这项研究的目的是评估中国南方学龄前儿童视力障碍的患病率和分布。
在汕头市,36-83个月的学龄前儿童参加了视力筛查计划。进行视力测试和非睫状肌麻痹屈光检查。根据美国眼科学会(AAO)指南,视力障碍定义为36-47、48-59和60-83个月儿童中<20/50、20/40和20/32的未矫正视力(UCVA)。分别,以及眼间差异(IOD)≥两行UCVA。
对7,880名儿童(占登记人口的94.6%)成功进行了UCVA测试。共有938名(11.9%;95%CI11.2-12.6)儿童被发现在较差的眼睛中UCVA降低,393名(5%;95%CI4.5-5.5)儿童的IOD为两行或更多行.将降低的UCVA与IOD标准相结合,确定了1,032名(13.1%;95%CI12.4-13.8)患有视力障碍的儿童。学龄前儿童的UCVA随年龄自然改善,男孩的年龄调整后的UCVA比女孩略好。视力下降的原因包括未矫正的屈光不正,弱视,先天性白内障,和其他人。视力下降的儿童右眼的圆柱屈光度高于视力正常的儿童(1.19±1.05vs.0.52±0.49,P<0.001)。共有146人(1.9%,95%CI1.6-2.2)的学龄前儿童戴眼镜。戴眼镜的比例随年龄增长而增加(χ2=35.714,P<0.001),但是随着IOD增加1logMAR,戴眼镜的几率下降了44.8%。
本研究通过大规模的学校视力筛查提供了中国学龄前儿童视力障碍患病率的数据。应进行进一步的研究以验证视力筛查的益处。
The goal of this study is to assess the prevalence and distribution of visual impairment in preschool children in southern China.
Preschool children aged 36-83 months were enrolled in a vision screening program in Shantou City. Visual acuity test and non-cycloplegic refraction were conducted. According to the American Academy of Ophthalmology (AAO) guidelines, visual impairment was defined as uncorrected visual acuity (UCVA) in either eye <20/50, 20/40, and 20/32 in children aged 36-47, 48-59, and 60-83 months, respectively, as well as an interocular difference (IOD) of ≥ two lines of UCVA.
The UCVA test was successfully performed on 7,880 children (94.6% of the enrolled population). A total of 938 (11.9%; 95% CI 11.2-12.6) children were found to have reduced UCVA in the worse eye, and 393 (5%; 95% CI 4.5-5.5) of the children had an IOD of two or more lines. Combining the reduced UCVA with the IOD criteria identified 1,032 (13.1%; 95% CI 12.4-13.8) children with visual impairment. UCVA in preschool children improves with age naturally and boys have slightly better age-adjusted UCVA than girls. Causes of reduced visual acuity included uncorrected refractive error, amblyopia, congenital cataract, and others. The cylindrical diopter in the right eye of children with reduced vison was higher than that of children with normal vision (1.19 ± 1.05 vs. 0.52 ± 0.49, P < 0.001). A total of 146 (1.9%, 95% CI 1.6-2.2) of the preschool children wore spectacles. The proportion of wearing spectacles increased with age (χ2 = 35.714, P < 0.001), but with IOD increasing by.1 logMAR, the odds of wearing spectacles decreased by 44.8%.
This study provided data on the prevalence of visual impairment in preschool children in China by large-scale school-based vision screening. Further studies should be conducted to verify the benefit from vision screening.