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Ravid-Saffir A, Sella S, Ben-Eli H. Development and validation of a questionnaire for assessing parents' health literacy regarding vision screening for children: a Delphi study. Sci Rep 2023; 13:13887. [PMID: 37620666 PMCID: PMC10449776 DOI: 10.1038/s41598-023-41006-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 08/20/2023] [Indexed: 08/26/2023] Open
Abstract
Preschool vision screening is recommended to reduce the incidence of amblyopia that persists into adulthood. However, parent's perceptions regarding the importance of screening and early intervention may constitute a significant barrier to seeking vision exams and pursuing treatment. The aim of this study is to develop and validate a questionnaire for assessing parent's awareness, perception and health literacy of children's vision tests. The questionnaire was developed using the Delphi method with experts from the fields of pediatric ophthalmology, optometry, orthoptics, pediatric medicine, social sciences and Mother and Child Health Care centers. Experts were provided with drafts of the questions iteratively in three rounds until a consensus was reached independently on the relevant items, coherently language and redundancies. For the first, second and third stages of the Delphi process, 17, 15 and 13 experts participated in the panel respectively. Validity was achieved by wide consensus among the panel on the relevance of each question, of 75%, 85% and 90%, for the three rounds respectively. Here we describe the final questionnaire, EYES: Evaluating Young-Children Eye health Survey, which includes 31 questions regarding demographics, ocular history, parental health literacy, and perceptions of vision and vison exams.
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Affiliation(s)
- Ahuva Ravid-Saffir
- Department of Optometry and Vision Science, Hadassah Academic College, Jerusalem, Israel
- Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Shulamit Sella
- Department of Optometry and Vision Science, Hadassah Academic College, Jerusalem, Israel
| | - Hadas Ben-Eli
- Department of Optometry and Vision Science, Hadassah Academic College, Jerusalem, Israel.
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
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Chen CW, Ma CH, Yao JY. Evaluation of retinal microvasculature in exotropia with abnormal binocular vision by optical coherence tomography angiography. BMC Ophthalmol 2023; 23:152. [PMID: 37041540 PMCID: PMC10091658 DOI: 10.1186/s12886-023-02900-w] [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: 11/19/2022] [Accepted: 04/03/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND To explore the retinal microvasculature in large-angle concomitant exotropia patients with abnormal binocular vision using optical coherence tomography angiography (OCTA) analysis. METHODS OCTA images of 52 healthy and 100 strabismic eyes were analyzed to quantify the retinal thickness (RT), superficial capillary plexus (SCP), deep capillary plexus (DCP), and foveal avascular zone (FAZ). Paired t-tests were performed to compare differences between the two groups, the dominant eye and the deviated eye in the exotropia group, respectively. A p-value < 0.01 was considered significant. RESULTS The mean angle of deviation was 79.38 [± 25.64] (prism diopters, PD). There were significant differences in the DCP in deviated eyes between the exotropia group and the control group (fovea: p = 0.007; temporal: p = 0.014; nasal: p = 0.028; inferior: p = 0.013). The temporal SCP in the exotropia group was significantly higher than in the control group in deviated eyes (p = 0.020). No significant difference was found between dominant eyes and strabismic eyes (p > 0.01). CONCLUSIONS The study showed that OCTA revealed subnormal DCP in patients with large-angle exotropia and abnormal binocularity which may be related to retinal suppression. Changes in the macular microvasculature may provide valuable insights into the development of strabismus. Further studies are needed to determine the clinical relevance of this finding. TRIAL REGISTRATION This trial is registered as ChiCTR2100052577 at www.Chictr.org.cn .
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Affiliation(s)
- Chun-Wen Chen
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Chun-Hui Ma
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jing-Yan Yao
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, China.
