在三级转诊中心的低视力康复诊所工作7年

A. Riazi, Reza Gharebaghi MD MPH FAAO PhDc, A/Prof. Fatemeh Heidary MD, MPH, FAAO, FICO
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引用次数: 1

摘要

背景:低视力是世界范围内一个主要的公共卫生问题。本研究旨在描述到访过低视力康复诊所的患者的特征。方法:在这项回顾性研究中,我们回顾了在三级转诊中心低视力康复诊所就诊的低视力患者7年来的医疗记录。纳入标准是视力障碍诊断和完整记录的可用性。我们从每条记录中提取以下数据:年龄、性别、教育程度、就业状况、视力主诉、相关眼部疾病、未矫正的远近视力、最佳矫正的远近视力、既往和目前处方的光学设备状况、患者验光时的配合情况。结果:我们共纳入567例患者,其中男性338例(59.6%),女性229例(40.4%),平均(标准差)年龄为40.46(28.34)岁。大多数(98.4%)的参与者是合作的,失业率高(90.5%),受教育程度低。半数(49.2%)患者有中度视力损害。视网膜病变,主要是先天性(28.4%)和年龄相关性黄斑变性(ARMD;26.5%)是低视力的常见原因。阅读困难是最常见的主诉(22.9%),54.7%的患者同时存在阅读、写作和面部识别困难。至少有5%的患者报告有其他功能上的不适。我们的多因素logistic回归分析显示,年龄每增加10岁,在室内活动、阅读、面部识别和社交互动以及驾驶方面出现困难的可能性增加,比值比分别为1.39、1.31、1.24和1.22(均P < 0.05)。在较好的眼睛的最佳矫正距离视力中,每增加0.1个最小分辨率增量角度,报告三种抱怨(阅读、写作和面部识别)的可能性增加,优势比为2.05 (P < 0.05)。此外,男性更容易在驾驶和阅读方面遇到困难,而女性更容易在面部识别和社交互动或内部活动方面遇到困难(均P < 0.05)。大多数患者都使用了远视或近视光学设备。结论:患者多为男性,无业。最常见的低视力类别是中度损害。视网膜疾病,主要是先天性疾病和ARMD,是最常见的原因。阅读、写作和面部识别方面的困难是最常见的抱怨。验光师在对低视力患者进行康复治疗时应注意这些发现。
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Seven-year experience in a low vision rehabilitation clinic at a tertiary referral center
Background: Low vision is a major public health concern worldwide. This study was aimed at describing the characteristics of patients who had visited a low-vision rehabilitation clinic. Methods: In this retrospective study, we reviewed the medical records of patients with low vision attending a low-vision rehabilitation clinic at a tertiary referral center over 7 years. Inclusion criteria were a diagnosis of vision impairment and availability of complete records. We extracted the following data from each record: age, sex, education level, employment status, chief complaints concerning vision, associated ocular diseases, uncorrected distance and near visual acuities, best-corrected distance and near visual acuities, statuses of previous and current prescribed optical devices, and cooperation status of patients during the optometric examination. Results: We enrolled a total of 567 patients, including 338 (59.6%) men and 229 (40.4%) women, with a mean (standard deviation) age of 40.46 (28.34) years. Most (98.4%) participants were cooperative, with a high rate of unemployment (90.5%) and low education level. Half (49.2%) of the patients had moderate visual impairment. Retinal pathologies, mainly congenital (28.4%), and age-related macular degeneration (ARMD; 26.5%) were common causes of low vision. Difficulty in reading was the most frequent complaint (22.9%), and a combination of difficulties in reading, writing, and facial recognition was recorded in 54.7% of the patients. Other functional complaints were reported by at least 5% of the patients. Our multivariate logistic regression analysis revealed that the likelihood of difficulties in performing in-house activities, reading, facial recognition and social interaction, and driving increased per 10-year increment in age, with odds ratios of 1.39, 1.31, 1.24, and 1.22, respectively (all P < 0.05). The likelihood of reporting three complaints (reading, writing, and facial recognition together) increased per 0.1-logarithm of the minimum angle of resolution increment in the best-corrected distance visual acuity of the better eye, with an odds ratio of 2.05 (P < 0.05). In addition, men were more likely to experience difficulties in driving and reading, while women were more likely to experience difficulties in facial recognition and social interaction or in-house activities (all P < 0.05). Optical devices for distance or near vision were prescribed to most patients. Conclusions: Most patients were men and unemployed. The most common category of low vision was moderate impairment. Retinal conditions, mainly congenital ones and ARMD, were the most frequent causes. A combination of difficulties in reading, writing, and facial recognition was the most common complaint. Optometrists should address these findings during rehabilitation therapy to treat patients with low vision.
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