Methods: Retrospective observational clinical record review of pediatric children with diagnosis of uveitis.
Results: In total, 310 children were evaluated, 51.9% were female, mean age of 10.1 years. Posterior uveitis was the most common location (58.7%), of insidious onset (87.4%) and chronic course (78.1%). The most common etiology was infection (58.4%) caused by toxoplasmosis (76.8%). There was a statistically significant difference in visual acuity between anterior (20/68) and intermediate uveitis (20/70), compared with posterior uveitis (20/434) (p<0.05).
Conclusions: This is the first study to report the clinical features of pediatric uveitis in Colombia, where infectious etiologies are the leading cause. It will improve awareness and knowledge of pediatric uveitis in developing countries, and contribute to the development of public health policies of pediatric visual health.
Received 12 September 2015; revised 23 February 2016; accepted 25 February 2016; published online 18 May 2016 相似文献
Methods: A cross-sectional study using multistage random sampling from four cocoa growing districts in Ghana was conducted from November 2013 to April 2014. A total of 512 cocoa farmers aged 40 years and older were interviewed and examined. The brief interview questionnaire was administered to elicit information on the demographics and socioeconomic details of participants. The examination included assessment of visual acuity (VA), retinoscopy, subjective refraction, direct ophthalmoscopy, slit-lamp biomicroscopy and intraocular pressure (IOP). For quality assurance, a random sample of cocoa farmers were selected and re-examined independently.
Results: Moderate to severe visual impairment (VA <6/18 to 3/60 in the better-seeing eye) was present in 89 participants (17.4%) and 27 (5.3%) were blind (presenting VA <3/60 in the better eye) defined using presenting VA. The main causes of visual impairment were cataract (45, 38.8%), uncorrected refractive error (42, 36.2%), posterior segment disorders (15, 12.9%), and corneal opacity (11, 9.5%).
Conclusion: The prevalence of visual impairment and blindness among cocoa farmers in Ghana is relatively high. The major causes of visual impairment and blindness are largely preventable or treatable, indicating the need for early eye care service interventions. 相似文献
Methods: Data were collected from all pediatric eye injury records (N = 454) admitted to three pediatric ophthalmology hospitals in two regions of Tajikistan between 2010 and 2012.
Results: A review of the records revealed a cumulative annual incidence of 12.8 PEI cases/100,000, with marked inter- and intra-regional differences. Mean age was 7.0 years (95% confidence interval, CI, 6.7–7.4), and male to female ratio was 2.5:1. PEI occurred predominantly outdoors (63%), in rural settings (76%) during unsupervised play, and typically resulted from the eye being hit (53%) by a pointed object (51%), resulting in an open-globe injury (56%). Median time-to-presentation was 24 hours (range 9.6 hours–10 days) and median duration of hospitalization was 15 days (range 2–29 days). Of the 454 cases, 111 (25%) resulted in a blind eye, 62 (14%) in severe visual impairment, and 45 (10%) in moderate visual impairment.
Conclusions: PEI is a major cause of pediatric monocular visual impairment in Tajikistan, with a high rural incidence of severe blinding injuries. Potential risks and outcomes relate to Tajikistan’s cultural, historical, and physical settings. We anticipate that the information provided by this study will facilitate development of culturally derived strategies to reduce PEI in Tajikistan. 相似文献
Methods: Retrospective study of children with uveitis who underwent phacoemulsification with IOL implantation between January 2006 and May 2014.
Results: Twenty-one eyes of 16 children were included. Mean age at cataract surgery was 10.9 years. Juvenile idiopathic arthritis was associated in 37.5%, tuberculosis in 18.7%, Vogt Koyanagi Harada disease in 6.2%, and idiopathic uveitis in 37.5%. Anterior uveitis occurred in 8/21 eyes, intermediate uveitis in 9/21 eyes, and panuveitis in 4/21 eyes. Mean follow-up was 29.9 months. Posterior capsule opacification occurred in 15 eyes, glaucoma in two eyes, choroidal neovascular membrane in one eye, and cystoid macular edema in five eyes. At the last follow up, 19/21 eyes had improved vision and 14 had 20/40 or better vision.
Conclusion: Tight perioperative inflammatory control with immunosuppression may result in good vision after phacoemulsification and IOL implantation without posterior capsulorrhexis in older children with uveitic cataract. 相似文献
Methods: We conducted a rapid assessment of avoidable blindness (RAAB) in 8 districts of Bangladesh (January 2010 – December 2012) to establish the prevalence and causes of blindness. People aged ≥50 years were selected, and eligible participants had visual acuity (VA) measured. Ocular examinations were performed in those with VA<6/18. Additional information was collected for those who had or had not undergone cataract surgery to understand service barriers and quality of service.