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Hu B, Liu Z, Zhao J, Zeng L, Hao G, Shui D, Mao K. The Global Prevalence of Amblyopia in Children: A Systematic Review and Meta-Analysis. Front Pediatr 2022; 10:819998. [PMID: 35601430 PMCID: PMC9114436 DOI: 10.3389/fped.2022.819998] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 03/15/2022] [Indexed: 01/15/2023] Open
Abstract
Epidemiological data about the prevalence of amblyopia around the world vary widely among regions and periods. This meta-analysis aimed to determine the global prevalence of amblyopia in children. PubMed, Embase, and the Cochrane Library were searched for prevalence studies published up to 5 November 2021. The outcome was the prevalence of amblyopia, analyzed as pooled estimates with 95% confidence intervals (CI). A total of 97 studies were included, including 4,645,274 children and 7,706 patients with amblyopia. The overall worldwide pooled prevalence of amblyopia was 1.36% (95%CI: 1.27-1.46%). The prevalence of amblyopia was higher in males (1.40%, 95%CI: 1.10-1.70%) than in females (1.24%, 95%CI: 0.94-1.54%) (OR = 0.885, 95%CI: 0.795-0.985, P = 0.025). The results of the meta-regression analysis showed that there were no significant associations between the prevalence of amblyopia and geographical area, publication year, age, sample size, and whether it was carried out in a developed or developing country (all P > 0.05). Begg's test (P = 0.065) and Egger's test (P < 0.001) showed that there was a significant publication bias in the prevalence of amblyopia. In conclusion, amblyopia is a significant vision problem worldwide, and public health strategies of early screening, treatment, and management are important.
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Gong W, Chen H, Yang F, Lin S, Li C, Wang G. Inter-eye Differences in Ocular Biometric Parameters of Concomitant Exotropia. Front Med (Lausanne) 2022; 8:724122. [PMID: 35059408 PMCID: PMC8763704 DOI: 10.3389/fmed.2021.724122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/25/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: To evaluate the ocular biometric parameters in patients with constant and intermittent exotropia by the measurement of swept-source optical coherence tomography (SS-OCT) optical biometer OA-2000 and comparing it with the normal control subjects. Design: Cross-sectional case-control study. Participants: Fifty-five constant and 24 intermittent patients with exotropia with central fixation and 77 orthotropic normal control participants aged 4-18 years old. Methods: Non-contact and high-resolution optical biometric OA-2000 measurements were conducted under uniform ambient light conditions. The statistical analysis included intraclass correlation coefficient (ICC), Bland-Altman plot, and independent t-tests. Main Outcome Measures: Spherical equivalent (SE), ocular biological parameters such as pupil diameter (PD), anterior chamber depth (ACD), lens thickness (LT), and axial lengths (AL). The absolute values of inter-eye differences for SE, PD, ACD, LT, and AL were recorded as AnisoSE, AnisoPD, AnisoACD, AnisoLT, and AnisoAL, respectively. Results: AnisoSE (0.878 vs. 0.577, P = 0.019), AnisoAL (0.395 vs. 0.208, P = 0.001), AnisoACD (0.060 vs. 0.032, P < 0.001), AnisoLT (0.060 vs. 0.031, P = 0.002), and AnisoPD (0.557 vs. 0.340, P = 0.002) were significantly larger in concomitant patients with exotropia. The SE, AL, ACD, LT, and PD showed excellent binocular correlation with ICC values that ranged from 0.943 to 0.987 in control participants and from 0.767 to 0.955 in concomitant exotropia patients. Bland-Altman plots showed the wider range of agreement in patients with concomitant exotropia than the control participants (SE: 5.0288 vs. 3.3258; AL: 2.2146 vs. 1.3172; ACD:0.3243 vs. 0.1682; PD: 2.4691 vs. 1.9241; and LT:0.3723 vs 0.1858). Conclusion: Patients with concomitant exotropia showed larger inter-eye differences in SE, ACD, LT, PD, and AL. Advice should be given to suspicious children to avoid or delay the development of concomitant exotropia.
