Tang Shu Min, Chan Rachel Y T, Bin Lin Shi, Rong Shi Song, Lau Henry H W, Lau Winnie W Y, Yip Wilson W K, Chen Li Jia, Ko Simon T C, Yam Jason C S
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong.
Joint Shantou International Eye Center, Shantou University and The Chinese University of Hong Kong, Shantou, China.
Sci Rep. 2016 Oct 12;6:35177. doi: 10.1038/srep35177.
This systematic review and meta-analysis is to evaluate the risk of development of concomitant strabismus due to refractive errors. Eligible studies published from 1946 to April 1, 2016 were identified from MEDLINE and EMBASE that evaluated any kinds of refractive errors (myopia, hyperopia, astigmatism and anisometropia) as an independent factor for concomitant exotropia and concomitant esotropia. Totally 5065 published records were retrieved for screening, 157 of them eligible for detailed evaluation. Finally 7 population-based studies involving 23,541 study subjects met our criteria for meta-analysis. The combined OR showed that myopia was a risk factor for exotropia (OR: 5.23, P = 0.0001). We found hyperopia had a dose-related effect for esotropia (OR for a spherical equivalent [SE] of 2-3 diopters [D]: 10.16, P = 0.01; OR for an SE of 3-4D: 17.83, P < 0.0001; OR for an SE of 4-5D: 41.01, P < 0.0001; OR for an SE of ≥5D: 162.68, P < 0.0001). Sensitivity analysis indicated our results were robust. Results of this study confirmed myopia as a risk for concomitant exotropia and identified a dose-related effect for hyperopia as a risk of concomitant esotropia.
本系统评价和荟萃分析旨在评估屈光不正导致共同性斜视发生的风险。从MEDLINE和EMBASE数据库中检索了1946年至2016年4月1日发表的符合条件的研究，这些研究将任何类型的屈光不正（近视、远视、散光和屈光参差）作为共同性外斜视和共同性内斜视的独立因素进行评估。共检索到5065条发表记录进行筛选，其中157条符合详细评估条件。最终，7项基于人群的研究，涉及23541名研究对象，符合我们的荟萃分析标准。合并后的比值比显示，近视是外斜视的一个危险因素（比值比：5.23，P = 0.0001）。我们发现远视对内斜视有剂量相关效应（等效球镜度[SE]为2 - 3屈光度[D]时的比值比：10.16，P = 0.01；SE为3 - 4D时的比值比：17.83，P < 0.0001；SE为4 - 5D时的比值比：41.01，P < 0.0001；SE≥5D时的比值比：162.68，P < 0.0001）。敏感性分析表明我们的结果是可靠的。本研究结果证实近视是共同性外斜视的一个危险因素，并确定远视作为共同性内斜视的危险因素存在剂量相关效应。
