Dataset Information

Risk factors for decreased visual acuity in preschool children: the multi-ethnic pediatric eye disease and Baltimore pediatric eye disease studies.

ABSTRACT:

Objective

To investigate risk factors associated with unilateral or bilateral decreased visual acuity (VA) in preschool children.

Design

Population-based, cross-sectional prevalence study.

Participants

Population-based samples of 6504 children ages 30 to 72 months from California and Maryland.

Methods

Participants were preschool African-American, Hispanic, and non-Hispanic white children from Los Angeles, California, and Baltimore, Maryland. Data were obtained by a parental interview and a detailed ocular examination. Logistic regression models were used to evaluate the independent associations between demographic, behavioral, and clinical risk factors with unilateral and bilateral decreased VA.

Main outcome measures

Odds ratios (ORs) for various risk factors associated with interocular difference (IOD) in VA of ?2 lines with ?20/32 in the worse eye, or bilateral decreased VA <20/40 or <20/50 if <48 months of age.

Results

In multivariate logistic regression analysis, 2-line IOD with a VA of ?20/32 was independently associated with Hispanic ethnicity (OR, 2.05), esotropia (OR, 8.98), spherical equivalent (SE) anisometropia (ORs ranging between 1.5 and 39.7 for SE anisometropia ranging between 0.50 to <1.00 diopters [D] and ?2.00 D), and aniso-astigmatism in J0 or J45 (ORs ranging between 1.4 and ?5.3 for J0 or J45 differences ranging between 0.25 to <0.50 D and ?1.00 D). Bilateral decreased VA was independently associated with lack of health insurance (OR, 2.9), lower primary caregiver education (OR, 1.7), astigmatism (OR, 2.3 and 17.6 for astigmatism 1.00 to <2.00 D and ?2.00 D), and SE hyperopia ?4.00 D (OR, 10.8).

Conclusions

Anisometropia and esotropia are risk factors for IOD in VA. Astigmatism and high hyperopia are risk factors for bilateral decreased VA. Guidelines for the screening and management of decreased VA in preschool children should be considered in light of these risk associations.

Financial disclosure(s)

The authors have no proprietary or commercial interest in any of the materials discussed in this article.

SUBMITTER: Tarczy-Hornoch K

PROVIDER: S-EPMC3208077 | biostudies-literature | 2011 Nov

REPOSITORIES: biostudies-literature

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Publications

Risk factors for decreased visual acuity in preschool children: the multi-ethnic pediatric eye disease and Baltimore pediatric eye disease studies.

Tarczy-Hornoch Kristina K Varma Rohit R Cotter Susan A SA McKean-Cowdin Roberta R Lin Jesse H JH Borchert Mark S MS Torres Mina M Wen Ge G Azen Stanley P SP Tielsch James M JM Friedman David S DS Repka Michael X MX Katz Joanne J Ibironke Josephine J Giordano Lydia L

Ophthalmology 20110819 11

<h4>Objective</h4>To investigate risk factors associated with unilateral or bilateral decreased visual acuity (VA) in preschool children.<h4>Design</h4>Population-based, cross-sectional prevalence study.<h4>Participants</h4>Population-based samples of 6504 children ages 30 to 72 months from California and Maryland.<h4>Methods</h4>Participants were preschool African-American, Hispanic, and non-Hispanic white children from Los Angeles, California, and Baltimore, Maryland. Data were obtained by a p ...[more]