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Affiliation(s)
- Weifen Gong
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China
| | | | | | | | | | - Geng Wang
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China
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von Scheibler ENMM, van der Valk Bouman ES, Nuijts MA, Bauer NJC, Berendschot TTJM, Vermeltfoort P, Bok LA, van Eeghen AM, Houben ML, van Amelsvoort TAMJ, Boot E, van Egmond-Ebbeling MB. Ocular findings in 22q11.2 deletion syndrome: A systematic literature review and results of a Dutch multicenter study. Am J Med Genet A 2021; 188:569-578. [PMID: 34773366 PMCID: PMC9298823 DOI: 10.1002/ajmg.a.62556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 09/04/2021] [Accepted: 10/19/2021] [Indexed: 12/02/2022]
Abstract
The 22q11.2 deletion syndrome (22q11.2DS) is a multisystem disorder with an estimated prevalence of 1:3000 live births. Manifestations show a marked variability in expression and include speech‐ and language delay, intellectual disability, and neuropsychiatric disorders. We aim to provide an overview of ocular findings in 22q11.2DS in order to optimize recommendations for ophthalmic screening. We combined results from a systematic literature review with results from a multicenter cross‐sectional study of patients with 22q11.2DS who were assessed by an ophthalmologist. Our systematic literature search yielded four articles, describing 270 patients. We included 132 patients in our cross‐sectional study (median age 8.9 [range 0–56] years). Most reported ocular findings were retinal vascular tortuosity (32%–78%), posterior embryotoxon (22%–50%), eye lid hooding (20%–67%), strabismus (12%–36%), amblyopia (2%–11%), ptosis (4%–6%), and refractive errors, of which hyperopia (6%–48%) and astigmatism (3%–23%) were most common. Visual acuity was (near) normal in most patients (91%–94%). Refractive errors, strabismus, and amblyopia are treatable conditions that are frequently present in patients with 22q11.2DS and should be corrected at an early stage. Therefore, in 22q11.2DS, we recommend ophthalmic and orthoptic screening at the age of 3 years or at diagnosis, and a low‐threshold referral in adults.
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Affiliation(s)
- Emma N M M von Scheibler
- Advisium, 's Heeren Loo Zorggroep, Amersfoort, The Netherlands.,Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | | | - Myrthe A Nuijts
- Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Noël J C Bauer
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Tos T J M Berendschot
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Pit Vermeltfoort
- Department of Ophthalmology, Máxima Medical Center, Veldhoven, The Netherlands
| | - Levinus A Bok
- Department of Pediatrics, Máxima Medical Center, Veldhoven, The Netherlands
| | - Agnies M van Eeghen
- Advisium, 's Heeren Loo Zorggroep, Amersfoort, The Netherlands.,ENCORE, Erasmus Medical Center, Rotterdam, The Netherlands.,Emma Children's Hospital, University of Amsterdam, Amsterdam, The Netherlands
| | - Michiel L Houben
- Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Erik Boot
- Advisium, 's Heeren Loo Zorggroep, Amersfoort, The Netherlands.,Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands.,The Dalglish Family 22q Clinic, University Health Network, Toronto, Ontario, Canada
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Yang MK, Kim N, Choung HK, Khwarg SI. Effect of Congenital Lower Eyelid Epiblepharon Surgery on Asymmetric Margin Reflex Distance 1. Curr Eye Res 2020; 46:954-960. [PMID: 33249930 DOI: 10.1080/02713683.2020.1857781] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objectives: To investigate the characteristics of margin reflex distance 1 (MRD1) asymmetry in congenital lower eyelid epiblepharon and its resolution after surgical correction of epiblepharon.Methods: Among patients who underwent lower eyelid epiblepharon surgery from November 2015 to September 2017, patients with a preoperative MRD1 difference of more than 1.0 mm between the two eyes according to medical photographs were defined as having MRD1 asymmetry. A postoperative MRD1 difference of less than 1.0 mm between the two eyes was regarded as MRD1 asymmetry resolution. The preoperative MRD1 difference was compared between subgroups with resolved or sustained MRD1 asymmetry. Astigmatism and amblyopia were also assessed.Results: Among 432 patients, MRD1 asymmetry was observed in 24 patients (5.6%). MRD1 was always lower in the side with more extensive epiblepharon. At 6 months after surgery, the mean MRD1 difference between the two eyes was significantly decreased (1.8 ± 0.7 mm to 0.5 ± 0.8 mm, p < .001, paired t-test) and MRD1 asymmetry resolution occurred in 19 patients (79%). In the resolved MRD1 asymmetry group, the preoperative MRD1 difference was 2.0 mm or less and was significantly smaller than that in the sustained MRD1 asymmetry group (p = .010, Mann-Whitney U test). Six patients had preoperative aniso-astigmatism ≥ 1.50 D. Unilateral amblyopia presented in nine patients (38%) and improved within 1 year postoperatively.Conclusions: MRD1 asymmetry can be resolved after epiblepharon surgery, especially when the preoperative MRD1 difference is 2.0 mm or less. Unilateral amblyopia was frequent, but the treatment outcome was good.
