Purpose: This paper presents estimates of the prevalence of blindness and low vision among older adults over 50 years of age in mainland China. Methods: All primary reports of population-based studies that reported the prevalence or incidence of visual impairment among older populations in mainland China were identified. Twenty-four population-based studies were included in this systematic review. Blindness is defined as visual acuity of less than 3/60, or a corresponding visual-field loss to less than 10 degrees in the better eye with the best possible correction; low vision is defined as visual acuity of less than 6/18, but equal to or better than 3/60 in the better eye with the best possible correction. The pooled prevalence estimates of blindness and low vision were calculated assuming a random-effects model. Relative odds with 95% confidence intervals (95% CIs) were calculated, stratified by methodological and socioeconomic variables. Results: The overall pooled prevalence of blindness was 1.7% (95% CI 1.4–2.1). The results of the meta-regression showed the significance of a predictor variable: geographic region. The blindness rates per 100 older adults in various regions were 1.4 (0.9–2.0) in East China, and 1.4 (1.0–2.0) in Central China and 2.5 (1.9–3.2) in Western China. The overall pooled prevalence of low vision was 4.1% (3.4–5.1) and the independent pooled prevalence rates stratified by geographic region were 3.6% (2.6–5.1) in East China, 3.6% (2.4–5.2) in Central China and 5.2% (3.6–7.4) in Western China. Conclusions: Blindness or low vision affects approximately 5.8% Chinese adults older than 50 years. The prevalence of visual impairment, and especially blindness, vary greatly by the developmental status of geographic region.

Keywords:
Blindness, Low vision, China, Population-based study, Elderly individuals
1.
China National Committee on Aging: China’s aged population growing at fastest rate in 60 years. Available at: http://www.cncaprc.gov.cn/en/info/267.html. Accessed 2010.
2.
Resnikoff S, Pascolini D, Etya’ale D, Kocur I, Pararajasegaram R, Pokharel GP, Mariotti SP: Global data on visual impairment in the year 2002. Bull World Health Organ 2004;82:844–851.
3.
Zhang SY, Zou LH, Gao YQ, Di Y, Wang XD: National epidemiological survey of blindness and low vision in China. Chin Med J (Engl) 1992;105:603–608.
4.
Zhao J, Jia L, Sui R, Ellwein LB: Prevalence of blindness and cataract surgery in Shunyi County, China. Am J Ophthalmol 1998;126:506–514.
5.
World Health Organization: Global initiative for the elimination of avoidable blindness. Geneva, WHO, 1998. Available at: http://whqlibdoc.who.int/hq/1997/WHO_PBL_97.61_Rev.1.pdf. Accessed 2009.
6.
Zhao J, Ellwein LB, Cui H, Ge J, Guan H, Lv J, Ma X, Yin J, Yin ZQ, Yuan Y, Liu H: Prevalence of vision impairment in older adults in rural China: the China Nine-Province Survey. Ophthalmology 2010;117:409–416, 416.e1.
7.
Xu L, Wang Y, Li Y, Wang Y, Cui T, Li J, Jonas JB: Causes of blindness and visual impairment in urban and rural areas in Beijing: the Beijing Eye Study. Ophthalmology 2006;113:1134.e1–11.
8.
Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB: Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of Observational Studies in Epidemiology (MOOSE) group. JAMA 2000;283:2008–2012.
9.
Say L, Donner A, Gülmezoglu AM, Taljaard M, Piaggio G: The prevalence of stillbirths: a systematic review. Reprod Health 2006;3:1.
10.
DerSimonian R, Laird N: Meta-analysis in clinical trials: Control Clin Trials 1986;7:177–188.
11.
Thompson SG, Higgins JP: How should meta-regression analyses be undertaken and interpreted? Stat Med 2002;21:1559–1573.
12.
Liu S, Li X, Zhang M: Scenario analysis on urbanization and rural-urban migration in China. Available at: http://www.iiasa.ac.at/Admin/PUB/Documents/IR-03-036.pdf. Accessed 2011.
13.
Maldonado G, Greenland S: Simulation study of confounder-selection strategies. Am J Epidemiol 1993;138:923–936.
14.
Limburg H, Barria von-Bischhoffshausen F, Gomez P, Silva JC, Foster A: Review of recent surveys on blindness and visual impairment in Latin America. Br J Ophthalmol 2008;92:315–319.
15.
Li L, Guan H, Xun P, Zhou J, Gu H: Prevalence and causes of visual impairment among the elderly in Nantong, China. Eye 2008;22:1069–1075.
16.
Huang S, Zheng Y, Foster PJ, Huang W, He M; Liwan Eye Study: Prevalence and causes of visual impairment in Chinese adults in urban southern China. Arch Ophthalmol 2009;127:1362–1367.
17.
Song W, Sun X, Shao Z, Zhou X, Kang Y, Sui H, Yuan H: Prevalence and causes of visual impairment in a rural North-east China adult population: a population-based survey in Bin County, Harbin. Acta Ophthalmol 2010;88:669–674.
18.
Liang YB, Friedman DS, Wong TY, Zhan SY, Sun LP, Wang JJ, Duan XR, Yang XH, Wang FH, Zhou Q, Wang NL; Handan Eye Study Group: Prevalence and causes of low vision and blindness in a rural Chinese adult population: the Handan Eye Study. Ophthalmology 2008;115:1965–1972.
19.
Congdon N, O’Colmain B, Klaver CC, Klein R, Muñoz B, Friedman DS, Kempen J, Taylor HR, Mitchell P; Eye Diseases Prevalence Research Group: Causes and prevalence of visual impairment among adults in the United States. Arch Ophthalmol 2004;122:477–485.
20.
You QS, Xu L, Yang H, Wang YX, Jonas JB: Five-year incidence of visual impairment and blindness in adult Chinese: the Beijing Eye Study. Ophthalmology 2011;118:1069–1075.
21.
Limburg H, Barria von-Bischhoffshausen F, Gomez P, Silva JC, Foster A: Review of recent surveys on blindness and visual impairment in Latin America. Br J Ophthalmol 2008;92:315–319.
22.
Congdon N, O’Colmain B, Klaver CC, Klein R, Muñoz B, Friedman DS, Kempen J, Taylor HR, Mitchell P, Eye Diseases Prevalence Research Group: Causes and prevalence of visual impairment among adults in the United States. Arch Ophthalmol 2004;122:477–485.
23.
Abdull MM, Sivasubramaniam S, Murthy GV, Gilbert C, Abubakar T, Ezelum C, Rabiu MM; Nigeria National Blindness and Visual Impairment Study Group: Causes of blindness and visual impairment in Nigeria: the Nigeria national blindness and visual impairment survey. Invest Ophthalmol Vis Sci 2009;50:4114–4120.
24.
Dineen B, Bourne RR, Jadoon Z, Shah SP, Khan MA, Foster A, Gilbert CE, Khan MD; Pakistan National Eye Survey Study Group: Causes of blindness and visual impairment in Pakistan. The Pakistan national blindness and visual impairment survey. Br J Ophthalmol 2007;91:1005–1010.
25.
Laitinen A, Koskinen S, Härkänen T, Reunanen A, Laatikainen L, Aromaa A: A nationwide population-based survey on visual acuity, near vision, and self-reported visual function in the adult population in Finland. Ophthalmology 2005;112:2227–2237.
26.
Saw SM, Foster PJ, Gazzard G, Seah S: Causes of blindness, low vision, and questionnaire-assessed poor visual function in Singaporean Chinese adults: The Tanjong Pagar Survey. Ophthalmology 2004;111:1161–1168.
© 2012 S. Karger AG, Basel
2012
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