1
|
Miyata M, Kido A, Miyake M, Tamura H, Kamei T, Wada S, Ueshima H, Kawai K, Nakao S, Yamamoto A, Suda K, Nakano E, Tagawa M, Tsujikawa A. Prevalence and Incidence of Strabismus by Age Group in Japan: A Nationwide Population-Based Cohort Study. Am J Ophthalmol 2024; 262:222-228. [PMID: 38040322 DOI: 10.1016/j.ajo.2023.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/02/2023] [Accepted: 11/22/2023] [Indexed: 12/03/2023]
Abstract
PURPOSE To investigate the prevalence and incidence of strabismus in the Japanese population by age group and to estimate the subtype proportions. DESIGN A nationwide population-based cohort study. METHODS This study investigated the number of cases with previous and new diagnoses of strabismus by age group between 2009 and 2020 using the National Database of Health Insurance Claims and Specific Health Checkups of Japan, which includes almost all (≥95%) medical claims data. We calculated the strabismus prevalence and 1-year incidence in 2019 and analyzed the proportion of each strabismus subtype. RESULTS The strabismus prevalence was 2.154% (2 709 207/125 708 000; 95% CI, 2.152%-2.157%). It showed a bimodal distribution, with a high proportion in school and old ages (especially ≥75 years). Exotropia, esotropia, and cyclovertical strabismus proportions were 67.3%, 26.0%, and 6.7%, respectively. Cyclovertical strabismus was uncommon in patients aged ≤18 years (1.4%) and more common (10.2%) in those aged >18 years. The strabismus incidence in 2019 was 321 per 100 000 person-years (403 093/125 708 000; 95% CI, 320-322). The annual incidence proportion of cyclovertical strabismus as opposed to whole strabismus subtypes in patients aged >18 years (13.1%) was higher than that in those aged ≤18 years (1.4%). CONCLUSIONS This is the first nationwide population-based cohort study to demonstrate strabismus's overall prevalence and incidence. The high prevalence of cyclovertical strabismus in adults compared with children may suggest that cyclovertical strabismus is a primarily age-related strabismus. The high prevalence of exotropia may indicate a genetic difference between Japanese and other ethnicities.
Collapse
Affiliation(s)
- Manabu Miyata
- From the Department of Ophthalmology and Visual Sciences, Graduate School of Medicine (M. Miyata, A.K., M. Miyake, H.T., T.K., S.W., K.K., S.N., A.Y., K.S., E.N., M.T., A.T.).
| | - Ai Kido
- From the Department of Ophthalmology and Visual Sciences, Graduate School of Medicine (M. Miyata, A.K., M. Miyake, H.T., T.K., S.W., K.K., S.N., A.Y., K.S., E.N., M.T., A.T.)
| | - Masahiro Miyake
- From the Department of Ophthalmology and Visual Sciences, Graduate School of Medicine (M. Miyata, A.K., M. Miyake, H.T., T.K., S.W., K.K., S.N., A.Y., K.S., E.N., M.T., A.T.)
| | - Hiroshi Tamura
- From the Department of Ophthalmology and Visual Sciences, Graduate School of Medicine (M. Miyata, A.K., M. Miyake, H.T., T.K., S.W., K.K., S.N., A.Y., K.S., E.N., M.T., A.T.); Center for Innovative Research and Education in Data Science, Institute for Liberal Arts and Sciences (H.T., H.U.), Kyoto University, Kyoto City, Kyoto, Japan
| | - Takuro Kamei
- From the Department of Ophthalmology and Visual Sciences, Graduate School of Medicine (M. Miyata, A.K., M. Miyake, H.T., T.K., S.W., K.K., S.N., A.Y., K.S., E.N., M.T., A.T.)
| | - Saori Wada
- From the Department of Ophthalmology and Visual Sciences, Graduate School of Medicine (M. Miyata, A.K., M. Miyake, H.T., T.K., S.W., K.K., S.N., A.Y., K.S., E.N., M.T., A.T.)