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Affiliation(s)
- Min Kyu Yang
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Namju Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Ho-Kyung Choung
- Department of Ophthalmology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Sang In Khwarg
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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Wu KR, Yu YJ, Tang LY, Chen SY, Zhang MY, Sun T, Wu SN, Yu K, Li B, Shao Y. Altered Brain Network Centrality in Patients with Adult Strabismus with Amblyopia: A Resting-State Functional Magnetic Resonance Imaging (fMRI) Study. Med Sci Monit 2020; 26:e925856. [PMID: 33226973 PMCID: PMC7693780 DOI: 10.12659/msm.925856] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background The aim of this study was to explore potential changes in brain function network activity in patients with adult strabismus with amblyopia (SA) using the voxel-wise degree centrality (DC) method. Material/Methods We enrolled 15 patients with SA (6 males, 9 females) and 15 sex-matched healthy controls (HCs). All subjects completed resting functional magnetic resonance imaging scans. Independent-sample t tests and receiver operating characteristic (ROC) curves were used to assess DC value differences between groups, and Pearson correlation analysis was performed to evaluate correlations between DC-changed brain regions and clinical data of patients with SA. Results Compared with the HC group, DC values that were lower in patients with SA included the left middle frontal gyrus and bilateral angular gyri. Increases were observed in the left fusiform gyrus, right lingual gyrus, right middle occipital gyrus, right postcentral gyrus, and left paracentral lobule. However, DC values were not correlated with clinical manifestations. ROC curve analysis showed high accuracy. Conclusions We found abnormal neural activity in specific brain regions in patients with SA. Specifically, we observed significant changes in DC values compared to HCs. These changes may be useful to identify the specific mechanisms involved in brain dysfunction in SA.
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Affiliation(s)
- Kang-Rui Wu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China (mainland)
| | - Ya-Jie Yu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China (mainland)
| | - Li-Ying Tang
- Department of Ophthalmology, Xiang'an Hospital of Xiamen University; Fujian Provincial Key Laboratory of Ophthalmology and Visual Science; Eye Institute of Xiamen University; Xiamen University School of Medicine, Xiamen, Fujian, China (mainland)
| | - Si-Yi Chen
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China (mainland)
| | - Meng-Yao Zhang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China (mainland)
| | - Tie Sun
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China (mainland)
| | - Shi-Nan Wu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China (mainland)
| | - Kang Yu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China (mainland)
| | - Biao Li
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China (mainland)
| | - Yi Shao
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China (mainland)
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The Prevalence of Ptosis and Nystagmus in Rural Population. J Curr Ophthalmol 2020; 32:178-182. [PMID: 32671302 PMCID: PMC7337018 DOI: 10.1016/j.joco.2018.11.007] [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] [Received: 04/27/2018] [Revised: 11/15/2018] [Accepted: 11/19/2018] [Indexed: 11/20/2022] Open
Abstract
Purpose To determine the prevalence of ptosis and nystagmus in the general rural population in Iran. Methods Two villages were selected from the north and southwest of Iran using a multi-stage cluster sampling approach. After selection of the participants and inviting them to a complete eye exam, they all had vision tests and an ophthalmic examination. Vision tests included measurement of visual acuity, refraction, and the cover test. Then the slit-lamp exam was performed, and the diagnosis of ptosis and nystagmus was determined by an ophthalmologist. Results Of the 3851 invitees, 3314 people participated in the study. The prevalence of ptosis in this study was 2.23% [95% confidence interval (CI): 1.73-2.74], and 45.3% of the cases were bilateral ptosis. The prevalence of ptosis was lowest in the 21-30 year (0.2%) and the under 5 year (0.8%) age groups, and the highest prevalence was observed in people over 70 years of age (6.7%) (P < 0.001). The prevalence of ptosis was higher in illiterate people than those with an academic education level (P = 0.012). The prevalence of astigmatism was 62.8% in those with ptosis and 34.2% in those without ptosis (P < 0.001). The prevalence of nystagmus was 0.39% (13 cases). Conclusions This study found that the prevalence of ptosis is relatively high in the general rural population in Iran, and the prevalence increases with age. Astigmatism is significantly high among cases with ptosis, and its prevalence has an inverse relation with the level of education. Nystagmus also had a high prevalence in this population.
