Department of Ophthalmology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong Province, People's Republic of China.
Emergency Department, The First Affiliated Hospital of Jiamusi University, Heilongjiang Province, People's Republic of China.
PLoS One. 2022 Jul 1;17(7):e0268800. doi: 10.1371/journal.pone.0268800. eCollection 2022.
There are limited systematic reviews on the prevalence of uncorrected refractive errors in children. We aimed to summarize the prevalence and causes of pediatric uncorrected refractive error (URE) from studies in the Global Burden of Disease (GBD) sub-regions.
The pooled analysis used the individual participant data (ages less than 20 years old) from population-based studies around the world by regions. URE was defined as presenting VA < 6/18 and improving to ≥ 6/18 or ≥1 line on using a pinhole in either eye, with main causes of myopia, hyperopia or astigmatism. Each study provided data on any URE, myopia, hyperopia or astigmatism by age, gender, and ethnicity. Prevalence rates were directly age and gender standardized to the 2020 world population with all age groups. Estimates were calculated by study and sub-regions after pooling. Summary estimates included studies in which URE was assessed from a pinhole-corrected refraction in the better eye.
The combined pooled data contained 302,513,219 patients including 8 963 URE cases individuals from 57 studies. Prevalence varied by age and GBD sub-regions and differed by gender. The age- and region-standardized prevalence of URE was 3.41 per 1000 (CI, 1.537.62) in Western Pacific region (12 studies), 2.26 per 1000 (CI, 0.856.01) in South-East Asia region (14 studies), 5.85 per 1000 (CI, 3.759.13) in Americans (11 studies) and 4.40 per 1000 (CI, 3.06.45) in Eastern Mediterranean region (13 studies). On the basis of these data, myopia was the first-leading cause in female children with 1217 age group, with the prevalence rate 18.2 per 1000 (CI, 11.5223.61). Astigmatism was detected in 27.2 per 1000 male children with 6~11 age group (CI: 19.12-30.68).
Prevalence of URE available data within these sub-regions are widely disparate. Myopia and astigmatism in young age children continue as the leading cause of URE worldwide. Providing appropriate refractive correction to those individuals whose vision can be improved is an important public health endeavor with implications for safety and quality of life.
目前针对儿童未矫正屈光不正患病率的系统评价十分有限。本研究旨在汇总全球疾病负担（GBD）各子区域研究中儿童未矫正屈光不正（URE）的患病率及其病因。
使用来自全球各地区的基于人群的研究中个体参与者数据（年龄小于 20 岁）进行汇总分析。未矫正屈光不正定义为双眼远视力 < 6/18 经小孔镜矫正后提高至≥6/18 或≥1 行，主要病因包括近视、远视或散光。各研究按年龄、性别和种族提供了任何 URE、近视、远视或散光的数据。患病率根据年龄和性别直接标准化为 2020 年世界人口，包括所有年龄组。在汇总后，通过研究和子区域进行估计。汇总估计包括了从更好眼的小孔镜矫正视力评估 URE 的研究。
合并的汇总数据包含 302513219 名患者，其中 57 项研究中有 8963 名 URE 患者。患病率因年龄和 GBD 子区域而异，且存在性别差异。在西太平洋地区（12 项研究），URE 的年龄和区域标准化患病率为每 1000 人 3.41（95%CI：1.537.62）；在东南亚地区（14 项研究）为每 1000 人 2.26（95%CI：0.856.01）；在美洲（11 项研究）为每 1000 人 5.85（95%CI：3.759.13）；在东地中海地区（13 项研究）为每 1000 人 4.40（95%CI：3.06.45）。根据这些数据，女性儿童 1217 岁年龄段的首位病因是近视，患病率为每 1000 人 18.2（95%CI：11.5223.61）。男性儿童 611 岁年龄段首位病因是散光，患病率为每 1000 人 27.2（95%CI：19.1230.68）。
这些子区域内 URE 患病率的数据差异很大。近视和散光在儿童早期仍然是全球 URE 的主要病因。为那些视力可以改善的人提供适当的屈光矫正，是一项重要的公共卫生工作，对安全和生活质量都有影响。