Results: In total, 21,596 people were examined, of which 471 (2.2%, 95% confidence interval, CI, 2.0–2.4%) were blind. The primary cause of blindness was cataract (75.8%). The majority of blindness (86.2%) was avoidable. Cataract and refractive error were the primary causes of severe visual impairment (73.6%) and moderate visual impairment (63.6%), respectively. Cataract surgical coverage for blind persons was 69.3% (males 76.6%, females 64.3%, P<0.001). The magnitude of blindness among people aged ≥50 years was estimated to be 563,200 people (95% CI 512,000–614,400), of whom 426,342 had un-operated cataract.
Conclusions: In Bangladesh, the majority of blindness (86.2%) among people aged ≥50 years was avoidable, and cataract was the most important cause of avoidable blindness. Improving cataract surgical services and refraction services would be the most important step towards the elimination of avoidable blindness in Bangladesh. 相似文献
Methods: A total of 51 clusters of 80 people (all ages) were sampled with probability proportionate to size and compact segment sampling. Visual acuity (VA) was measured with a tumbling “E” chart. An ophthalmic nurse examined people with VA<6/18 in either eye. The presence of hearing and physical impairments were assessed using clinical examination, and self-reported visual problems using the Washington Group Short Set.
Results: In total, 4080 people were enumerated of whom 3567 were screened (response rate 87%). The overall prevalence of visual impairment was 2.3% (95% CI 1.8–3.0%) and blindness was 0.6% (0.3–1.0%). The prevalence of both blindness and visual impairment increased rapidly with age, so that the vast majority of cases of visual impairment (84%) and blindness (82%) were in people aged 50+. Posterior segment disease and cataract were the main causes of blindness and visual impairment, with refractive error also an important cause of visual impairment. Cataract surgical coverage (proportion of all cataracts that had received surgery) was relatively high (87% of people at VA<6/60). Post-surgery outcomes were poor, with 31% of operated eyes having VA<6/60. Among the 82 people with visual impairment, 22% had a physical impairment or epilepsy and 30% had a hearing impairment. Self-reported difficulties in vision were relatively closely related to clinical measures of visual impairment.
Conclusions: Ophthalmic programmes in Cameroon need to incorporate control of posterior segment diseases while also working to improve outcomes after cataract surgery. 相似文献
Methods: A cross-sectional interviewer-administered survey together with eye screenings was conducted among schoolchildren in the capital Yerevan and in Gegharkunik Province. The study used multi-stage random sampling to obtain the sample of 1260 schoolchildren. Study questionnaires were developed based on the Sydney Myopia Study questionnaire. Continuous reading was defined as the average number of hours spent reading or on near work without a break. Children underwent measurements of visual acuity using a Golovin-Sivtsev eye chart, cycloplegic retinoscopy, and dilated fundus examination.
Results: The mean age of the children was 13 years, and myopia was present in 18.1%. The prevalence of myopia was higher among Yerevan children (23.3%) than those living in Gegharkunik Province (12.5%). In the adjusted model, myopia was significantly associated with age (odds ratio, OR, 1.11, 95% confidence interval, CI, 1.04–1.18), region (OR 2.40, 95% CI 1.62–3.57), school achievement (OR 1.62, 95% CI 1.05–2.51), parental myopia (OR 2.89, 95% CI 1.79–4.69), and continuous reading (OR 1.99, 95% CI 1.31–3.02), but not near work (OR 0.97, 95% CI 0.89–1.05).
Conclusion: The study found that a positive family history of myopia and environmental factors had independent associations with myopia. The number of near work hours did not play a major role in the development of myopia, but length of time of focused continuous reading did. 相似文献
Methods: Ninety-one clusters of 60 people aged 50+ were selected randomly and a rapid assessment of avoidable blindness (RAAB) was conducted. Participants had their visual acuity and cause of visual impairment assessed, underwent a random glucose test and fundoscopy under mydriasis if they had diabetes. The diabetic retinopathy (DR) degree was classified according to the Scottish diabetic retinopathy grading scheme.
Results: From the sample 5,055 (92.6%) people were examined. The blindness prevalence was 1.7% (95% Confidence Interval: 1.3–2.1%). Cataract (32.6%), DR (29.1%) and glaucoma (16.3%) were the leading causes of blindness. The prevalence of severe, moderate, and early visual impairment was 1.0%, 5.1%, and 7.7%, respectively. Among respondents, 31% had diabetes and 8.1% of them was not diagnosed prior to the study. Of all participants with diabetes, 50% had glucose levels of 200 mg/dl or higher and 15.7% had sight-threatening diabetic retinopathy.