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Fu Z, Hong H, Su Z, Lou B, Pan CW, Liu H. Global prevalence of amblyopia and disease burden projections through 2040: a systematic review and meta-analysis. Br J Ophthalmol 2019; 104:1164-1170. [DOI: 10.1136/bjophthalmol-2019-314759] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 10/17/2019] [Accepted: 10/21/2019] [Indexed: 12/11/2022]
Abstract
PurposeAmblyopia is a leading cause of vision impairment among children and young adults. Individual studies showed significant variations in the prevalence of amblyopia in different regions and age groups. This study is to estimate the global prevalence of amblyopia by pooling its prevalence from the previous studies and to project the number of people affected through 2040.MethodsWe performed a systematic review and meta-analysis on the prevalence of amblyopia using data published before 20 October 2018. We estimated the prevalence rate of amblyopia and its 95% CI globally and by subgroups (eg, region and age). The prevalence data were applied to United Nations World Population Prospects to derive the projected number with amblyopia through 2040.ResultsA meta-analysis of 60 studies (1 859 327 subjects) showed that the pooled prevalence rate of amblyopia was 1.44% (95% CI 1.17% to 1.78%). Prevalences in Europe (2.90%) and North America (2.41%) were higher than in Asia (1.09%) and Africa (0.72%). The highest prevalence was found in subjects over 20 years old (3.29%). There was no difference in the prevalence between genders. We estimated 99.2 (95% CI 71.7 to 146.1) million people with amblyopia in 2019 worldwide, increasing to 175.2 (95% CI 81.3 to 307.8) million by 2030 and 221.9 (95% CI 83.7 to 429.2) million by 2040.ConclusionsThe amblyopia is becoming a significant vision problem worldwide. It is of great importance to design and implement amblyopia screening, treatment and related public health strategies.
