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ABSTRACT: To investigate the prevalence and visual acuity (VA) outcomes of cataract surgery in adults of the Bai Nationality populations in rural China.
We conducted a population-based cross-sectional survey (from randomly selected block groups) of Chinese Bai Nationality aged ≥50 years in southwestern China. Presenting visual acuity (PVA), best corrected visual acuity (BCVA) were recorded and a detailed eye examination was carried out. For all aphakic and pseudophakic subjects identified, information on the date, setting, type, and complications of cataract surgery were recorded. In eyes with VA <20/63, the principal cause of visual impairment was identified.
Of 2133 (77.8% of 2742) subjects, 99 people (129 eyes) had undergone cataract surgery. The prevalence of cataract surgery was 4.6%. Surgical coverage among those with PVA <20/200 in both eyes because of cataract was 52.8%. Unoperated cataract was associated with older age. The main barrier to cataract surgery was lack of awareness and knowledge, cost, and fear. Among the 129 cataract-operated eyes, 22.5% had PVA of ≥20/32, 25.6% had PVA of 20/40 to 20/63, 23.3% had PVA <20/63 to 20/200, and 28.7% had PVA<20/200. With BCVA, the percentages were 42.6%, 23.3%, 10.9%, and 23.3%, respectively. Aphakia (odds ratio [OR], 8.49; P<0.001) and no education (OR, 10.18; P = 0.001) or less education (OR, 6.49; P = 0.014) were significantly associated with postoperative visual impairment defined by PVA, while aphakia (OR, 8.49; P<0.001) and female gender (OR, 4.19; P = 0.004) were significantly associated with postoperative visual impairment by BCVA. The main causes of postoperative visual impairment were refractive error, retinal disorders and glaucoma.
Half of those with bilateral visual impairment or blindness because of cataract remain in need of cataract surgery in Bai population. Surgical uptake and visual outcomes should be further improved in the future.
PLoS ONE 01/2013; 8(4):e60236. · 4.09 Impact Factor
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Hua Zhong,
Xueping Cha,
Tao Wei,
Xianchai Lin,
Xun Li,
Jun Li,
Ning Cai,
Juanjuan Li,
Xiaodan Su,
Yongming Yang,
Minbin Yu,
Yuansheng Yuan
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ABSTRACT: Purpose. The purpose of the study was to describe the prevalence, severity, and associated risk factors for pterygium in a population-based sample of rural residents of the Bai minority population in rural Dali, China. Methods. A population-based survey of Chinese Bai Nationality aged ≥50 years from randomly selected block groups in southwestern China was conducted. A clinical examination by experienced ophthalmologists was carried out, and the presence of pterygium was diagnosed at the examination. Pterygium was graded clinically by slit lamp examination. Questionnaires were conducted on risk factors. Results. From a total of 2742 eligible subjects, 2133 (77.8%) were examined. The prevalence of pterygium was high (overall 39.0% [95% confidence interval (CI) 37.0-41.0]). Women had a higher rate than men (27.3% vs. 11.7%, respectively). In multivariate analysis, pterygium was independently associated with increasing age (odds ratio [OR] 1.55 [95% CI 1.24-1.93], 1.47 [95% CI 1.13-1.91], and 1.79 [95% CI 1.17-2.73], respectively, for persons 60-69 years, 70-79 years, and 80 years and older compared with 50-59 years), female sex (OR 1.42 [95% CI 1.08-1.88]), lack of formal education (OR 1.26 [95% CI 1.03-1.56]), and presence of outdoor work (OR 1.51 [95% CI 1.10-1.92]). Height, weight, hypertension, diabetes, smoking, and alcohol use history were not associated with pterygium. Conclusions. The prevalence of pterygium in Dali is 39.0% among Chinese Bai aged 50 years and older. Independent associations with increasing age (>59 years), female sex, lack of education, and occupations linked to outdoor work suggest a multifactorial cause of this condition.
Investigative ophthalmology & visual science 09/2012; 53(10):6617-21. · 3.43 Impact Factor
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Jun Li, Hua Zhong,
Ning Cai,
Tinghao Luo,
Juanjuan Li,
Xiaodan Su,
Xun Li,
Xuan Qiu,
Yongming Yang,
Yuansheng Yuan,
Minbin Yu
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ABSTRACT: To assess the prevalence and causes of visual impairment in the elderly Bai ethnic group in rural China.
Random cluster sampling was used to identify the Bai ethnic group 50 years and older living in the Dali county of Yunnan, China. Presenting visual acuity (PVA) and best-corrected visual acuity (BCVA) were measured using the Early Treatment Diabetic Retinopathy Study visual chart. Blindness and low vision were defined according to World Health Organization criteria. The major cause of visual impairment was identified for all participants who were visually impaired.
Of the 2742 eligible individuals, 2133 (77.8%) participated in the study, and 2115 (77.1%) had visual acuity data available. With the PVA, the prevalence of blindness and low vision was 3.59% and 15.22%, respectively. When the BCVA was used, these rates were reduced to 2.88% and 7.75%. Blindness and low vision were associated with older age and lack of education, but no sex difference was seen. Based on the BCVA, the predominant causes of blindness were cataract (70.5%), corneal opacity (8.2%), and glaucoma (6.6%). The majority of PVA-defined low vision cases were attributable to cataract (53.0%) and uncorrected refractive error (22.0%).
A higher rate of visual impairment was seen in this Bai nationality sample than has been reported from the Han nationality population in rural China. Since potentially treatable eye disease, cataract, and uncorrected refractive error were the most important causes of visual impairment in this population, affordable provision of surgery and low-vision rehabilitation programs would help to address this problem.
Investigative ophthalmology & visual science 06/2012; 53(8):4498-504. · 3.43 Impact Factor
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ABSTRACT: We evaluated the prevalence of glaucoma in adults of the Bai Nationality populations in rural China.
A population-based survey of Chinese Bai Nationality aged ≥50 years from randomly selected block groups in southwestern China was conducted. Eligible persons were invited to local examination sites for a complete ophthalmic examination. Glaucoma was diagnosed using the International Society of Geographical and Epidemiological Ophthalmology Classification scheme.
In the study, 2133 subjects (77.8% participation rate) were examined, with a crude prevalence of all glaucoma of 2.2% (95% confidence interval [CI] 1.6%-2.9%). Primary open angle glaucoma (POAG) was found in 1.0% of cases (95% CI 0.6%-1.6%) and primary angle-closure glaucoma (PACG) in 0.9% (95% CI 0.6%-1.4%). The prevalence of all glaucoma was significantly higher in older people and women. Mean intraocular pressure (IOP) was 16.17 ± 3.74 mm Hg (97.5th and 99.5th percentiles, 24 mm Hg and 30 mm Hg, respectively). The mean vertical cup-to-disc ratio (VCDR) was 0.43 ± 0.17 (97.5th and 99.5th percentiles 0.7 and 0.8, respectively). Unilateral blindness was found in 80% of PACG, compared to only 36.3% of POAG cases.
Prevalence of POAG is similar to PACG in the ethnic Bai population living in rural southwestern China. PACG has a worse visual impairment and prognosis compared to POAG.
Investigative ophthalmology & visual science 04/2012; 53(6):3221-5. · 3.43 Impact Factor
