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要約 目的:鹿児島大学病院眼科ロービジョン外来受診者の現状を検討した。
対象と方法:2010年1月〜2021年3月にロービジョン外来を受診した342例(男性174例,女性168例)を対象とし,初診時年齢,視力良好眼の最高矯正視力(logMAR値),原因疾患,受診回数,身体障害者手帳所持率,手帳等級,ニーズ,実施したロービジョンケアを後ろ向きに調査した。
結果:初診時平均年齢62.54±21.00(0〜95歳),最高矯正視力0.78±0.67(−0.18〜2.9),原因疾患は網膜色素変性92例(26.9%),緑内障68例(19.9%),加齢黄斑変性50例(14.6%),錐体ジストロフィ20例(5.8%),糖尿病網膜症18例(5.3%),視神経疾患17例(5.0%),その他の網膜疾患17例(5.0%),強度近視15例(4.4%),先天性眼疾患11例(3.2%),その他60例(17.5%)であった。受診回数は平均1.9回(1〜28回),身体障害者手帳所持率187人(55%),平均身体障害者手帳等級2.4級,ニーズは上位より,読み書き226件(66%),屋外羞明182件(53%),手帳申請希望60件(18%)などであった。ロービジョンケアは,拡大読書器紹介164件(48%),遮光眼鏡処方137件(40%),白杖紹介98件(29%),拡大鏡紹介/処方91件(27%),タイポスコープ紹介71件(21%),同行援護紹介69件(20%),手帳申請/近用眼鏡処方各60件(18%)などであった。
結論:受診患者は網膜色素変性と緑内障が約半数を占めるも,さまざまな原因疾患がみられ,まずは「読み書きの困難」と「羞明の軽減」の2大ニーズに対応したロービジョンケアが必要であると考えられる。
Abstract Purpose:To investigate the clinical and demographic characteristics of low vision(LV) outpatients at the Department of Ophthalmology, Kagoshima University Hospital.
Subjects and Methods:The study included 342 patients(174 males and 168 females) who attended the LV outpatient clinic between January 2010 and March 2021. We retrospectively investigated the age at the initial visit, best corrected visual acuity BCVA:log MAR in the better eye), underlying causes of LV, number of visits, possession rate and grade of physical disability certificates, patient needs, and provided LV care.
Results:The mean age at the initial visit was 62.54±21 years(range, 0-95 years), the causative diseases were retinitis pigmentosa in 92 cases(27%), glaucoma in 68 cases(20%), age-related macular degeneration in 50 cases(15%), cone dystrophy in 20 cases(6%), diabetic retinopathy in 18 cases(5%), optic nerve disease in 17 cases(5%), other retinal diseases in 17 cases(5%), and other diseases in 60 cases(17%). The mean number of visits was 1.9(range, 1-28). The mean BCVA was 0.78±0.67(−0.18 to 2.9). The number of people with a physical disability certificate for vision was 187(55%), with a mean certificate grade of 2.4. The primary patient needs included reading and writing in 226 cases(66%), outdoor glare in 182 cases(53%), certificate application in 60 cases(18%), and others. The top needs were reading and writing 226 cases(66%), outdoor photophobia with 182 cases(53%), application for physical disability certificate with 60 cases(18%), and others. The top LV care included the introduction of the closed circuit television in 164 cases(48%), prescription of light-shielding glasses in 137 cases(40%), introduction of white canes in 98 cases(29%), prescription of magnifying glasses in 91 cases(27%), introduction of typoscopes in 71 cases(21%), guide helper service in 69 cases(20%), and application for physical disability certificate and prescription of near vision glasses in 60 cases each(18%) and others.
Conclusion:Retinitis pigmentosa and glaucoma accounted for approximately half of the LV cases, however, diverse causes were identified. LV care that addresses the two major needs of reading and writing, photophobia is considered essential.

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