学龄前儿童视力下降的危险因素：多民族儿科眼病研究和巴尔的摩儿科眼病研究。
Risk factors for decreased visual acuity in preschool children: the multi-ethnic pediatric eye disease and Baltimore pediatric eye disease studies.
机构信息
Doheny Eye Institute and the Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
出版信息
Ophthalmology. 2011 Nov;118(11):2262-73. doi: 10.1016/j.ophtha.2011.06.033. Epub 2011 Aug 19.
OBJECTIVE
To investigate risk factors associated with unilateral or bilateral decreased visual acuity (VA) in preschool children.
DESIGN
Population-based, cross-sectional prevalence study.
PARTICIPANTS
Population-based samples of 6504 children ages 30 to 72 months from California and Maryland.
METHODS
Participants were preschool African-American, Hispanic, and non-Hispanic white children from Los Angeles, California, and Baltimore, Maryland. Data were obtained by a parental interview and a detailed ocular examination. Logistic regression models were used to evaluate the independent associations between demographic, behavioral, and clinical risk factors with unilateral and bilateral decreased VA.
MAIN OUTCOME MEASURES
Odds ratios (ORs) for various risk factors associated with interocular difference (IOD) in VA of ≥2 lines with ≤20/32 in the worse eye, or bilateral decreased VA <20/40 or <20/50 if <48 months of age.
RESULTS
In multivariate logistic regression analysis, 2-line IOD with a VA of ≤20/32 was independently associated with Hispanic ethnicity (OR, 2.05), esotropia (OR, 8.98), spherical equivalent (SE) anisometropia (ORs ranging between 1.5 and 39.7 for SE anisometropia ranging between 0.50 to <1.00 diopters [D] and ≥2.00 D), and aniso-astigmatism in J0 or J45 (ORs ranging between 1.4 and ≥5.3 for J0 or J45 differences ranging between 0.25 to <0.50 D and ≥1.00 D). Bilateral decreased VA was independently associated with lack of health insurance (OR, 2.9), lower primary caregiver education (OR, 1.7), astigmatism (OR, 2.3 and 17.6 for astigmatism 1.00 to <2.00 D and ≥2.00 D), and SE hyperopia ≥4.00 D (OR, 10.8).
CONCLUSIONS
Anisometropia and esotropia are risk factors for IOD in VA. Astigmatism and high hyperopia are risk factors for bilateral decreased VA. Guidelines for the screening and management of decreased VA in preschool children should be considered in light of these risk associations.
FINANCIAL DISCLOSURE(S): The authors have no proprietary or commercial interest in any of the materials discussed in this article.
目的
研究与学龄前儿童单眼或双眼视力下降（VA）相关的危险因素。
设计
基于人群的横断面患病率研究。
参与者
来自加利福尼亚州和马里兰州的 6504 名 30 至 72 个月大的儿童的基于人群的样本。
方法
参与者为洛杉矶加利福尼亚州和巴尔的摩马里兰州的学龄前非裔美国人、西班牙裔和非西班牙裔白人儿童。通过父母访谈和详细的眼部检查获得数据。使用逻辑回归模型评估人口统计学、行为和临床危险因素与单眼和双眼 VA 下降之间的独立关联。
主要观察指标
双眼间差异（IOD）与 VA 的比值比（OR），差异≥ 2 行，最差眼视力≤20/32，或双眼 VA 下降<20/40 或<20/50（如果年龄<48 个月）。
结果
在多变量逻辑回归分析中，2 行 IOD 且 VA 为≤20/32 与西班牙裔（OR，2.05）、内斜视（OR，8.98）、等效球镜（SE）屈光参差（SE 屈光参差 0.50 至<1.00 D 之间的 OR 范围为 1.5 至 39.7，≥2.00 D）和 J0 或 J45 散光（J0 或 J45 差异 0.25 至<0.50 D 和≥1.00 D 之间的 OR 范围为 1.4 至≥5.3）独立相关。双眼 VA 下降与缺乏健康保险（OR，2.9）、初级保健提供者教育程度较低（OR，1.7）、散光（OR，2.3 和 17.6，散光 1.00 至<2.00 D 和≥2.00 D）和 SE 远视≥4.00 D（OR，10.8）独立相关。
结论
屈光参差和内斜视是 VA 中 IOD 的危险因素。散光和高度远视是双眼 VA 下降的危险因素。应根据这些风险关联考虑制定针对学龄前儿童视力下降的筛查和管理指南。
财务披露
作者没有与本文讨论的任何材料有任何专有或商业利益。
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