亚洲和非西班牙裔白种人学龄前儿童视力障碍的患病率和病因：多民族儿科眼病研究。
Prevalence and causes of visual impairment in Asian and non-Hispanic white preschool children: Multi-ethnic Pediatric Eye Disease Study.
机构信息
Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA.
出版信息
Ophthalmology. 2013 Jun;120(6):1220-6. doi: 10.1016/j.ophtha.2012.12.029. Epub 2013 Apr 3.
PURPOSE
To determine the prevalence and causes of decreased visual acuity (VA).
DESIGN
Population-based cross-sectional study.
PARTICIPANTS
Multi-ethnic sample of children 30 to 72 months of age identified in Los Angeles.
METHODS
All eligible children underwent a comprehensive ophthalmic evaluation including monocular VA testing, cover testing, cycloplegic autorefraction, fundus evaluation, and VA retesting with refractive correction. Decreased VA was defined as presenting or best-measured VA worse than 20/50 in children 30 to 47 months of age and worse than 20/40 for children 48 months of age and older. The prevalence and causes of decreased VA were determined, for both presenting and best-measured VA, in the better-seeing and the worse-seeing eyes.
MAIN OUTCOME MEASURES
Prevalence and causes of decreased vision.
RESULTS
Presenting VA was assessed in 1840 children and best-measured VA was assessed in 1886 children. Presenting VA was decreased in the worse eye of 4.2% of Asian children and of 3.6% of non-Hispanic white (NHW) children. Close to one-fourth of these cases had no identifiable cause, and 81% of these resolved on retesting. Decreased presenting VA in the worse eye with an identifiable ophthalmic cause was present in 3.4% of Asian children and in 2.6% of NHW children. Decreased presenting VA attributable to simple refractive error (myopia ≥ 0.5 diopters [D]; hyperopia ≥ 3.0 D; astigmatism ≥ 2.0 D or ≥ 1.5 D for children older than 36 months) was present in the worse eye of 2.3% of Asian children and of 1.4% of NHW children and in the better eye of 0.5% of Asian children and of 0.3% of NHW children. Decreased best-measured VA attributable to a cause was present in the worse eye of 1.2% of both Asian children and NHW children and in the better eye of 0.2% of Asian and of 0.3% of NHW children. Amblyopia related to refractive error was the most common cause, and was 10 times as common as ocular disease. Severe visual impairment was rare.
CONCLUSIONS
Seventy percent of all decreased VA in Asian and NHW preschool children and more than 90% of decreased VA with an identifiable cause is related to refractive error--either uncorrected refractive error or amblyopia resulting from refractive error.
FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
目的
确定视力下降（VA）的患病率和原因。
设计
基于人群的横断面研究。
参与者
在洛杉矶确定的 30 至 72 个月大的多民族儿童样本。
方法
所有符合条件的儿童均接受全面的眼科评估，包括单眼 VA 测试、遮盖测试、睫状肌麻痹自动折射、眼底评估以及屈光矫正后的 VA 复测。VA 下降定义为 30 至 47 个月大的儿童表现或最佳测量 VA 差于 20/50，48 个月及以上的儿童差于 20/40。确定了表现和最佳测量 VA 在视力较好的眼睛和视力较差的眼睛中的患病率和原因。
主要观察指标
视力下降的患病率和原因。
结果
评估了 1840 名儿童的表现 VA 和 1886 名儿童的最佳测量 VA。亚洲儿童的较差眼视力下降的比例为 4.2%，非西班牙裔白人（NHW）儿童为 3.6%。近四分之一的病例没有明确的原因，81%的病例在复测时得到解决。在亚洲儿童中，3.4%的较差眼视力下降有明确的眼科原因，在 NHW 儿童中，2.6%的较差眼视力下降有明确的眼科原因。亚洲儿童的较差眼视力下降归因于单纯屈光不正（近视≥0.5 屈光度[D]；远视≥3.0 D；散光≥2.0 D 或≥36 个月儿童的 1.5 D）的比例为 2.3%，NHW 儿童为 1.4%，亚洲儿童的较好眼视力下降的比例为 0.5%，NHW 儿童的较好眼视力下降的比例为 0.3%。在亚洲儿童和 NHW 儿童中，较差眼的最佳测量 VA 归因于有原因的比例分别为 1.2%，较好眼的最佳测量 VA 归因于有原因的比例分别为 0.2%和 0.3%。与屈光不正相关的弱视是最常见的原因，是眼部疾病的 10 倍。严重视力损害很少见。
结论
在亚洲和 NHW 学龄前儿童中，70%的所有 VA 下降以及超过 90%的有明确原因的 VA 下降都与屈光不正有关，要么是未矫正的屈光不正，要么是屈光不正引起的弱视。
利益冲突披露
作者在本文讨论的任何材料中均无专有的或商业利益。
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