Conclusions: Besides strengthening of cataract intervention activities, more ophthalmic services for diabetic retinopathy and glaucoma control are needed in Nuevo León to provide timely intervention to prevent blindness. 相似文献
Methods: In a retrospective study, records of pediatric uveitis cases presenting at our center between 1996 and 2015 were reviewed for demographic data, anatomic distribution, and diagnosis.
Results: Out of 9600 patients with uveitis, 369 children (3.84%; age ≤16 years; males: 54.20%) were included in the study. Anterior uveitis was the commonest presentation (n = 158; 42.81%), followed by posterior uveitis (n = 102; 27.64%). Uveitis was bilateral in 57.18% (n = 211). Infective etiology was seen in 99 children, of which tuberculosis was the commonest cause (n = 55; 14.91%). Among non-infectious etiologies, juvenile idiopathic arthritis (JIA) was the commonest cause (n = 59; 15.99%).
Conclusions: While anterior uveitis is the commonest uveitis in children, our cohort reported a high number of posterior uveitis cases compared to previous studies. Tuberculosis and JIA were the commonest causes of pediatric uveitis. 相似文献
Methods: A cross-sectional population-based survey was performed on a representative sample of urban and rural individuals aged ≥50 years of the province. Blindness was defined as presenting visual acuity (PVA) <3/60 in the better eye. Moderate visual impairment (MVI) and severe visual impairment (SVI) were defined as 6/60 ≤ PVA <6/18 and 3/60 ≤ PVA <6/60 in the better eye, respectively. Diabetes mellitus (DM) was determined based on random blood sugar (RBS) levels ≥200 mg/dL or a previous diagnosis. We used the Scottish grading system to grade DR.
Results: We invited 2975 individuals from 85 clusters. Age- and sex-adjusted prevalence and 95% confidence interval (CI) of blindness, SVI, MVI, and DM in 2587 participants (response rate: 86.9%) were 1.5% (95% CI: 1.1–2.0), 1.5% (95% CI: 0.9–2.0), 11.3% (95% CI: 9.9–12.7) and 21.4% (95% CI: 19.2–23.7), respectively. The leading causes of blindness were cataract (47.1%), age-related macular degeneration (14.7%) and DR (8.8%). Cataract surgery (CS) coverage was 69.3%. The main challenges for CS were cost and unawareness. The outcome of CS was good in 66.9% of operated eyes. Any DR and/or maculopathy were observed in 25.3% (95% CI: 21.0–29.5) of subjects including 12.6% (95% CI: 9.7–15.6) sight-threatening DR. In previously known DM cases, 215 (41.7%) had never undergone an eye examination for DR.
Conclusion: The proportion of avoidable blindness and DR is considerable in Gilan Province. 相似文献
Methods: The study was conducted between June and August 2015. All facilities in the country providing cataract services were contacted to obtain information on surgeries performed in 2014. Hospitals performing eye surgery in Quena, Sharkia, and Fayoum regions were visited and a questionnaire on resources for cataract surgery was completed.
Results: Cataract surgery was offered in the public sector by 64 government and 16 university teaching hospitals and in the private sector by 101 hospitals. Over 90% of all facilities in the country contacted participated in the study. In 2014, the national cataract surgical rate (CSR) was 3674 varying in governorates from 7579 in Ismailia to 402 in Suez. The private sector performed 70% of cataract surgeries.
Analysis of three regions showed an 11.7% increase in cataract output between 2010 and 2014. The average number of cataract surgeries per unit in 2014 was 2272 in private, 1633 in university, and 824 in government hospitals. Private hospitals had 60% of human resources for eye care. Phacoemulsification was the surgical technique in 85.6% of private, 72.1% of university, and 41% of government hospitals.
Reasons explaining the differences in output between public and private sectors were the lack of trainers, supervisors, and incentives.
Conclusion: The private sector provides most of the cataract services in Egypt, resulting in inadequate services for the poor. There is a 15-fold variation in CSR between the best and least served regions. The public sector could increase cataract output by improving training, supervision, and incentives. 相似文献
Methods: Non-Indigenous Australians aged 50 years and older and Indigenous Australians aged 40 years and older were recruited using a door-to-door approach from 30 randomly selected geographical areas, stratified by remoteness. Participants underwent a vision examination, anterior segment assessment, intraocular pressure testing, perimetry, and fundus photography.
