination for those with a visual acuity worse than 6/12. Visual impairment was defined as a best-corrected acuity in the better-seeing eye worse than 6/12. Results: Samples of 572 (367 residents in Taipei, and 205 residents in Matsu) elderly people were included. The proportion of overall bilateral presenting acuity worse than 6/12 was 19.2% (8.0% in Taipei and 39.1% in Matsu, p＜0.0001). We estimated the proportion of visual impairment among the elderly in Taiwan was 2.80% (1.91% in Taipei and 4.39% in Matsu, p＜0.0001). Cataract-related disease was the most frequent factor (70.5%) associated to visual impairment, retinopathy-related disease with/without macular edema the second (40.9%). There was no significant diffidence in the distribution of factors associated to visual impairment between Taipei and Matsu. Multiple logistic regression revealed that retinopathy with/without macular edema was the most significant associated factor correlated with the visual impairment among the elderly (OR=25.02, 95%Cl: 4.32-145.01). Conclusions: Although cataract was the most frequent factor in visual impairment, we found retinopathy with/without macular edema was the most significantly associated factor related to visual impairment for the elderly people in Taiwan. Aged people in the rural (Matsu) area were more likely to remain visually impaired than those in the urban (Taipei) area.