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Hashemi H, Pakzad R, Heydarian S, Yekta A, Aghamirsalim M, Shokrollahzadeh F, Khoshhal F, Pakbin M, Ramin S, Khabazkhoob M. Global and regional prevalence of strabismus: a comprehensive systematic review and meta-analysis. Strabismus 2019; 27:54-65. [PMID: 31012389 DOI: 10.1080/09273972.2019.1604773] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Purpose: Despite the importance of information on the prevalence of strabismus, which can be effective in planning preventive and curative services, no study has addressed its prevalence comprehensively. In this study, a systematic search was done to estimate the regional and global prevalence of strabismus in different age and sex groups and factors affecting prevalence heterogeneity. Methods: A comprehensive and systematic search was done in different international databases, including Web of Science, Scopus, PubMed, Embase, etc. to find published articles on the total prevalence of strabismus and the prevalence of exotropia and esotropia. A binomial distribution was used to calculate the prevalence and 95% confidence interval (CI). The Cochran's Q-test and I2 were applied to evaluate heterogeneity and a random-effects model was used to assess the pooled prevalence. The Begg's test was administered to investigate publication bias and finally, a meta-regression method was applied to determine the factors affecting the heterogeneity among studies. Results: Of 7980 articles, 56 articles with a total sample size of 229,396 were analyzed. Many of these articles (n = 14) were from the Regional Office for the Americas. The estimated of pooled prevalence (95% CI) of any strabismus, exotropia, and esotropia was 1.93% (1.64-2.21), 1.23% (1.00-1.46), and 0.77% (0.59-0.95), respectively. The heterogeneity in prevalence of strabismus and its subtypes according to I2 was above 95% (p value <.001 for all). Age had a direct effect on heterogeneity in the prevalence of exotropia (b: 3.491; p: 0.002). Moreover, WHO region had a significant direct effect on heterogeneity in the prevalence of strabismus (b: 0.482; p < .001) and esotropia (b: 0.168; p: 0.027), and publication year had a significant direct effect on heterogeneity in the prevalence of exotropia (b: 0.059; p: 0.045). Sample size and publication year did not have any association with strabismus nor with other variables. There was no publication bias according to the Begg's test. Conclusion: The prevalence of strabismus varies widely in the world. As for factors affecting heterogeneity in the prevalence of strabismus, the results showed that age affected heterogeneity in the prevalence of exotropia, WHO region affected heterogeneity in the prevalence of strabismus and esotropia, and publication year affected heterogeneity in the prevalence of exotropia. Information about the global prevalence of strabismus can help health care planners design interventions and prioritize resource allocation.
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Affiliation(s)
- Hassan Hashemi
- a Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital , Tehran
| | - Reza Pakzad
- b Department of Epidemiology, Faculty of Health, Ilam University of Medical Sciences , Ilam
| | - Samira Heydarian
- c Department of rehabilitation science, School of Allied Medical Sciences, Mazandaran University of Medical Sciences , Sari
| | - Abbasali Yekta
- d Refractive Errors Research Center, Mashhad University of Medical Sciences , Mashhad
| | | | | | - Fahimeh Khoshhal
- f Department of Pediatrics, Dezful University of Medical Sciences , Dezful
| | - Mojgan Pakbin
- a Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital , Tehran
| | - Shahroukh Ramin
- g Department of Optometry, Shahid Beheshti University of Medical Sciences , Tehran
| | - Mehdi Khabazkhoob
- h Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences , Tehran
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Chegeni M, Khanjani N, Rahmatpour P, Ahmadi Pishkuhi M, Abdolalian N. The prevalence of amblyopia in Iran: A systematic review. J Curr Ophthalmol 2018; 30:194-201. [PMID: 30197947 PMCID: PMC6127360 DOI: 10.1016/j.joco.2018.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 01/07/2018] [Accepted: 02/06/2018] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The aim of this study was to determine the prevalence of amblyopia in the population of Iran. METHODS This article is a systematic review. A comprehensive search was conducted in PubMed, Scopus, Science Direct, Ovid, Web of Science, SID, Magiran, with appropriate terms. Information related to the sample size and the prevalence of amblyopia was extracted and summarized in tables. Analysis was performed using STATA software. RESULTS From 551 articles that were originally extracted from the databases, 31 articles met the criteria for entering the review. These studies were conducted in different regions of Iran. The prevalence of amblyopia in different regions varied between 0.19 and 3.69%. Study results were heterogeneous (I2 = 99.7%), and therefore, a meta-analysis was not done. CONCLUSIONS The prevalence of amblyopia in Iran is very different. In addition to conducting national screenings, it is necessary to report the incidence of amblyopia and its related factors in different parts of the country.
