2016년도 국민건강영양조사를 바탕으로 한 소아의 약시 유병률 조사
The 2016 Korea National Health and Nutritional Examination Survey of the Prevalence of Amblyopia
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목적: 2016년 국민건강영양조사를 바탕으로 5세에서 8세 소아의 약시 유병률을 알아보고자 하였다. 대상과 방법: 2016년 실시된 국민건강영양조사의 안과 검사 결과를 바탕으로, 전체 표본 443명 중 시력을 측정한 420명을 분석하였다. 나안시력이 0.8 미만인 경우 자동굴절검사를 사용한 굴절검사를 실시하여 최대교정시력을 측정하였다. 약시의 기준은 0.8 또는 0.63 미만으로 설정하였다. 자동굴절검사를 바탕으로 양안 굴절이상 차이가 구면렌즈 1.5디옵터 이상이거나 난시 1.0디옵터 이상과 양안의 경우 난시 2.5디옵터, 원시 4.0디옵터 이상인 경우 약시를 유발할 수 있는 의미 있는 굴절이상으로 정의하였다. 소아의 지역, 부모의 소득 수준을 비교 분석하였다. 결과: 전체 420명(남:여=219:201) 중 0.8 미만과 0.63을 기준으로 한 약시의 유병률은 각각 21명(5.0%)과 16명(3.8%)이었다. 연령별 약시 유병률(0.8 미만 기준)은 5세에서는 10명(10%), 6세 6명(5.6%), 7세 4명(3.8%), 8세 1명(0.9%)로 나이가 들수록 유병률이 줄어들었다. 의미 있는 굴절이상을 보인 경우가 전체 21명 중 9명(42.9%)이었다. 지역별 분포는 강원도, 충청남도에서 가장 높게 나타났으며 부모의 소득이 약시의 유병률에 영향을 미치지는 않았다(p=0.189). 결론: 약시의 유병률은 나이가 들수록 줄어드는 양상을 보였으며 이는 약시를 조기에 발견하여 치료하는 것이 중요함을 의미한다. 따라서 약시를 조기에 발견할 수 있는 체계적인 안과검진이 중요할 것으로 생각된다.
Abstract
Purpose: To investigate the prevalence of amblyopia in children between the ages of 5-8 years based on the Korean National Health and Nutrition Examination Survey (2016). Methods: Based on the results of the Korean National Health and Nutrition Examination Survey conducted in 2016, among a total of 443 children, we measured and analyzed the visual acuities of 420 children. The visual acuity was measured using a conventional visual acuity chart. When the uncorrected visual acuity was < 0.8 in the first visual acuity test, a refraction test was performed using the automatic refraction test (KR-8800, Topcon, Tokyo, Japan) and the corrected visual acuity was measured. Unilateral amblyopia and bilateral amblyopia were defined as a ≥ 2 line difference between two eyes and visual acuity in the better eye < 0.8 or < 0.63. The significant refractive errors were defined as follows: the spherical lens was 1.5 diopters (D) or more, astigmatism was 1.0 D or more, or astigmatism of 2.5 D was 4.0 D or more. Results: The prevalence of amblyopia was 5.0% (21 patients, < 0.8 in the better eye) and 3.8% (16 patients, < 0.63 in the better eye) in a total of 420 patients (male:female = 219:201). The prevalence of amblyopia in different age groups was: 10 (10%) at 5 years of age, 6 (5.6%) at 6 years of age, 3.8% at 7 years of age, and 0.9% at 8 years of age. Nine out of 21 patients (42.9%) had significant refractive errors. The regional distribution was highest in Gangwon-do and Chungcheongnam-do provinces and parental income did not affect the prevalence of amblyopia (p = 0.189). Conclusions: The prevalence of amblyopia decreased with age suggesting that early detection and treatment of amblyopia are important. Therefore, systematic eye examinations that can detect amblyopia in the early stage may be important in the National Health Care results.
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