Hashemi Hassan, Pakzad Reza, Heydarian Samira, Yekta Abbasali, Aghamirsalim Mohamadreza, Shokrollahzadeh Fereshteh, Khoshhal Fahimeh, Pakbin Mojgan, Ramin Shahroukh, Khabazkhoob Mehdi
a Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital , Tehran.
b Department of Epidemiology, Faculty of Health, Ilam University of Medical Sciences , Ilam.
Strabismus. 2019 Jun;27(2):54-65. doi: 10.1080/09273972.2019.1604773. Epub 2019 Apr 23.
: Despite the importance of information on the prevalence of strabismus, which can be effective in planning preventive and curative services, no study has addressed its prevalence comprehensively. In this study, a systematic search was done to estimate the regional and global prevalence of strabismus in different age and sex groups and factors affecting prevalence heterogeneity. : A comprehensive and systematic search was done in different international databases, including Web of Science, Scopus, PubMed, Embase, etc. to find published articles on the total prevalence of strabismus and the prevalence of exotropia and esotropia. A binomial distribution was used to calculate the prevalence and 95% confidence interval (CI). The Cochran's Q-test and I were applied to evaluate heterogeneity and a random-effects model was used to assess the pooled prevalence. The Begg's test was administered to investigate publication bias and finally, a meta-regression method was applied to determine the factors affecting the heterogeneity among studies. : Of 7980 articles, 56 articles with a total sample size of 229,396 were analyzed. Many of these articles (n = 14) were from the Regional Office for the Americas. The estimated of pooled prevalence (95% CI) of any strabismus, exotropia, and esotropia was 1.93% (1.64-2.21), 1.23% (1.00-1.46), and 0.77% (0.59-0.95), respectively. The heterogeneity in prevalence of strabismus and its subtypes according to I was above 95% (p value <.001 for all). Age had a direct effect on heterogeneity in the prevalence of exotropia (b: 3.491; p: 0.002). Moreover, WHO region had a significant direct effect on heterogeneity in the prevalence of strabismus (b: 0.482; p < .001) and esotropia (b: 0.168; p: 0.027), and publication year had a significant direct effect on heterogeneity in the prevalence of exotropia (b: 0.059; p: 0.045). Sample size and publication year did not have any association with strabismus nor with other variables. There was no publication bias according to the Begg's test. : The prevalence of strabismus varies widely in the world. As for factors affecting heterogeneity in the prevalence of strabismus, the results showed that age affected heterogeneity in the prevalence of exotropia, WHO region affected heterogeneity in the prevalence of strabismus and esotropia, and publication year affected heterogeneity in the prevalence of exotropia. Information about the global prevalence of strabismus can help health care planners design interventions and prioritize resource allocation.
尽管斜视患病率信息对于规划预防和治疗服务很重要，但尚无研究全面探讨其患病率。在本研究中，进行了系统检索，以估计不同年龄和性别组斜视的区域和全球患病率以及影响患病率异质性的因素。
在不同的国际数据库中进行了全面系统的检索，包括科学网、Scopus、PubMed、Embase等，以查找关于斜视总患病率、外斜视和内斜视患病率的已发表文章。使用二项分布计算患病率和95%置信区间（CI）。应用 Cochr an's Q检验和I统计量评估异质性，并使用随机效应模型评估合并患病率。进行Begg检验以调查发表偏倚，最后应用元回归方法确定影响研究间异质性的因素。
在7980篇文章中，分析了56篇文章，总样本量为229396。其中许多文章（n = 14）来自美洲区域办事处。任何斜视、外斜视和内斜视的合并患病率估计值（95%CI）分别为1.93%（1.64 - 2.21）、1.23%（1.00 - 1.46）和0.77%（0.59 - 0.95）。根据I统计量，斜视及其亚型患病率的异质性高于95%（所有p值均<0.001）。年龄对外斜视患病率的异质性有直接影响（b：3.491；p：0.002）。此外，世界卫生组织区域对斜视患病率（b：0.482；p < 0.001）和内斜视患病率（b：0.168；p：0.027）的异质性有显著直接影响，发表年份对外斜视患病率的异质性有显著直接影响（b：0.059；p：0.045）。样本量和发表年份与斜视及其他变量均无关联。根据Begg检验，不存在发表偏倚。
斜视患病率在世界范围内差异很大。至于影响斜视患病率异质性的因素，结果表明年龄影响外斜视患病率的异质性，世界卫生组织区域影响斜视和内斜视患病率的异质性，发表年份影响外斜视患病率的异质性。斜视全球患病率信息有助于医疗保健规划者设计干预措施并确定资源分配的优先顺序。
