Bunce Catey, Zekite Antra, Wormald Richard, Bowman Richard
Department of Primary Care & Public Health Sciences, King's College London, London, UK.
Department of Research & Development, Moorfields Eye Hospital NHS Foundation Trust, London, UK.
BMJ Open. 2017 Sep 1;7(9):e016888. doi: 10.1136/bmjopen-2017-016888.
To use routine data capture from hospitals in England and Wales to identify whether there has been an increase in the annual numbers of children newly certified sight impaired in England and Wales between 1999/2000 and 2014/2015 and to examine causes of certifiable sight impairment in children certified in 2014/2015.
A cross-sectional study including an analysis of all certificates of vision impairment completed in hospitals in England and Wales each year between 2007/2008 and 2014/2015 and all certificates completed in hospitals in England and Wales in 1999/2000.
Certificates for all individuals aged 16 years or less at the time of certification in England and Wales for each financial year between 1 April 2007 and the 31 March 2015 and for individuals aged 15 years or less for the year ending 31 March 2000. We obtained information on the main cause of certifiable sight loss for all children certified in 2014/2015. We estimated crude and sex specific incidence estimates with 95% confidence intervals computed by Byars method.
In 1999/2000, the estimated incidence (95 % CI) of certification was 8.2 (7.7 to 8.8) per 1 00 000. In 2007/2008, the estimated incidence was statistically significantly higher at 10.1 (9.5 to 10.7). Since then a trend of increasing incidence with time has been observed until 2014/2015 when an estimated incidence of 13.3 (12.6 to 14.0) was observed. Hereditary retinal dystrophies, cerebral visual impairment and nystagmus were the most common single causes of certifiable sight impairment in children in 2014/2015.
Our findings show that in England and Wales there has been an increase in the number of children newly certified sight impaired by consultant ophthalmologists since 1999/2000. This mirrors our previous findings based on data originating within social service departments.
利用从英格兰和威尔士医院收集的常规数据，确定在1999/2000年至2014/2015年期间，英格兰和威尔士每年新被认证为视力受损儿童的数量是否有所增加，并调查2014/2015年被认证儿童可认证视力损害的原因。
一项横断面研究，包括对2007/2008年至2014/2015年期间英格兰和威尔士医院每年完成的所有视力损害证书，以及1999/2000年在英格兰和威尔士医院完成的所有证书进行分析。
2007年4月1日至2015年3月31日每个财政年度在英格兰和威尔士认证时年龄在16岁及以下的所有个人的证书，以及截至2000年3月31日年度年龄在15岁及以下个人的证书。我们获得了2014/2015年所有被认证儿童可认证视力丧失的主要原因的信息。我们使用拜尔斯方法计算了粗略发病率和按性别划分的发病率估计值及其95%置信区间。
在1999/2000年，认证的估计发病率（95%CI）为每100,000人中有8.2（7.7至8.8）例。在2007/2008年，估计发病率在统计学上显著更高，为10.1（9.5至10.7）。从那时起，观察到发病率随时间呈上升趋势，直到2014/2015年，估计发病率为13.3（12.6至14.0）。遗传性视网膜营养不良、脑性视力损害和眼球震颤是2014/2015年儿童可认证视力损害最常见的单一原因。
我们的研究结果表明，自1999/2000年以来，在英格兰和威尔士，由眼科顾问医生新认证为视力受损的儿童数量有所增加。这与我们之前基于社会服务部门数据得出的研究结果一致。
