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弱视治疗的实践模式:一项调查研究。

Practice Patterns in the Management of Amblyopia: A Survey Study.

作者信息

Laplant Jacquelyn, Vagge Aldo, Nelson Leonard B

出版信息

J Pediatr Ophthalmol Strabismus. 2018 Mar 1;55(2):100-106. doi: 10.3928/01913913-20170718-02. Epub 2017 Nov 14.

Abstract

PURPOSE

To characterize current practice preferences of pediatric ophthalmologists in the management of amblyopia and whether these are influenced by demographic variables.

METHODS

A 10-question survey was distributed to all pediatric ophthalmologists and fellows attending the Annual Joseph H. Calhoun Pediatric Ophthalmology Forum at Wills Eye Hospital in 2016. The questionnaire consisted of demographic information and clinical management of amblyopia using clinical scenarios commonly encountered in pediatric ophthalmology practice.

RESULTS

Of the 133 pediatric ophthalmologists who attended, 74 completed the survey, all of which were included in the data analysis. Seventy-six percent of respondents prescribed refractive correction to a 3 year old with untreated anisometropic amblyopia prior to initiating occlusion therapy. For a child with coexisting exotropia, 57% recommended refractive and occlusion therapy until significant visual improvement, then surgery; however, 30% would perform surgery earlier. Fifty-seven percent stopped occlusion therapy at 10 years of age or older. Sixty-four percent estimated a patient patching compliance rate of 50% to 75%. There was no significant relationship (P < .05) between any of the demographic variables, indicating that no group was more or less likely to respond to the question in any way.

CONCLUSIONS

This study highlights the lack of a unified approach to certain aspects of amblyopia management. Physician-related demographic variables did not significantly affect clinical decision-making; however, variation did exist among respondents, a finding that warrants further investigation. [J Pediatr Ophthalmol Strabismus. 2018;55(2):100-106.].

摘要

目的

描述儿科眼科医生在弱视治疗方面当前的实践偏好,以及这些偏好是否受到人口统计学变量的影响。

方法

向参加2016年威尔斯眼科医院约瑟夫·H·卡尔霍恩儿科眼科年度论坛的所有儿科眼科医生和研究员发放了一份包含10个问题的调查问卷。问卷包括人口统计学信息以及使用儿科眼科实践中常见临床场景的弱视临床治疗情况。

结果

在参加的133名儿科眼科医生中,74人完成了调查,所有回复均纳入数据分析。76%的受访者在开始遮盖治疗前,会给一名3岁未经治疗的屈光参差性弱视患儿开具屈光矫正处方。对于一名同时患有外斜视的儿童,57%的人建议先进行屈光和遮盖治疗,直到视力有显著改善,然后进行手术;然而,30%的人会更早进行手术。57%的人在患儿10岁及以上时停止遮盖治疗。64%的人估计患者的眼罩佩戴依从率为50%至75%。任何人口统计学变量之间均无显著关系(P < 0.05),这表明没有哪个群体对问题的回答更可能或更不可能存在某种方式的差异。

结论

本研究突出了在弱视治疗某些方面缺乏统一方法的问题。与医生相关的人口统计学变量并未显著影响临床决策;然而,受访者之间确实存在差异,这一发现值得进一步研究。[《小儿眼科与斜视杂志》。2018;55(2):100 - 106。]

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