1
|
Herron MS, Wang L, von Bartheld CS. Prevalence and Types of Strabismus in Cerebral Palsy: A Global and Historical Perspective Based on a Systematic Review and Meta-Analysis. Ophthalmic Epidemiol 2024:1-18. [PMID: 38635869 DOI: 10.1080/09286586.2024.2331537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/08/2024] [Indexed: 04/20/2024]
Abstract
PURPOSE Strabismus is more frequent in cerebral palsy (CP) than in the normal population, but reports differ how much it is increased. We here examined the global prevalence and types of strabismus in CP, whether esotropia or exotropia is more frequent, and whether the prevalence differs between ethnicities and/or country income levels, and between generations. METHODS We compiled in a systematic review and meta-analysis the results of 147 CP studies that report the prevalence of strabismus or the ratio of esotropia to exotropia, and we conducted subgroup analyses for region (income level) and ethnicity. We performed a pooled analysis for the CP strabismus prevalence, and estimated the global number of CP cases with strabismus. RESULTS The pooled prevalence of strabismus in CP is 49.8% in high-income countries and 39.8% in lower-income countries. We estimate the global number of strabismus cases in CP as 12.2 million, with 7.6 million males and 4.6 million females, based on current estimates of 29.6 million global CP cases. Esotropia is more frequent than exotropia in Caucasians, while exotropia is more frequent than esotropia in Hispanic and in some Asian and African populations. The strabismus prevalence in CP increases with increasing country income levels. CONCLUSION Generational changes in strabismus prevalence appear to reflect a transition of CP types and an increase in prevalence as countries attain higher income and more effective maternal health care. The distribution of esotropia and exotropia in CP patients largely reflects the horizontal strabismus type that is predominant in the subject's ethnicity.
Collapse
Affiliation(s)
- Michael S Herron
- Center of Biomedical Research Excellence in Cell Biology, School of Medicine, University of Nevada, Reno, Nevada, USA
| | - Lingchen Wang
- School of Public Health, University of Nevada, Reno, Nevada, USA
| | - Christopher S von Bartheld
- Center of Biomedical Research Excellence in Cell Biology, School of Medicine, University of Nevada, Reno, Nevada, USA
- Department of Physiology and Cell Biology, School of Medicine, University of Nevada, Reno, Nevada, USA
| |
Collapse
|
2
|
Herron MS, Wang L, von Bartheld CS. Prevalence and types of strabismus in cerebral palsy: A global and historical perspective based on a systematic review and meta-analysis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.23.24301684. [PMID: 38343841 PMCID: PMC10854329 DOI: 10.1101/2024.01.23.24301684] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
Purpose Strabismus is more frequent in cerebral palsy (CP) than in the normal population, but reports differ how much it is increased. We here examined the global prevalence and types of strabismus in CP, whether esotropia or exotropia is more frequent, and whether the prevalence differs between ethnicities and/or country income levels, and between generations. Methods We compiled in a systematic review and meta-analysis the results of 147 CP studies that report the prevalence of strabismus or the ratio of esotropia to exotropia, and we conducted subgroup analyses for region (income level) and ethnicity. We performed a pooled analysis for the CP strabismus prevalence, and estimated the global number of CP cases with strabismus. Results The pooled prevalence of strabismus in CP is 49.8% in high-income countries and 39.8% in lower-income countries. We estimate the global number of strabismus cases in CP as 12.2 million, with 7.6 million males and 4.6 million females, based on current estimates of 29.6 million global CP cases. Esotropia is more frequent than exotropia in Caucasians, while exotropia is more frequent than esotropia in Hispanic and in some Asian and African populations. The strabismus prevalence in CP increases with increasing country income levels. Conclusion Generational changes in strabismus prevalence appear to reflect a transition of CP types and an increase in prevalence as countries attain higher income and more effective maternal health care. The distribution of esotropia and exotropia in CP patients largely reflects the horizontal strabismus type that is predominant in the subject's ethnicity.
Collapse
Affiliation(s)
- Michael S. Herron
- Center of Biomedical Research Excellence in Cell Biology, University of Nevada, Reno School of Medicine, Reno, Nevada, USA
| | - Lingchen Wang
- 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
|
Mohapatra M, Rath S, Agarwal P, Singh A, Singh R, Sutar S, Sahu A, Maan V, Ganesh S. Cerebral visual impairment in children: Multicentric study determining the causes, associated neurological and ocular findings, and risk factors for severe vision impairment. Indian J Ophthalmol 2022; 70:4410-4415. [PMID: 36453355 PMCID: PMC9940545 DOI: 10.4103/ijo.ijo_801_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose To evaluate the causes, associated neurological and ocular findings in children with cerebral visual impairment (CVI), and to identify risk factors for severe vision impairment. Methods A multicenter, retrospective, cross-sectional analysis was carried out from January 2017 to December 2019 on patients less than 16 years of age with a diagnosis of CVI. Results A total of 405 patients were included of which 61.2% were male and 38.8% were female. The median age at presentation was 4 years (range 3 months to 16 years). Antenatal risk factors were present in 14% of the cases. The most common cause of CVI was hypoxic-ischemic encephalopathy (35.1%), followed by seizure associated with brain damage (31.3%). The most common neurological finding was seizure (50.4%), followed by cerebral palsy (13.6%). Associated ophthalmological findings were significant refractive error (63.2%), esotropia (22.2%), exotropia, (38%), nystagmus (33.3%), and optic nerve atrophy (25.9%). Severe visual impairment (<20/200) was associated with optic atrophy (odds ratio: 2.9, 95% confidence interval: 1.4-6.0; P = 0.003) and seizure disorder (odds ratio: 1.9, 95% confidence interval: 1.2-3.3; P = 0.012). Conclusion The various ophthalmic, neurological manifestations and etiologies could guide the multidisciplinary team treating the child with CVI in understanding the visual impairment that affects the neuro development of the child and in planning rehabilitation strategies.