| | - Hiroaki Ueshima
- Center for Innovative Research and Education in Data Science, Institute for Liberal Arts and Sciences (H.T., H.U.), Kyoto University, Kyoto City, Kyoto, Japan
| | - Kentaro Kawai
- From the Department of Ophthalmology and Visual Sciences, Graduate School of Medicine (M. Miyata, A.K., M. Miyake, H.T., T.K., S.W., K.K., S.N., A.Y., K.S., E.N., M.T., A.T.)
| | - Shinya Nakao
- From the Department of Ophthalmology and Visual Sciences, Graduate School of Medicine (M. Miyata, A.K., M. Miyake, H.T., T.K., S.W., K.K., S.N., A.Y., K.S., E.N., M.T., A.T.)
| | - Akinari Yamamoto
- From the Department of Ophthalmology and Visual Sciences, Graduate School of Medicine (M. Miyata, A.K., M. Miyake, H.T., T.K., S.W., K.K., S.N., A.Y., K.S., E.N., M.T., A.T.)
| | - Kenji Suda
- From the Department of Ophthalmology and Visual Sciences, Graduate School of Medicine (M. Miyata, A.K., M. Miyake, H.T., T.K., S.W., K.K., S.N., A.Y., K.S., E.N., M.T., A.T.)
| | - Eri Nakano
- From the Department of Ophthalmology and Visual Sciences, Graduate School of Medicine (M. Miyata, A.K., M. Miyake, H.T., T.K., S.W., K.K., S.N., A.Y., K.S., E.N., M.T., A.T.)
| | - Miho Tagawa
- From the Department of Ophthalmology and Visual Sciences, Graduate School of Medicine (M. Miyata, A.K., M. Miyake, H.T., T.K., S.W., K.K., S.N., A.Y., K.S., E.N., M.T., A.T.)
| | - Akitaka Tsujikawa
- From the Department of Ophthalmology and Visual Sciences, Graduate School of Medicine (M. Miyata, A.K., M. Miyake, H.T., T.K., S.W., K.K., S.N., A.Y., K.S., E.N., M.T., A.T.)
| |
Collapse
|
2
|
Laughton SC, Hagen MM, Yang W, von Bartheld CS. Gender differences in horizontal strabismus: Systematic review and meta-analysis shows no difference in prevalence, but gender bias towards females in the clinic. J Glob Health 2023; 13:04085. [PMID: 37651634 PMCID: PMC10471156 DOI: 10.7189/jogh.13.04085] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
Background Strabismus is a misalignment of the visual axis that affects 2-3% of the population and can lead to loss of binocular vision. It is currently controversial whether there is a gender difference in the most common form of visual misalignment: horizontal strabismus. Some studies claimed that more females than males have an outward deviation (exotropia), while others concluded that there is no significant gender difference. No previous work has systematically explored gender differences in horizontal strabismus or has compared the results of population-based studies with those of clinic-based studies. Methods We conducted a systematic review and meta-analysis of studies reporting the prevalence of horizontal strabismus. We included 73 population-based studies and compared their disclosed gender population with that in 141 comparable clinical-based studies. We analysed the data according to gender, strabismus type (esotropia, exotropia), and geographic region/ethnicity. Results Summary statistics showed a nearly identical prevalence of horizontal strabismus (2.558% for males, 2.582% for females), esotropia (1.386% males vs. 1.377% females), and of exotropia (1.035% males vs. 1.043% females). Meta-analysis results showed that these differences between males and females were not statistically significant (odds ratio (OR) = 1.01; 95% confidence interval (CI) = 0.97-1.10), but that females were significantly more frequent (by 7.50%) in clinic-based studies than males, with 5.00% more females for esotropia, and 12.20% more females for exotropia when adjusted for the population's sex ratio. The extent of the female gender bias differed between geographic regions/societies, with Asians having the lowest bias towards females and Latin American countries having the strongest bias. Conclusions Males and females have the same prevalence of horizontal strabismus, including exotropia. Females with strabismus seek health care or are brought to clinics significantly more often than males. This is an example of gender bias in health care in favour of females rather than males, apparently because parents - erroneously fearing only cosmetic consequences - are more concerned about strabismus in their daughters than their sons. Societal attitudes towards females, as well as economic factors (insurance status), appear to be relevant factors that determine the magnitude of the gender bias in horizontal strabismus.
