Kim Suzie, Rachitskaya Aleksandra, Babiuch Allison, Eisenberg Marina, Ghasia Fatema, Sears Jonathan, Williamson Alexandra, Traboulsi Elias I
Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio.
Cleveland Clinic Cole Eye Institute, Cleveland, Ohio.
J AAPOS. 2024 Dec;28(6):104033. doi: 10.1016/j.jaapos.2024.104033. Epub 2024 Nov 8.
To investigate the demographics, eye surgeries, and social determinants of health in pediatric patients with low vision in one or both eyes.
This is a cross-sectional study of children 3-18 years of age examined at an academic eye center from 2014 to 2019. Low vision was present if one eye had a distance best-corrected visual acuity (BCVA) of <20/70. ZIP code was used to estimate patient income via a public third-party database.
Of 47,571 children examined during the study period, 882 had at least one eye with low vision. Of the 882, 88 (10%) had BCVA of <20/400 in at least one eye, and 228 patients (26%) had bilateral low vision. The most common cause of low vision was refractive/strabismic amblyopia (n = 304). The severest forms of vision loss (BCVA<20/200) were predominantly due to retinal dystrophies or detachment (n = 91). Three hundred patients (34%) had undergone at least one ophthalmic surgery-predominantly extraocular muscle procedures in eyes with mild visual loss and vitreoretinal surgeries in those with more severe loss. The severity of vision loss was significantly associated with a higher likelihood and number of surgeries (P < 0.0001). Income and insurance coverage did not have a significant association with BCVA or the likelihood of surgery.
Refractive and strabismic amblyopia are the predominant causes of reduced worse-eye vision in children, and retinal diseases commonly caused severe vision loss. The type and number of surgeries correlate with the severity of vision loss. We did not find any association of income and insurance type with studied outcomes.
调查单眼或双眼低视力儿科患者的人口统计学特征、眼科手术及健康的社会决定因素。
这是一项对2014年至2019年在一家学术眼科中心接受检查的3至18岁儿童进行的横断面研究。如果一只眼睛的最佳矫正远视力（BCVA）<20/70，则存在低视力。通过公共第三方数据库使用邮政编码来估计患者收入。
在研究期间接受检查的47571名儿童中，882名儿童至少有一只眼睛存在低视力。在这882名儿童中，88名（10%）至少有一只眼睛的BCVA<20/400，228名患者（26%）为双眼低视力。低视力最常见的原因是屈光性/斜视性弱视（n = 304）。最严重的视力丧失形式（BCVA<20/200）主要是由于视网膜营养不良或脱离（n = 91）。300名患者（34%）至少接受过一次眼科手术，在视力轻度丧失的眼睛中主要进行眼外肌手术，在视力丧失更严重的眼睛中进行玻璃体视网膜手术。视力丧失的严重程度与手术的可能性和次数显著相关（P < 0.0001）。收入和保险覆盖范围与BCVA或手术可能性没有显著关联。
屈光性和斜视性弱视是儿童较差眼视力下降的主要原因，视网膜疾病通常导致严重视力丧失。手术的类型和次数与视力丧失的严重程度相关。我们没有发现收入和保险类型与研究结果之间存在任何关联。