PMID: 21856014

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Project description:PurposeTo describe the risk factors associated with hyperopia and myopia among children 6 to 72 months of age.DesignPopulation-based cross-sectional study.ParticipantsPopulation-based samples of 9970 children 6 to 72 months of age from Los Angeles County, California, and Baltimore, Maryland.MethodsParticipants were preschool African-American, Hispanic, and non-Hispanic white children (n = 9770) from Los Angeles, California, and Baltimore, Maryland. Parental questionnaires and a comprehensive eye examination were administered. Demographic, behavioral, and clinical risk factors associated with hyperopia (?2.00 diopters [D]) and myopia (?-1.00 D) were determined.Main outcome measuresOdds ratios (ORs) for risk factors associated with myopia and hyperopia.ResultsCompared with non-Hispanic whites, African-American (OR, 6.0) and Hispanic (OR, 3.2) children were more likely to be myopic. Children 6 to 35 months of age were more likely to be myopic compared with those 60 to 72 months of age (OR, ?1.7). Compared with African-American children, non-Hispanic white (OR, 1.63) and Hispanic (OR, 1.49) children were more likely to be hyperopic. Children whose parents had health insurance (OR, 1.5) and those with a history of maternal smoking during pregnancy (OR, 1.4) were more likely to have hyperopia. Astigmatism of 1.5 D or more at any axis was associated with myopia (OR, 4.37) and hyperopia (OR, 1.43).ConclusionsChildren in specific racial or ethnic groups and age groups are at higher risk of having myopia and hyperopia. Cessation of maternal smoking during pregnancy may reduce the risk of hyperopia in these children. Given that both myopia and hyperopia are risk factors for the development of amblyopia and strabismus, these risk factors should be considered when developing guidelines for screening and intervention in preschool children.Financial disclosure(s)The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Project description:ObjectiveTo investigate risk factors associated with esotropia or exotropia in infants and young children.DesignPopulation-based cross-sectional prevalence study.ParticipantsPopulation-based samples of 9970 children 6 to 72 months of age from California and Maryland.MethodsParticipants were preschool African-American, Hispanic, and non-Hispanic white children participating in the Multi-Ethnic Pediatric Eye Disease Study and the Baltimore Eye Disease Study. Data were obtained by parental interview and ocular examination. Odd ratios and 95% confidence intervals were calculated to evaluate the association of demographic, behavioral, and clinical risk factors with esotropia and exotropia.Main outcome measuresOdds ratios (ORs) for various risk factors associated with esotropia or exotropia diagnosis based on cover testing.ResultsIn multivariate logistic regression analysis, esotropia was associated independently with prematurity, maternal smoking during pregnancy, older preschool age (48-72 months), anisometropia, and hyperopia. There was a severity-dependent association of hyperopia with the prevalence of esotropia, with ORs increasing from 6.4 for 2.00 diopters (D) to less than 3.00 D of hyperopia, to 122.0 for 5.00 D or more of hyperopia. Exotropia was associated with prematurity, maternal smoking during pregnancy, family history of strabismus, female sex, astigmatism (OR, 2.5 for 1.50 to <2.50 D of astigmatism, and 5.9 for ?2.5 D of astigmatism), and anisoastigmatism in the J0 component (OR, ?2 for J0 anisoastigmatism of ?0.25 D).ConclusionsPrematurity and maternal smoking during pregnancy are associated with a higher risk of having esotropia and exotropia. Refractive error is associated in a severity-dependent manner to the prevalence of esotropia and exotropia. Because refractive error is correctable, these risk associations should be considered when developing guidelines for the screening and management of refractive error in infants and young children.Financial disclosure(s)The author(s) have no proprietary or commercial interest in any materials discussed in this article.

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Project description:To determine the age- and race-specific prevalence of amblyopia in Asian and non-Hispanic white children aged 30 to 72 months and of strabismus in children aged 6 to 72 months.Cross-sectional survey.A population-based, multiethnic sample of children aged 6 to 72 months was identified in Los Angeles and Riverside counties in California to evaluate the prevalence of ocular conditions.A comprehensive eye examination and in-clinic interview were conducted with 80% of eligible children. The examination included evaluation of ocular alignment, refractive error, and ocular structures in children aged 6 to 72 months, as well as a determination of optotype visual acuity (VA) in children aged 30 to 72 months.The proportion of 6- to 72-month-old participants with strabismus and 30- to 72-month-olds with optotype VA deficits and amblyopia risk factors consistent with study definitions of amblyopia.Strabismus was found in 3.55% (95% confidence interval [CI], 2.68-4.60) of Asian children and 3.24% (95% CI, 2.40-4.26) of non-Hispanic white children, with a higher prevalence with each subsequent older age category from 6 to 72 months in both racial/ethnic groups (P=0.0003 and 0.02, respectively). Amblyopia was detected in 1.81% (95% CI, 1.06-2.89) of Asian and non-Hispanic white children; the prevalence of amblyopia was higher for each subsequent older age category among non-Hispanic white children (P=0.01) but showed no significant trend among Asian children (P=0.30).The prevalence of strabismus was similar in Asian and non-Hispanic white children and was found to be higher among older children from 6 to 72 months. The prevalence of amblyopia was the same in Asian and non-Hispanic white children; prevalence seemed to be higher among older non-Hispanic white children but was relatively stable by age in Asian children. These findings may help clinicians to better understand the patterns of strabismus and amblyopia and potentially inform planning for preschool vision screening programs.The author(s) have no proprietary or commercial interest in any materials discussed in this article.

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Dataset Information

Risk factors for decreased visual acuity in preschool children: the multi-ethnic pediatric eye disease and Baltimore pediatric eye disease studies.

Objective

Design

Participants

Methods

Main outcome measures

Results

Conclusions

Financial disclosure(s)

Publications

Risk factors for decreased visual acuity in preschool children: the multi-ethnic pediatric eye disease and Baltimore pediatric eye disease studies.

Similar Datasets

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