美国城市人口中学龄前儿童视力下降的患病率：巴尔的摩儿童眼病研究、方法及结果
Prevalence of decreased visual acuity among preschool-aged children in an American urban population: the Baltimore Pediatric Eye Disease Study, methods, and results.
作者信息
Friedman David S, Repka Michael X, Katz Joanne, Giordano Lydia, Ibironke Josephine, Hawes Patricia, Burkom Diane, Tielsch James M
机构信息
Dana Center for Prevention Ophthalmology, Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland 21210, USA.
出版信息
Ophthalmology. 2008 Oct;115(10):1786-95, 1795.e1-4. doi: 10.1016/j.ophtha.2008.04.006. Epub 2008 Jun 5.
OBJECTIVE
To determine the age- and ethnicity-specific prevalence of decreased visual acuity (VA) in white and black preschool-aged children.
DESIGN
Cross-sectional study.
PARTICIPANTS
The Baltimore Pediatric Eye Disease Study is a population-based evaluation of the prevalence of ocular disorders in children 6 through 71 months of age in Baltimore, Maryland, United States. Among 4132 children identified, 3990 eligible children (97%) were enrolled and 2546 children (62%) were examined. This report focuses on 1714 of 2546 examined children (67%) who were 30 through 71 months of age.
METHODS
Field staff identified 63 737 occupied dwelling units in 54 census tracts. Parents or guardians of eligible participants underwent an in-home interview, and eligible children underwent a comprehensive eye examination including optotype visual acuity (VA) testing in children 30 months of age and older, with protocol-specified retesting of children with VA worse than an age-appropriate standard.
MAIN OUTCOME MEASURES
The proportion of children 30 through 71 months of age testable for VA and the proportion with decreased VA as defined by preset criteria.
RESULTS
Visual acuity was testable in 1504 of 1714 children (87.7%) 30 through 71 months of age. It was decreased at the initial test (wearing glasses if brought to the clinic) in both eyes of 7 of 577 white children (1.21%; 95% confidence interval [CI], 0.49-2.50) and 13 of 725 black children (1.79%; 95% CI, 0.95-3.08), a difference that is not statistically significant. Decreased VA in both eyes after retesting was found in 3 of 598 white children (0.50%; 95% CI, 0.10-1.48) and in 8 of 757 black children (1.06%, 95% CI = 0.45, 2.10), also not statistically significantly different. Uncorrected ametropia explained the decreased VA on initial testing in 10 of the 20 children.
CONCLUSIONS
Decreased VA in both eyes of children 30 through 71 months of age at presentation in urban Baltimore was 1.2% among white children and 1.8% among black children. After retesting within 60 days of the initial examination and with children wearing best refractive correction, the rate of decreased VA in both eyes was 0.5% among white children and 1.1% among black children.
目的
确定美国马里兰州巴尔的摩市白人及黑人学龄前儿童中视力下降的年龄及种族特异性患病率。
设计
横断面研究。
参与者
巴尔的摩小儿眼病研究是一项基于人群的对美国马里兰州巴尔的摩市6至71个月大儿童眼部疾病患病率的评估。在确定的4132名儿童中，3990名符合条件的儿童（97%）被纳入研究，2546名儿童（62%）接受了检查。本报告聚焦于2546名接受检查儿童中的1714名（67%），这些儿童年龄在30至71个月之间。
方法
现场工作人员在54个人口普查区确定了63737个有人居住的住宅单元。符合条件参与者的父母或监护人接受了入户访谈，符合条件的儿童接受了全面的眼科检查，包括对30个月及以上儿童进行视标视力测试，对视力低于年龄适宜标准的儿童按照方案进行重新测试。
主要观察指标
30至71个月大儿童中可进行视力测试的比例以及根据预设标准视力下降的比例。
结果
在1714名30至71个月大的儿童中，1504名（87.7%）可进行视力测试。在577名白人儿童中，7名（1.21%；95%置信区间[CI]，0.49 - 2.50）双眼在初次测试时（若戴眼镜则戴着到诊所）视力下降；在725名黑人儿童中，13名（1.79%；95%CI，0.95 - 3.08）双眼视力下降，差异无统计学意义。重新测试后，598名白人儿童中有3名（0.50%；95%CI，0.10 - 1.48）双眼视力下降，757名黑人儿童中有8名（1.06%，95%CI = 0.45，2.10）双眼视力下降，差异也无统计学意义。20名视力下降儿童中有10名在初次测试时未矫正的屈光不正可解释视力下降情况。
结论
在巴尔的摩市城区，30至71个月大儿童中，白人儿童双眼视力下降的比例为1.2%，黑人儿童为1.8%。在初次检查后60天内重新测试且儿童佩戴最佳屈光矫正的情况下，白人儿童双眼视力下降的比例为0.5%，黑人儿童为1.1%。
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