Elsevier

Ophthalmology

Volume 116, Issue 11, November 2009, Pages 2119-2127
Ophthalmology

Original article
Refractive Errors in a Rural Chinese Adult Population: The Handan Eye Study

Presented at: The World Ophthalmology Congress 2008, July 2, 2008, Hong Kong, China.
https://doi.org/10.1016/j.ophtha.2009.04.040Get rights and content

Purpose

To describe the prevalence of and risk factors for myopia and other refractive errors in a rural, adult, Chinese population.

Design

Population-based, cross-sectional study.

Participants

A clustered, random sampling procedure was used to select 7557 Chinese people aged ≥30 years from Handan, China.

Methods

All eligible subjects were invited to undergo a comprehensive eye examination, including standardized refraction. Myopia, high myopia, and hyperopia were defined as a spherical equivalent (SE) in the right eye of more than −0.5 diopter (D), less than −5.0 D, and 0.5 D or more, respectively. Astigmatism was less than −0.5 D of cylinder. Anisometropia was defined as a difference in SE of >1.0 D between the 2 eyes. Only phakic eyes were analyzed.

Main Outcome Measures

Myopia and other refractive errors.

Results

We included 6491 (85.9% participation rate) eligible subjects in this study. Adjusted to the 2000 China population census, the prevalence rate of myopia was 26.7% (95% confidence interval [CI], 25.6–27.8), hyperopia 15.9 % (95% CI, 15.0–16.8), astigmatism 24.5% (95% CI, 23.5–25.5), and anisometropia 7.7% (95% CI, 7.0–8.4). The prevalence of high myopia was 1.8% (95% CI, 1.5–2.1). Using a multivariate regression model, current smoking (odds ratio [OR], 0.7, 95% CI, 0.5–0.9), hours of reading (OR, 1.2; 95% CI, 1.1–1.4), diabetes (OR, 8.4; 95% CI, 2.2–32.5), and number of family members with myopia (OR, 1.3; 95% CI, 1.1–1.7, for each family member) were associated with myopia in younger persons (30–49 years). High school or higher education (OR, 1.8; 95% CI, 1.1–3.1), diabetes (OR, 1.6; 95% CI, 1.2–2.7), nuclear opacity (OR, 1.7; 95% CI, 1.2–2.3), and number of family members with myopia (OR, 1.5; 95% CI, 1.2–1.9) were risk factors in persons ≥50 years of age.

Conclusions

Myopia affects more than one quarter of rural Chinese persons ≥30 years of age. Myopia is more common in younger people and is associated with different risk factors than in older people.

Financial Disclosure(s)

The authors have no proprietary or commercial interest in any materials discussed in this article.

Section snippets

Study Design and Procedure

The Handan Eye Study is a population-based, cross-sectional study of eye diseases among 7557 Chinese people aged ≥30 years from Handan, China. The study adhered to the Declaration of Helsinki. Ethics approval was obtained from the Beijing Tongren Hospital Ethical Committee and all participants signed written informed consent before participating in the study.8, 9

In brief, subjects ≥30 years of age were selected using a randomized, clustered, sampling technique with probabilities proportionate

Results

A total of 6830 participants (90.4% response rate) were recruited and completed an eye examination; however, 114 (1.7%) who were examined at home did not have refractive error data. An additional 188 (2.8%) persons had no refraction data for their right eye (either missing or patients had corneal opacities, dense cataracts, or other media opacities), 32 subjects (0.5%) had prior cataract extraction in their right eyes, and 5 (0.1%) were phthisical or had severe anomalies of the anterior or

Discussion

This study provides new population-based data on the prevalence of refractive errors in Chinese people aged ≥30 years living in a rural village setting in mainland China. We report an overall prevalence of 26.7% for myopia, 1.8% for high myopia, and 15.9% for hyperopia. Our study showed a classic “U-shaped” pattern of myopia, with higher rates in younger and older people, the latter reflecting increasing prevalence of age-related cataract. We found that 24.5% of our subjects had astigmatism

References (42)

  • S. Wang et al.

    Alcohol and eye diseases

    Surv Ophthalmol

    (2008)
  • R.G. Watten et al.

    Visual functions and acute ingestion of alcohol

    Ophthalmic Physiol Opt

    (1996)
  • The prevalence of refractive errors among adults in the United States, Western Europe, and Australia

    Arch Ophthalmol

    (2004)
  • S. Vitale et al.

    Prevalence of visual impairment in the United States

    JAMA

    (2006)
  • M. He et al.

    Refractive error and visual impairment in urban children in southern China

    Invest Ophthalmol Vis Sci

    (2004)
  • M.Z. Zhan et al.

    Refractive errors in Singapore and Xiamen, China—a comparative study in school children aged 6 to 7 years

    Optom Vis Sci

    (2000)
  • Y.B. Liang et al.

    Prevalence and causes of low vision and blindness in a rural Chinese adult population: the Handan Eye Study

    Ophthalmology

    (2008)
  • Y.B. Liang et al.

    Rationale, design, methodology, and baseline data of a population-based study in rural China: the Handan Eye Study

    Ophthalmic Epidemiol

    (2009)
  • Annual report of Chinese residents' income (2006) [in Chinese]

  • M. He et al.

    Prevalence and clinical characteristics of glaucoma in adult Chinese: a population-based study in Liwan District, Guangzhou

    Invest Ophthalmol Vis Sci

    (2006)
  • Z. Hu et al.

    An epidemiologic study of fundus diseases in Shunyi County, Beijing [in Chinese]

    Chin J Ocul Fundus Dis

    (1988)
  • Cited by (0)

    Manuscript no. 2008-1327.

    Financial Disclosure(s): The authors have no proprietary or commercial interest in any of the materials discussed in this article.

    Supported by National Basic Research Program of China (973 Program), Grant 2007CB512201 from the Ministry of Science and Technology of the People's Republic of China, Program of Health Policy for blindness prevention from Ministry of Health the People's Republic of China, Partially funded by the Key Technologies R&D Program. No.2006-10903 from Bureau of Science and Technology of Handan city, Hebei Province, China. With additional support from Beijing Tongren Hospital and the key discipline fund of Bureau of Health, Handan city, Hebei Province, China.

    View full text