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Affiliation(s)
- Maryam Chegeni
- Department of Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Narges Khanjani
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Pardis Rahmatpour
- Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
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Hashemi H, Pakzad R, Yekta A, Bostamzad P, Aghamirsalim M, Sardari S, Valadkhan M, Pakbin M, Heydarian S, Khabazkhoob M. Global and regional estimates of prevalence of amblyopia: A systematic review and meta-analysis. Strabismus 2018; 26:168-183. [PMID: 30059649 DOI: 10.1080/09273972.2018.1500618] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Background: Amblyopia is one of the most important causes of vision impairment in the world, especially in children. Although its prevalence varies in different parts of the world, no study has evaluated its prevalence in different geographical regions comprehensively. The aim of the present study was to provide global and regional estimates of the prevalence of amblyopia in different age groups via a systematic search.Methods: In this study, international databases, including Embase, Scopus, PubMed, Web of Science, and other relevant databases, were searched systematically to find articles on the prevalence of amblyopia in different age groups published in English. The prevalence and 95% CI were calculated using binomial distribution. The Cochran's Q-test and I2 statistic were applied to assess heterogeneity, a random-effects model was used to estimate the pooled prevalence, and a meta-regression method was utilized to investigate the factors affecting heterogeneity between studies.Results: Of 1252 studies, 73 studies were included in the analysis (sample volume: 530,252). Most of these studies (n = 25) were conducted in the WHO-Western Pacific Regional Office. The pooled prevalence estimate of amblyopia was 1.75% (95% CI: 1.62-1.88), with the highest estimate in European Regional Office (3.67%, 95% CI: 2.89-4.45) and the lowest in African Regional Office (0.51%, 95% CI: 0.24-0.78). The most common cause of amblyopia was anisometropia (61.64%). The I2 heterogeneity was 98% (p < 0.001). According to the results of univariate meta-regression, the variables of WHO region (b: 0.566, p < 0.001), sample size (b: -0.284 × 10-4, p: 0.025), and criteria for definition of amblyopia (b: -0.292, p: 0.010) had a significant effect on heterogeneity between studies, while age group, publication date, and cause of amblyopia had no significant effect on heterogeneity.Conclusion: The prevalence of amblyopia varies in different parts of the world, with the highest prevalence in European countries. Geographical location and criteria for definition of amblyopia are among factors contributing to the difference across the world. The results of this study can help stakeholders to design health programs, especially health interventions and amblyopia screening programs.
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Affiliation(s)
- Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran
| | - Reza Pakzad
- Department of Epidemiology, Faculty of Health, Ilam University of Medical Sciences, Ilam
| | - Abbasali Yekta
- Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad
| | | | | | - Sara Sardari
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran
| | - Mehrnaz Valadkhan
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran
| | - Mojgan Pakbin
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran
| | - Samira Heydarian
- Department of rehabilitation science, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari
| | - Mehdi Khabazkhoob
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran
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Hashemi H, Saatchi M, Ali B, Yekta A, Asharlous A, Ostadimoghaddam H, Heravian J, Khabazkhoob M. The prevalence of Amblyopia in a young Population. BRITISH JOURNAL OF VISUAL IMPAIRMENT 2018. [DOI: 10.1177/0264619618775768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - Mohammad Saatchi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
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14
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Li D, Li S, Zeng X. Analysis of alterations in white matter integrity of adult patients with comitant exotropia. J Int Med Res 2018; 46:1963-1972. [PMID: 29569963 PMCID: PMC5991243 DOI: 10.1177/0300060518763704] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective This study was performed to investigate structural abnormalities of the white matter in patients with comitant exotropia using the tract-based spatial statistics (TBSS) method. Methods Diffusion tensor imaging data from magnetic resonance images of the brain were collected from 20 patients with comitant exotropia and 20 age- and sex-matched healthy controls. The FMRIB Software Library was used to compute the diffusion measures, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD). These measures were obtained using voxel-wise statistics with threshold-free cluster enhancement. Results The FA values in the right inferior fronto-occipital fasciculus (IFO) and right inferior longitudinal fasciculus were significantly higher and the RD values in the bilateral IFO, forceps minor, left anterior corona radiata, and left anterior thalamic radiation were significantly lower in the comitant exotropia group than in the healthy controls. No significant differences in the MD or AD values were found between the two groups. Conclusions Alterations in FA and RD values may indicate the underlying neuropathologic mechanism of comitant exotropia. The TBSS method can be a useful tool to investigate neuronal tract participation in patients with this disease.
