摘要
目的对比分析正常视力中老年人及老年性黄斑变性(AMD)患者的阅读速度,分析影响两者阅读速度的相关因素。方法前瞻性临床对照研究。自清华大学第一附属医院周边社区征集以汉语为母语、初中以上文化程度、年龄≥45岁且<85岁、双眼BCVA≥0.6的正常视力中老年志愿者;自清华大学第一附属医院视觉康复门诊征集有视力下降或视物变形主诉、好眼BCVA≥0.05的AMD患者。测量受检者视功能,最佳矫正近视力状态下,应用中文阅读视力表测定阅读视力;国际阅读速度文本(IReST)中文版测定阅读速度。对比观察AMD患者与正常视力老年人的阅读速度。对阅读速度的相关因素进行单因素相关分析,并对有统计学意义的因素进一步使用多元线性回归分析。结果2016年1~4月共征集正常视力中老年人53名。其中,男性17名,女性36名;平均年龄(60.7±8.8)岁。平均阅读速度(244±55)字/min。正常视力中年人(45~59岁)、老年人(≥60岁)平均阅读速度分别为(267±53)、(227±51)字/min;两者阅读速度比较,差异有统计学意义(t=2.797,P=0.007)。单因素相关分析结果显示,正常视力中老年人阅读速度与年龄(r=-0.476,P=0.000)、性别(t=-2.291,P=0.031)、文化程度(t=2.656,P=0.011)、阅读习惯(t=7.346,P=0.000)、双眼最佳远视力(r=-0.293,P=0.033)、双眼最佳近视力(r=-0.460,P=0.001)、阅读视力(r=-0.558,P=0.000)均相关。进一步多元线性回归分析显示,阅读视力、性别、文化程度和阅读习惯与阅读速度显著相关(β=-283.312、28.303、-37.700、-45.505,P=0.000、0.022、0.019、0.023)。2016年9月至2018年8月共征集AMD患者22例。其中,男性16例,女性6例;平均年龄(77.4±8.2)岁;阅读速度中位数为118字/min。与正常视力老年人比较,其年龄更大(t=-4.285,P=0.000),男性比例更高(χ2=3.981,P=0.046),阅读视力更差(t=-6.176,P=0.000),阅读速度显著降低(t=-5.719,P=0.000)。AMD患者阅读速度与双眼最佳远、近视力和阅读视力、对比敏感度相关(r=-0.771、-0.805、-0.776、0.511,P=0.000、0.000、0.000、0.015);与年龄(r=0.021,P=0.926)、性别(Z=-0.382,P=0.703)无关。结论正常视力中老年人阅读速度随年龄增长呈下降趋势,阅读视力较远视力是更好的预测阅读能力的指标;AMD患者阅读视力显著降低,阅读速度显著下降,视功能损伤程度是影响其阅读速度的主要因素。
Objective To evaluate the reading speed and related factors of normally-sighted middle-aged and elderly people,and compare with those assessed in age-related macular degeneration(AMD)patients.Methods Prospective case control study.Participants aged 45 to 85 years old with junior high school or above education and BCVA no less than 0.6 from the community around the First Hospital of Tsinghua University were recruited.People with ocular and nervous system diseases were excluded.AMD patients without other ocular and nervous system diseases,with the BCVA of their better eye above 0.05,were recruited from the Low Vision Clinic of the First Hospital of Tsinghua University.The best corrected vision,contrast sensitivity,and reading acuity were tested.Reading speed was evaluated with IReST Chinese version.Single factor correlation analysis was used to assess different factors which may be related with the reading speed,then multiple linear regression analysis was conducted further.Results From January to April,2016,53 volunteers aged 60.7±8.8 years old participated in the survey including 17 males and 36 females.Their median of best vision acuity both distance and near was 1.0,and their average reading speed was 244±55 characters/min.The average reading speed of younger participants in the middle-aged group(45-59 years old)was statistically faster(P<0.05)than the elderly group(≥60 years old),which was 267±53 and 227±51 characters/min separately.The reading speed was correlated with age(r=-0.476,P=0.000),gender(t=-2.291,P=0.031),educational level(t=2.656,P=0.011),reading habits(t=7.346,P=0.000),best corrected distance vision(r=-0.293,P=0.033),best corrected near vision(r=-0.460,P=0.001),and reading acuity(r=-0.558,P=0.000)by single factor correlation analysis.Further analysis with multiple linear regression showed that reading acuity,gender,education level,and reading habits were significantly correlated with reading speed(β=-283.312,28.303,-37.700,-45.505;P=0.000,0.022,0.019,0.023).Totally 22 AMD patients aged 77.4±8.2(59-90)years old joined the study from September 2016 to August 2018,including 16 males and 6 females.The median reading speed was 118 characters/min.Compared with the normally-sighted elderly,there were more males in AMD patients(χ2=3.981,P=0.046).They were older(t=-4.285,P=0.000),with significant poorer visual acuity(t=-6.176,P=0.000)and lower reading speed(t=-5.719,P=0.000).Significant correlation was found between reading speed and best binocular distance or near vision,reading acuity and contrast sensitivity(r=-0.771,-0.805,-0.776,0.511;P=0.000,0.000,0.000,0.015),no statistic relationship was found between reading speed and age(r=0.021,P=0.926)or gender(Z=-0.382,P=0.703)in AMD patients.Conclusions The reading speed of normally-sighted people declined with age.Reading acuity may be a better predictive factor than distance vision for reading function.Compared with normally-sighted group,the reading acuity and reading speed of AMD patients was significantly lower.The main factor affecting their reading speed was the severity of their visual impairment.
作者
崔珊珊
周琳
邹燕红
Cui Shanshan;Zhou Lin;Zou Yanhong(Department of Ophthalmology,First Hospital of Tsinghua University,Beijing 100016,China)
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2020年第6期453-457,共5页
Chinese Journal of Ocular Fundus Diseases
基金
国家自然科学基金(81273159)
首都临床特色应用研究(Z141107002514041)。
关键词
黄斑变性
中年人
老年人
阅读速度
Macular degeneration
Middle aged
Aged
Reading speed
