Department of Ophthalmology, Hadassah Medical Center; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Department of Genetics and Metabolic Diseases, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Eye (Lond). 2022 Oct;36(10):2052-2056. doi: 10.1038/s41433-021-01743-3. Epub 2021 Aug 23.
To assess the main causes leading to childhood visual impairment/blindness in a center for low vision in Israel and to analyze the literature on pediatric blinding diseases in developed countries.
Retrospective study based on observational case series. Data were obtained from medical records of visually impaired children, seen at a national referral low vision center. Children were divided into two groups: moderate visual impairment (6/18 to 6/60) and severe visual impairment (SVI)/blindness (<6/60). Inherited eye diseases (IED) were grouped together for analysis. Data from the Israeli blind registry from the same period of time were analyzed for comparison. A review of literature on childhood blindness in developed countries since 2000 was conducted.
A total of 1393 children aged 0-18 years were included in the study. Moderate visual impairment was seen in 1025 (73.6%) and SVI/blindness in 368 (26.4%) of the studied children. Among blind children, IED accounted for at least 51% of all diagnoses, including mainly albinism and retinal dystrophies. IED prevalence was equally high in both main ethnic groups (Jewish and Arab Muslims). Non-IED (22.6%) included mainly patients with cerebral visual impairment and retinopathy of prematurity.
The leading cause of childhood visual impairment and blindness in our patient cohort was IED. Analyses of the literature from the last two decades show that IED are a major cause for SVI/childhood blindness in other developed countries as well. Updated patterns of global childhood blindness may suggest a need for new approach for screening programs and modern tactics for prevention.
评估导致以色列低视力中心儿童视力障碍/失明的主要原因，并分析发达国家小儿致盲疾病的文献。
基于观察性病例系列的回顾性研究。数据来自于在国家转诊低视力中心就诊的视力受损儿童的病历。儿童分为两组：中度视力障碍（6/18 至 6/60）和重度视力障碍/失明（<6/60）。遗传性眼病（IED）被归为一组进行分析。同时分析了同期以色列盲人登记处的数据进行比较。对 2000 年以来发达国家儿童失明的文献进行了综述。
共纳入 1393 名 0-18 岁的儿童。1025 名（73.6%）患有中度视力障碍，368 名（26.4%）患有重度视力障碍/失明。在失明儿童中，IED 至少占所有诊断的 51%，主要包括白化病和视网膜营养不良。在两个主要民族（犹太人和阿拉伯穆斯林）中，IED 的患病率同样很高。非 IED（22.6%）主要包括脑瘫和早产儿视网膜病变患者。
在我们的患者群体中，导致儿童视力障碍和失明的主要原因是 IED。对过去二十年文献的分析表明，IED 也是其他发达国家儿童重度视力障碍/失明的主要原因。全球儿童失明模式的更新可能表明需要为筛查计划和预防采取新的方法。
