Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, 4/F, Hong Kong Eye Hospital, 147K Argyle Street, Kowloon, Hong Kong SAR, China.
Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Sha Tin, Hong Kong SAR, China.
Sci Rep. 2021 Jul 5;11(1):13820. doi: 10.1038/s41598-021-93131-w.
The study aims to determine the prevalence of strabismus and its risk factors among school children in Hong Kong. This is a cross-sectional study involving 6-8 year old children from different districts in Hong Kong. 4273 children received comprehensive ophthalmological examination, cycloplegic auto-refraction, best corrected visual acuity (BCVA), anterior segment examination, cover/uncover test, ocular motility, and fundus examination. Demographic information, pre- and post- natal background, parental smoking status, and family history of strabismus were obtained through questionnaires. Strabismus was found among 133 children (3.11%, 95% CI 2.59-3.63%), including 117 (2.74%) exotropia and 12 (0.28%) esotropia cases (exotropia-esotropia ratio: 9.75:1). There was no significant difference in prevalence across age (6-8 years) and gender. Multivariate analysis revealed associations of strabismus with myopia (≤ - 1.00D; OR 1.61; 95% CI 1.03-2.52; P = 0.037) hyperopia (≥ + 2.00D; OR 2.49; 95% CI 1.42-4.39; P = 0.002), astigmatism (≥ + 2.00D; OR 2.32; 95% CI 1.36-3.94; P = 0.002), and anisometropia (≥ 2.00D; OR 3.21; 95% CI 1.36-7.55; P = 0.008). Other risk factors for strabismus included maternal smoking during pregnancy (OR 4.21; 95% CI 1.80-9.81; P = 0.001), family history of strabismus (OR 6.36; 95% CI 2.78-14.50, P < 0.0001) and advanced maternal age at childbirth (> 35 years; OR 1.65; CI 1.09-2.49, P = 0.018). The prevalence of strabismus among children aged 6-8 years in Hong Kong is 3.11%. Refractive errors, family history of strabismus and maternal smoking history during pregnancy are risk factors. Early correction of refractive errors and avoidance of maternal smoking during pregnancy are potentially helpful in preventing strabismus.
本研究旨在确定香港学童斜视的患病率及其危险因素。这是一项涉及香港不同地区 6-8 岁儿童的横断面研究。4273 名儿童接受了全面的眼科检查、睫状肌麻痹自动折射、最佳矫正视力（BCVA）、眼前节检查、遮盖/揭开试验、眼球运动和眼底检查。通过问卷调查获得了人口统计学信息、产前和产后背景、父母吸烟状况以及斜视家族史。斜视患儿 133 例（3.11%，95%CI2.59-3.63%），其中外斜视 117 例（2.74%），内斜视 12 例（0.28%）（外斜视-内斜视比：9.75:1）。斜视患病率在年龄（6-8 岁）和性别上无显著差异。多因素分析显示，斜视与近视（≤-1.00D；OR1.61；95%CI1.03-2.52；P=0.037）、远视（≥+2.00D；OR2.49；95%CI1.42-4.39；P=0.002）、散光（≥+2.00D；OR2.32；95%CI1.36-3.94；P=0.002）和屈光参差（≥2.00D；OR3.21；95%CI1.36-7.55；P=0.008）有关。斜视的其他危险因素包括母亲孕期吸烟（OR4.21；95%CI1.80-9.81；P=0.001）、斜视家族史（OR6.36；95%CI2.78-14.50，P<0.0001）和产妇分娩年龄较大（>35 岁；OR1.65；CI1.09-2.49，P=0.018）。香港 6-8 岁儿童斜视患病率为 3.11%。屈光不正、斜视家族史和母亲孕期吸烟史是斜视的危险因素。早期矫正屈光不正和避免母亲孕期吸烟可能有助于预防斜视。
