The University of Sydney Children's Hospital Westmead Clinical School, Discipline of Child and Adolescent Health, Faculty of Medicine and Health, Westmead, NSW, Australia, and Sydney Children's Hospital Network, Kids Research, Westmead, Australia.
Alcohol & Pregnancy and FASD Research, Telethon Kids Institute, West Perth, Australia.
Ophthalmic Epidemiol. 2023 Aug;30(4):340-351. doi: 10.1080/09286586.2022.2123004. Epub 2022 Sep 14.
Although eye abnormalities are reported in fetal alcohol spectrum disorders (FASD), no systematic review based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines has been undertaken. Our aim was to document the range and prevalence of eye abnormalities reported in children with prenatal alcohol exposure (PAE) and/or FASD.
Searches of electronic databases and manual searches. Eligible articles were observational studies in children with PAE and/or FASD; peer reviewed journal articles in the English language; and studies reporting quantitative or frequency data on functional/structural eye abnormalities. Pooled prevalence, odds ratio, and mean differences were calculated.
Of the 1,068 retrieved articles 36 were eligible, including articles on children with diagnosed fetal alcohol syndrome/FASD (N = 31); PAE (N = 3); and FASD or PAE without FASD (N = 2). Structural and functional eye abnormalities were identified, the most prevalent being short palpebral fissure length (66.1%), visual impairment (55.5%), epicanthus (53.5%), subnormal stereoacuity (53.0%), abnormal retinal tortuosity (50.5%), impaired fixation ability (33.3%), telecanthus (31.7%), optic nerve hypoplasia (30.2%), and small optic discs (27.0%). Compared to non-exposed controls, strabismus, subnormal vision, ptosis, short palpebral fissure length, microphthalmos, smaller optic disc area, and retinal vessel tortuosity were more prevalent in children with FASD.
Examination of eyes and vision should be considered in children with PAE and suspected or diagnosed FASD to enable early identification and optimal management. This first comprehensive, systematic literature review demonstrates the variety and frequency of eye abnormalities reported in PAE/FASD.
尽管已有研究报告了胎儿酒精谱系障碍（FASD）患者的眼部异常，但尚未有基于系统评价和荟萃分析首选报告项目（PRISMA）指南的系统综述。本研究旨在记录产前酒精暴露（PAE）和/或 FASD 儿童的眼部异常的范围和发生率。
检索电子数据库和手动检索。合格的文章为观察性研究，研究对象为 PAE 和/或 FASD 儿童；同行评审的英文期刊文章；以及报告功能性/结构性眼部异常的定量或频率数据的研究。计算了汇总的患病率、比值比和均数差异。
从检索到的 1068 篇文章中，有 36 篇符合纳入标准，包括诊断为胎儿酒精综合征/FASD 的儿童的文章（n=31）；PAE 儿童的文章（n=3）；以及 FASD 或 PAE 但无 FASD 的儿童的文章（n=2）。确定了结构和功能性眼部异常，最常见的是短睑裂长度（66.1%）、视力障碍（55.5%）、内眦赘皮（53.5%）、立体视锐度降低（53.0%）、视网膜扭曲异常（50.5%）、固定能力受损（33.3%）、远距内斜视（31.7%）、视神经发育不全（30.2%）和小视盘（27.0%）。与无暴露对照组相比，FASD 儿童更易出现斜视、视力低下、上睑下垂、短睑裂长度、小眼球、视盘面积较小和视网膜血管扭曲。
应考虑对 PAE 儿童和疑似或诊断为 FASD 的儿童进行眼部和视力检查，以便早期发现和最佳管理。这是第一项全面的、系统的文献综述，展示了 PAE/FASD 中报告的眼部异常的种类和频率。