Collapse
Affiliation(s)
- Sydney C Laughton
- Center of Biomedical Research Excellence in Cell Biology, University of Nevada, Reno School of Medicine, Reno, Nevada, USA
| | - Molly M Hagen
- School of Public Health, University of Nevada, Reno, Nevada, USA
| | - Wei Yang
- School of Public Health, University of Nevada, Reno, Nevada, USA
| | - Christopher S von Bartheld
- Center of Biomedical Research Excellence in Cell Biology, University of Nevada, Reno School of Medicine, Reno, Nevada, USA
- Department of Physiology and Cell Biology, University of Nevada, Reno School of Medicine, Reno, Nevada, USA
| |
Collapse
|
3
|
Scott AB, Fahn S, Brin MF. Treatment of strabismus and blepharospasm with Botox (onabotulinumtoxinA): Development, insights, and impact. Medicine (Baltimore) 2023; 102:e32374. [PMID: 37499080 PMCID: PMC10374181 DOI: 10.1097/md.0000000000032374] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/29/2023] Open
Abstract
Strabismus, deviation of the ocular alignment, can adversely affect quality of life and activities of daily living. Surgery was the prior standard of care for strabismus, but up to 40% of patients required additional surgeries. This need for more effective and less invasive treatment, along with the convergence of other events such as the development of electromyography, purification of botulinum toxin A, and the finding that injection of botulinum toxin type A could paralyze the hind limbs of chicks, led Dr. Alan Scott to investigate injection of his formulation for strabismus. The positive results of initial trials in monkeys segued to human trials with observations of alignment improvements and few adverse events. The success of botulinum toxin type A in the treatment of strabismus led to interest in its use to treat other skeletal muscles, particularly in blepharospasm, a type of focal dystonia involving eyelid spasms and involuntary eye closure that lacked an effective pharmacological treatment. Patient groups helped to increase awareness of this novel treatment, and results from clinical trials confirmed its effectiveness. Dr. Scott's formulation, then known as Oculinum, received its first Food and Drug Administration approvals in 1989 for strabismus and blepharospasm. Allergan acquired Oculinum in 1991, renaming it Botox. These initial uses led to its application in a myriad of other indications as outlined in other articles of this supplement.
Collapse
Affiliation(s)
- Alan B Scott
- Strabismus Research Foundation, San Francisco, CA, USA
| | | | - Mitchell F Brin
- Allergan/AbbVie, Irvine, CA, USA
- University of California, Irvine, CA, USA
| |
Collapse
|
5
|
Agaje BG, Delelegne D, Abera E, Desta K, Girum M, Mossie M, Eshetu D, Hirigo AT. Strabismus prevalence and associated factors among pediatric patients in southern Ethiopia: a cross-sectional study. J Int Med Res 2021; 48:300060520964339. [PMID: 33076734 PMCID: PMC7583393 DOI: 10.1177/0300060520964339] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Objective To assess the strabismus prevalence and associated factors among children
aged ≤15 years. Methods This hospital-based cross-sectional study was conducted from March 2017 to
October 2017 in the Department of Ophthalmology & Optometry, Hawassa
University Comprehensive Specialized Hospital. Interviewer-administered
questionnaires were used to collect relevant data and clinical examinations
were performed for patient diagnosis. Results Overall, 582 children participated in the study (response rate, 97%). The
prevalence of childhood strabismus was 17.9% [95% confidence interval:
14.6–21.1]. Additionally, 9.6%, 16.7%, and 9.6% of the children had
anisometropia, amblyopia, and dense cataract, respectively. Among the 16.7%
of children with amblyopia, 56.7% had strabismus; among the 22.5% of
children with clinically significant refractive error, 52.7% had strabismus.
