Do Belinda, Lynch Paige, Macris Elena-Marie, Smyth Brianna, Stavrinakis Stephanie, Quinn Stephen, Constable Paul A
Discipline of Optometry, Flinders University, Adelaide, Australia.
Department of Statistics, Data Science and Epidemiology, Swinburne University of Technology, Melbourne, Australia.
Ophthalmic Physiol Opt. 2017 Mar;37(2):212-224. doi: 10.1111/opo.12350.
To determine whether there is an association with a congenital visual or hearing impairment (VI or HI) and Autism Spectrum Disorder (ASD) in children.
A systematic literature review was performed using nine relevant databases limited to peer reviewed articles in English between 1994 and January 2016. The search identified 1248 articles after duplicates were removed with subsequent screening of the abstracts excluding a further 1199, resulting in 49 full-text articles that were then independently assessed by five of the authors with a final 15 articles meeting the inclusion criteria. Bias assessment was determined through consensus of the first five authors. A meta-analysis of the included studies was performed to estimate the relative risk of ASD in the VI and HI groups compared to the general population based on reported prevalence rates in similar geographical regions. Overall prevalence rates for ASD were calculated from the combined studies in the VI and HI populations.
The overall prevalence of ASD in VI and HI populations was 19% (95% CI 13-25%) and 9% (95% CI 6-12%) respectively. The overall risk-ratio of ASD was greater in the VI 31.0 times (95% CI 18.62-51.56); z = 13.21, p < 0.001) and HI groups 14.1 times (95% CI 3.41-58.62; z = 3.65, p < 0.001) compared to reported ASD prevalence in the general population.
There is a high association of ASD in VI or HI children and therefore these populations should be assessed for ASD in the presence of a visual or hearing disability.
确定儿童先天性视力或听力障碍（VI或HI）与自闭症谱系障碍（ASD）之间是否存在关联。
进行了一项系统的文献综述，使用了九个相关数据库，限于1994年至2016年1月期间以英文发表的同行评审文章。搜索共识别出1248篇文章，去除重复项后，随后对摘要进行筛选，又排除了1199篇，最终得到49篇全文文章，然后由五位作者独立评估，最终有15篇文章符合纳入标准。通过前五位作者的共识确定偏倚评估。基于相似地理区域报告的患病率，对纳入研究进行荟萃分析，以估计VI和HI组中ASD相对于一般人群的相对风险。从VI和HI人群的综合研究中计算出ASD的总体患病率。
VI和HI人群中ASD的总体患病率分别为19%（95%CI 13 - 25%）和9%（95%CI 6 - 12%）。VI组中ASD的总体风险比更高，为31.0倍（95%CI 18.62 - 51.56；z = 13.21，p < 0.001），HI组为14.1倍（95%CI 3.41 - 58.62；z = 3.65，p < 0.001），与一般人群中报告的ASD患病率相比。
VI或HI儿童中ASD的关联性很高，因此在存在视力或听力残疾的情况下，应对这些人群进行ASD评估。
