Khandekar Rajiv, Al Awaidy Salah, Ganesh Anuradha, Bawikar Shyam
Eye and Ear Health Care Programme, Non-communicable Disease Control Department, Directorate General of Health Affairs, Ministry of Health, PO Box 393, Pin 113, Muscat, Oman.
Arch Ophthalmol. 2004 Apr;122(4):541-5. doi: 10.1001/archopht.122.4.541.
To conduct a follow-up study in patients with congenital rubella syndrome (CRS) in Oman and analyze the prevalence of ophthalmic disorders and associated systemic problems.
This historical prospective cohort study included review of 32 surviving patients with CRS reported by the surveillance system in Oman from 1987 through 2002. All patients underwent a complete ophthalmic examination that included visual acuity estimation, refraction and anterior and posterior segment evaluation, and intraocular pressure measurement. Pediatric and otorhinolaryngologic consultations were also performed.
The age-adjusted prevalence of CRS in Oman was 73.2 per million in the Omani population younger than 20 years, and the incidence was 0.6 per 1000 live births. Cataract, retinitis, microphthalmos, and glaucoma were observed in 11, 16, 6, and 4 patients, respectively. Keratoconus, corneal hydrops, and spontaneous resorption of lens were found in 1 patient each. Vision testing was possible in 16 children; 4 were bilaterally blind. Patients who had undergone eye surgery had significantly lower visual acuity, as compared with those who had not undergone surgery (relative risk 2.53; 95% confidence interval, 1.07-6.13). Among the 11 patients with CRS with cataract, we found hearing loss, cardiac anomalies, and neuropsychologic anomalies in 7, 4, and 6 children, respectively.
Congenital rubella syndrome has a wide variety of severe ophthalmic and systemic complications. High clinical vigilance for signs of CRS and regular observation of surviving patients with CRS is desirable. In patients with cataract, the functional results of surgery, despite state-of-the-art ophthalmic care, continue to be poor. Because of a high prevalence of visual, audiologic, and neurologic disabilities, surviving patients with CRS pose a burden on the medical and social communities. Emphasis in management ought to be prevention of CRS through effective immunization programs.
对阿曼先天性风疹综合征（CRS）患者进行随访研究，并分析眼部疾病及相关全身性问题的患病率。
这项历史性前瞻性队列研究包括对阿曼监测系统在1987年至2002年期间报告的32例存活的CRS患者进行回顾。所有患者均接受了全面的眼科检查，包括视力评估、验光以及眼前段和后段评估，还测量了眼压。同时还进行了儿科和耳鼻喉科会诊。
在阿曼20岁以下的人群中，CRS的年龄调整患病率为每百万73.2例，发病率为每1000例活产0.6例。分别在11例、16例、6例和4例患者中观察到白内障、视网膜炎、小眼症和青光眼。圆锥角膜、角膜水肿和晶状体自发吸收各在1例患者中发现。16名儿童可以进行视力测试；4名双侧失明。与未接受手术的患者相比，接受过眼部手术的患者视力明显更低（相对风险2.53；95%置信区间，1.07 - 6.13）。在11例患有CRS且伴有白内障的患者中，分别在7例、4例和6例儿童中发现听力损失、心脏异常和神经心理异常。
先天性风疹综合征有多种严重的眼部和全身性并发症。需要对CRS体征保持高度临床警惕，并对存活的CRS患者进行定期观察。对于患有白内障的患者，尽管有先进的眼科护理，手术的功能效果仍然很差。由于视力、听力和神经残疾的高患病率，存活的CRS患者给医疗和社会社区带来了负担。管理的重点应该是通过有效的免疫计划预防CRS。
