Akinci Arsen, Oner Ozgur, Bozkurt Ozlem Hekim, Guven Alev, Degerliyurt Aydan, Munir Kerim
Department of Pediatric Ophthalmology, Diskapi Children's Hospital, Ankara, Turkey.
J AAPOS. 2008 Oct;12(5):477-81. doi: 10.1016/j.jaapos.2008.04.009. Epub 2008 Jul 2.
To evaluate the ocular findings and refractive errors in children with intellectual disability and in controls of average intellectual development of similar socioeconomic backgrounds.
The study was conducted at Diskapi Children's Hospital in Ankara, Turkey: 724 subjects with intellectual disability and 151 control subjects were evaluated. The subjects with intellectual disability were subdivided into mild (IQ 50-69, n = 490), moderate (IQ 35-49, n = 164), and severe (IQ <34, n = 70) groups, and syndromic (n = 138) versus nonsyndromic (n = 586) disability. All children underwent cycloplegic autorefraction or retinoscopy, slit-lamp biomicroscopy, and dilated fundus examination. Ocular alignment was assessed by Hirschberg, Krimsky, or prism cover test. The main outcome measure was the prevalence of refractive errors and ocular findings.
Seventy-seven percent of subjects with intellectual disability, and 42.4% of controls, had ocular findings. The children with intellectual disability had significantly more nystagmus, strabismus, astigmatism, and hypermetropia than controls. Children with syndromic intellectual disability had significantly more nystagmus, strabismus, astigmatism, and hypermetropia than subjects with nonsyndromic intellectual disability. Increasing severity of intellectual disability was related to higher prevalence of nystagmus, strabismus, astigmatism, hypermetropia, and anisometropia.
From a public health perspective, evaluation and treatment of ocular and refractive findings in children with moderate, severe, and syndromic intellectual disability categories is urgently needed and likely to be highly effective in alleviating future health and social care costs, as well as improving the productive lives of individuals with intellectual disability.
评估智力残疾儿童以及社会经济背景相似、智力发育正常的对照组儿童的眼部检查结果和屈光不正情况。
该研究在土耳其安卡拉的迪斯卡皮儿童医院进行：对724名智力残疾受试者和151名对照受试者进行了评估。智力残疾受试者被分为轻度（智商50 - 69，n = 490）、中度（智商35 - 49，n = 164）和重度（智商<34，n = 70）组，以及综合征性（n = 138）与非综合征性（n = 586）残疾组。所有儿童均接受了睫状肌麻痹验光或检影验光、裂隙灯生物显微镜检查以及散瞳眼底检查。通过 Hirschberg、Krimsky 或棱镜遮盖试验评估眼位。主要观察指标为屈光不正和眼部检查结果的患病率。
77%的智力残疾受试者和42.4%的对照受试者有眼部检查结果。智力残疾儿童的眼球震颤、斜视、散光和远视明显多于对照组。综合征性智力残疾儿童的眼球震颤、斜视、散光和远视明显多于非综合征性智力残疾受试者。智力残疾严重程度的增加与眼球震颤、斜视、散光、远视和屈光参差患病率的升高有关。
从公共卫生角度来看，迫切需要对中度、重度和综合征性智力残疾儿童的眼部和屈光检查结果进行评估和治疗，这可能对减轻未来的健康和社会护理成本以及改善智力残疾个体的生产性生活非常有效。