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Affiliation(s)
- Dan Li
- Department of Radiology, The 117970 First Affiliated Hospital of Nanchang University , Nanchang, Jiangxi Province, China
| | - Shenghong Li
- Department of Radiology, The 117970 First Affiliated Hospital of Nanchang University , Nanchang, Jiangxi Province, China
| | - Xianjun Zeng
- Department of Radiology, The 117970 First Affiliated Hospital of Nanchang University , Nanchang, Jiangxi Province, China
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15
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Tan G, Dan ZR, Zhang Y, Huang X, Zhong YL, Ye LH, Rong R, Ye L, Zhou Q, Shao Y. Altered brain network centrality in patients with adult comitant exotropia strabismus: A resting-state fMRI study. J Int Med Res 2017; 46:392-402. [PMID: 28679330 PMCID: PMC6011327 DOI: 10.1177/0300060517715340] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Objective To investigate the underlying functional network brain-activity changes in patients with adult comitant exotropia strabismus (CES) and the relationship with clinical features using the voxel-wise degree centrality (DC) method. Methods A total of 30 patients with CES (17 men, 13 women), and 30 healthy controls (HCs; 17 men, 13 women) matched in age, sex, and education level participated in the study. DC was used to evaluate spontaneous brain activity. Receiver operating characteristic (ROC) curve analysis was conducted to distinguish CESs from HCs. The relationship between mean DC values in various brain regions and behavioral performance was examined with correlation analysis. Results Compared with HCs, CES patients exhibited decreased DC values in the right cerebellum posterior lobe, right inferior frontal gyrus, right middle frontal gyrus and right superior parietal lobule/primary somatosensory cortex (S1), and increased DC values in the right superior temporal gyrus, bilateral anterior cingulate, right superior temporal gyrus, and left inferior parietal lobule. However, there was no correlation between mean DC values and behavioral performance in any brain regions. Conclusions Adult comitant exotropia strabismus is associated with abnormal brain network activity in various brain regions, possibly reflecting the pathological mechanisms of ocular motility disorders in CES.
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Affiliation(s)
- Gang Tan
- 1 Department of Ophthalmology, First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute and Oculopathy Research Centre, Nanchang, Jiangxi Province, China.,2 Department of Ophthalmology, the First Affiliated Hospital, University of South China, Hengyang, Hunan Province, China
| | - Zeng-Renqing Dan
- 1 Department of Ophthalmology, First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute and Oculopathy Research Centre, Nanchang, Jiangxi Province, China.,3 The Second Clinical Medical College of Nanchang University, Nanchang, China
| | - Ying Zhang
- 1 Department of Ophthalmology, First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute and Oculopathy Research Centre, Nanchang, Jiangxi Province, China
| | - Xin Huang
- 1 Department of Ophthalmology, First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute and Oculopathy Research Centre, Nanchang, Jiangxi Province, China.,4 Department of Ophthalmology, First People's Hospital of Jiujiang City, Jiujiang, Jiangxi Province, China
| | - Yu-Lin Zhong
- 1 Department of Ophthalmology, First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute and Oculopathy Research Centre, Nanchang, Jiangxi Province, China
| | - Lin-Hong Ye
- 1 Department of Ophthalmology, First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute and Oculopathy Research Centre, Nanchang, Jiangxi Province, China
| | - Rong Rong
- 1 Department of Ophthalmology, First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute and Oculopathy Research Centre, Nanchang, Jiangxi Province, China
| | - Lei Ye
- 1 Department of Ophthalmology, First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute and Oculopathy Research Centre, Nanchang, Jiangxi Province, China
| | - Qiong Zhou
- 1 Department of Ophthalmology, First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute and Oculopathy Research Centre, Nanchang, Jiangxi Province, China
| | - Yi Shao
- 1 Department of Ophthalmology, First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute and Oculopathy Research Centre, Nanchang, Jiangxi Province, China
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