Moreover, among the 9.6% of children with anisometropia, 58.9% had
strabismus. The presence of amblyopia (adjusted odds ratio [95% confidence
interval]: 3.9, 1.7–8.6), age <5 years (13.5 [5.0–36.1]), age 5 to 10
years (6.1 [2.3–16.3]), and clinically significant refractive error (13.3
[5.8–30.6]) were significantly associated with childhood strabismus. Conclusions The prevalence of strabismus was relatively high among patients in this
study. Early screening for childhood strabismus is essential. A
well-controlled community-based study is needed to confirm strabismus
prevalence and predictors.
Collapse
Affiliation(s)
- Bekalu Getahun Agaje
- Department of Ophthalmology & Optometry, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Demoze Delelegne
- Department of Ophthalmology & Optometry, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Elias Abera
- Department of Ophthalmology & Optometry, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Kindie Desta
- Department of Ophthalmology & Optometry, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Mikael Girum
- Department of Ophthalmology & Optometry, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Mulat Mossie
- Department of Anesthesiology & Anesthesia, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Daniel Eshetu
- Department of Microbiology, Yirgalem Hospital Medical College, Yirgalem, Ethiopia
| | - Agete Tadewos Hirigo
- School of Medical Laboratory Sciences, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| |
Collapse
|
7
|
Serra P, Costa R, Almeida N, Baptista A. Visual Status in a Portuguese Population with Intellectual Disability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217715. [PMID: 33105693 PMCID: PMC7672629 DOI: 10.3390/ijerph17217715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 10/18/2020] [Accepted: 10/20/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Neurosensory deprivation associated with vision is a well-known fact in people with intellectual disability (ID). This work aims to report the visual status of a population with ID in Portugal. METHODS A vision screening protocol was conducted during two Special Olympics events. The vision protocol included personal medical history, ocular health evaluation, and clinical measures, such as visual acuity (VA), binocular vision, colour vision, refractive error, and intraocular pressure. This protocol was administered to 134 subjects. RESULTS Half of the subjects reported that they had never attended or they did not remember having attended a previous eye exam. Additionally, 10% of them had not attended an eye exam in the immediate past three years. Half the subjects failed the VA test and 13% presented moderate Visual Impairment (VI) (VA worse than 0.5 logMAR in the best eye). Manifest ocular deviation was found in 25% of the subjects and the most common ocular health dysfunction conditions were conjunctiva hyperaemia, meibomian gland dysfunction, and lens anomalies. Refractive error correction allowed a reduction in the level of moderate VI to 3.7%. CONCLUSIONS The population analysed showed a poor eye care attendance rate and vision-related conditions are in agreement with previous reports. The development of national strategies to promote the awareness for routine eye care in people with ID and improving accessibility to eye care services may mitigate many of the most prevalent conditions encountered.
Collapse
Affiliation(s)
- Pedro Serra
- Instituto Superior de Educação e Ciências, Alameda das Linhas de Torres, 1750-142 Lisboa, Portugal
| | - Regina Costa
- Novas Olimpiadas Especiais—Special Olympics Portugal, Rua Sítio do Casalinho da Ajuda, 1300-536 Lisboa, Portugal;
| | - Nuno Almeida
- Opening Eyes Portugal—Special Olympics Portugal, Rua Sítio do Casalinho da Ajuda, 1300-536 Lisboa, Portugal;
| | - António Baptista
- Centre of Physics, Campus Gualtar, School of Sciences, University of Minho, 4710-057 Braga, Portugal;
| |
Collapse
|