Results: In total, recruiters approached 23,235 residences, and 11,883 residents were successfully contacted (51.1%). Of these, 6760 (56.9%) were deemed eligible and 5764 agreed to participate (positive response rate = 85.3%). Of those who agreed, 4836 residents attended the examination (4836/6760 = 71.5%). This included 1738 Indigenous Australians (41.1% male) aged 40–92 years (mean ± standard deviation = 55.0 ± 10.0 years) and 3098 non-Indigenous Australians (46.4% male), aged 50–98 years (mean ± standard deviation = 66.6 ± 9.7 years).
Conclusions: The NEHS achieved an excellent positive response rate, and the data collected from 4836 Australians will provide the first population-based national estimate of the prevalence of vision impairment and blindness. This data will guide future economic analysis, policy formulation, and eye health service delivery in Australia. 相似文献
Methods: After brief training, teachers independently measured visual acuity (VA) in 555 children aged 12–15 years in Ba Ria – Vung Tau Province. Teacher VA measurements were compared to those of refractionists. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for uncorrected VA (UVA) and presenting VA (PVA) 20/40 or worse in either eye. Chi-square, Fisher’s exact test and multivariate logistic regression were used to assess factors associated with accuracy of vision screening. Level of significance was set at 5%.
Results: Trained teachers in Vietnam demonstrated 86.7% sensitivity, 95.7% specificity, 86.7% positive predictive value and 95.7% negative predictive value in identifying children with visual impairment using the UVA measurement. PVA measurement revealed low accuracy for teachers, which was significantly associated with child’s age, sex, spectacle wear and myopic status, but UVA measurement showed no such associations.
Conclusions: Better accuracy was achieved in measurement of VA and identification of children with visual impairment using UVA measurement compared to PVA. UVA measurement is recommended for teacher-based vision screening programs. 相似文献
Methods: Data were from the 2002–2014 Medical Expenditure Panel Survey (MEPS). Eye injuries in children aged <18 years were identified by the International Classification of Diseases-9 (ICD-9) codes. The trends of cumulative incidence of eye injury, total costs, and average costs were estimated from 2002-2014 MEPS data. All costs were adjusted to 2014 US dollars. Analyses accounted for the complex stratified multistage survey design of the MEPS. We used MarketScan data (2010–2013) to validate outpatient cost estimates.
Results: The 3-year average cumulative incidence of eye injuries declined from 0.56% in 2002–2004 to 0.31% in 2012–2014 (Trend p < 0.001). The average annual total costs decreased from $193 million during 2002–2004 to $66 million during 2012–2014 (p < 0.001).
Conclusion: The MEPS data showed that among children aged <18 years, the incidence of eye injuries and associated financial burden substantially declined during 2002–2014, highlighting the progress in preventing children eye injuries. Continuing efforts are needed to further reduce the burden in this population. 相似文献
Methods: Hospital records of children (≤16 years) from a large tertiary-care institute between January 2001 and December 2015 were reviewed.
Results: A total of 32 children (mean age: 10.7 ± 4.27 years; range 2–16) were diagnosed with TB-associated uveitis. The most common presentation was posterior uveitis (n = 14, 43.75%) and panuveitis (n = 14, 43.75%), followed by intermediate uveitis (n = 2, 6.25%) and anterior uveitis (n = 2, 6.25%); 14 children had probable intraocular tuberculosis (IOTB) (43.75%) and 17 (53.13%) had possible IOTB. Despite ATT and corticosteroids, 29.63% patients showed suboptimal response or worsening of disease requiring additional immunosuppression.
Conclusions: TB is an important cause of pediatric uveitis in endemic countries. The manifestations of the disease resemble adult TB-related uveitis. However, higher inflammatory response in children may require more aggressive therapy with corticosteroids/immunosuppression. 相似文献
Methods: Physicians who treat retinoblastoma were surveyed to glean underlying reasons for treatment refusal.
Results: Refusal rates were higher when less time was spent with parents explaining retinoblastoma/enucleation, and where fewer support services were available. Reasons for refusal included parental belief in alternative treatments, culture, and social stigma.
Conclusions: We suggest strategies to increase parental compliance with enucleation and save the lives of children with retinoblastoma. 相似文献
Methods: The eye movements of nine strabismic children from 11 to 15 years old were recorded with an eye tracker as they were reading a text under three visual conditions before and six months after eye surgery. The results were compared with those obtained from control groups of non-strabismic age-matched children. Eye movements were recorded during reading a text with both eyes open and under monocular vision with the dominant and non-dominant eye alternately covered.
Results: The duration of fixation was longer in strabismic children than in age-matched non-strabismic children. Children read faster under dominant eye open condition than under both eyes open condition. Surgery allowed an increase of reading speed and decrease of fixation duration. The number of backward saccades significantly decreased after surgery.
Conclusion: In strabismic children, eye movements during reading are impaired. The reduction of the squint allowed a better word comprehension. 相似文献