Collapse
Affiliation(s)
- Monalisa Mohapatra
- Department of Pediatric Ophthalmology, MGM Eye Institute, Raipur, Chattisgarh, India,The Bodhya Eye Consortium, a. MGM Eye Institute, Raipur, Chhattisgarh, India, b. Dr. Shroff’s Charity Eye Hospital, New Delhi, India, c. CL Gupta Eye Institute, Moradabad, Uttar Pradesh, India,Correspondence to: Dr. Monalisa Mohapatra, Department of Pediatric Ophthalmology, MGM Eye Institute, 5th Mile, Vidhan Sabha Road, Saddu, Raipur, Chhattisgarh - 493 111, India. E-mail:
| | - Soveeta Rath
- Department of Pediatric Ophthalmology, Dr. Shroff’s Charity Eye Hospital, New Delhi, India,The Bodhya Eye Consortium, a. MGM Eye Institute, Raipur, Chhattisgarh, India, b. Dr. Shroff’s Charity Eye Hospital, New Delhi, India, c. CL Gupta Eye Institute, Moradabad, Uttar Pradesh, India
| | - Pradeep Agarwal
- Department of Pediatric Ophthalmology, CL Gupta Eye Institute, Moradabad, Uttar Pradesh, India,The Bodhya Eye Consortium, a. MGM Eye Institute, Raipur, Chhattisgarh, India, b. Dr. Shroff’s Charity Eye Hospital, New Delhi, India, c. CL Gupta Eye Institute, Moradabad, Uttar Pradesh, India
| | - Abhishek Singh
- Department of Pediatric Ophthalmology, MGM Eye Institute, Raipur, Chattisgarh, India,The Bodhya Eye Consortium, a. MGM Eye Institute, Raipur, Chhattisgarh, India, b. Dr. Shroff’s Charity Eye Hospital, New Delhi, India, c. CL Gupta Eye Institute, Moradabad, Uttar Pradesh, India
| | - Rupali Singh
- Department of Pediatric Ophthalmology, Dr. Shroff’s Charity Eye Hospital, New Delhi, India,The Bodhya Eye Consortium, a. MGM Eye Institute, Raipur, Chhattisgarh, India, b. Dr. Shroff’s Charity Eye Hospital, New Delhi, India, c. CL Gupta Eye Institute, Moradabad, Uttar Pradesh, India
| | - Sameer Sutar
- Department of Pediatric Ophthalmology, CL Gupta Eye Institute, Moradabad, Uttar Pradesh, India,The Bodhya Eye Consortium, a. MGM Eye Institute, Raipur, Chhattisgarh, India, b. Dr. Shroff’s Charity Eye Hospital, New Delhi, India, c. CL Gupta Eye Institute, Moradabad, Uttar Pradesh, India
| | - Anupam Sahu
- Department of Pediatric Ophthalmology, MGM Eye Institute, Raipur, Chattisgarh, India,The Bodhya Eye Consortium, a. MGM Eye Institute, Raipur, Chhattisgarh, India, b. Dr. Shroff’s Charity Eye Hospital, New Delhi, India, c. CL Gupta Eye Institute, Moradabad, Uttar Pradesh, India
| | - Veenu Maan
- Department of Pediatric Ophthalmology, CL Gupta Eye Institute, Moradabad, Uttar Pradesh, India,The Bodhya Eye Consortium, a. MGM Eye Institute, Raipur, Chhattisgarh, India, b. Dr. Shroff’s Charity Eye Hospital, New Delhi, India, c. CL Gupta Eye Institute, Moradabad, Uttar Pradesh, India
| | - Suma Ganesh
- Department of Pediatric Ophthalmology, Dr. Shroff’s Charity Eye Hospital, New Delhi, India,The Bodhya Eye Consortium, a. MGM Eye Institute, Raipur, Chhattisgarh, India, b. Dr. Shroff’s Charity Eye Hospital, New Delhi, India, c. CL Gupta Eye Institute, Moradabad, Uttar Pradesh, India
| |
Collapse
|