Background Visual fields are important for postural stability and ability to manoeuvre around objects. Objective Examine the association between visual field loss and falls requiring hospitalisation in adults aged 50 +. Methods Older adults aged 50+ with and without visual field loss were identified using a fields database obtained from a cross-section of ophthalmologists’ practices in Western Australia (WA). Data were linked to the Hospital Morbidity Data Collection and WA Hospital Mortality System to identify participants who experienced falls-related hospitalisations between 1990 and 2019. A generalised linear negative binomial regression model examined the association between falls requiring hospitalisation for those with and without field loss, based on the better eye mean deviation (mild: −2 to –6 dB, moderate: −6.01 dB to –12 dB, severe < −12.01 dB) in the most contemporaneous visual field test (3 years prior or if not available, 2 years after the fall), after adjusting for potential confounders. Results A total of 31 021 unique individuals of whom 6054 (19.5%) experienced 11 818 falls requiring hospitalisation during a median observation time of 14.1 years. Only mean deviation index of <−12.01 dB (severe) was significantly associated with an increased rate of falls requiring hospitalisations by 14% (adjusted IRR 1.14, 95% CI 1.0–1.25) compared with no field loss, after adjusting for potential confounders. Other factors included age, with those aged 80+ having an increased rate (IRR 29.16, 95% CI 21.39–39.84), other comorbid conditions (IRR 1.49, 95% CI 1.38–1.60) and diabetes (IRR 1.25, 95% CI 1.14–1.37). Previous cataract surgery was associated with a decreased rate of falls that required hospitalisations by 13% (IRR 0.87, 95% CI 0.81–0.95) compared with those who did not have cataract surgery. Conclusion The findings highlight the importance of continuous clinical monitoring of visual field loss and injury prevention strategies for older adults with visual field loss.

中文翻译：

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视野缺损和需要住院治疗的跌倒：eFOVID 研究结果


背景 视野对于姿势稳定性和在物体周围操纵的能力很重要。目的 检查 50 + 岁成年人视野丧失与需要住院治疗的跌倒之间的关联。方法 使用从西澳大利亚州 （WA） 眼科医生实践横截面获得的视野数据库确定 50+ 岁有和没有视野缺损的老年人。数据与医院发病率数据收集和西澳医院死亡率系统相关联，以确定在 1990 年至 2019 年间经历过跌倒相关住院治疗的参与者。广义线性负二项式回归模型检查了有和没有视野损失的患者需要住院治疗的跌倒之间的关联，基于较好的眼睛平均偏差（轻度：-2 至 -6 dB，中度：-6.01 dB 至 -12 dB，严重 < -12.01 dB）在最同期视野测试中（3 年前或如果不可用， 跌倒 2 年后），在调整了潜在的混杂因素后。结果 共有 31 021 名独特个体，其中 6054 名 （19.5%） 在中位观察时间为 14.1 年期间经历了 11 818 次需要住院治疗的跌倒。在调整潜在的混杂因素后，只有 <-12.01 dB（严重）的平均偏差指数与需要住院治疗的跌倒率增加 14%（调整后的 IRR 1.14,95% CI 1.0-1.25）显著相关。其他因素包括年龄，80+ 岁人群的发病率增加 （IRR 29.16,95% CI 21.39-39.84），其他合并症 （IRR 1.49,95% CI 1.38-1.60） 和糖尿病 （IRR 1.25,95% CI 1.14-1.37）。既往白内障手术与需要住院治疗的跌倒率降低 13% 相关 （IRR 0.87,95% CI 0.81-0。95） 与未进行白内障手术的患者相比。结论 研究结果强调了对视野缺损老年人进行视野缺损和损伤预防策略的持续临床监测的重要性。