Dataset Information

The prevalence and causes of pediatric uncorrected refractive error: Pooled data from population studies for Global Burden of Disease (GBD) sub-regions.

ABSTRACT:

Background

There are limited systematic reviews on the prevalence of uncorrected refractive errors in children. We aimed to summarize the prevalence and causes of pediatric uncorrected refractive error (URE) from studies in the Global Burden of Disease (GBD) sub-regions.

Methods

The pooled analysis used the individual participant data (ages less than 20 years old) from population-based studies around the world by regions. URE was defined as presenting VA < 6/18 and improving to ≥ 6/18 or ≥1 line on using a pinhole in either eye, with main causes of myopia, hyperopia or astigmatism. Each study provided data on any URE, myopia, hyperopia or astigmatism by age, gender, and ethnicity. Prevalence rates were directly age and gender standardized to the 2020 world population with all age groups. Estimates were calculated by study and sub-regions after pooling. Summary estimates included studies in which URE was assessed from a pinhole-corrected refraction in the better eye.

Results

The combined pooled data contained 302,513,219 patients including 8 963 URE cases individuals from 57 studies. Prevalence varied by age and GBD sub-regions and differed by gender. The age- and region-standardized prevalence of URE was 3.41 per 1000 (CI, 1.53~7.62) in Western Pacific region (12 studies), 2.26 per 1000 (CI, 0.85~6.01) in South-East Asia region (14 studies), 5.85 per 1000 (CI, 3.75~9.13) in Americans (11 studies) and 4.40 per 1000 (CI, 3.0~6.45) in Eastern Mediterranean region (13 studies). On the basis of these data, myopia was the first-leading cause in female children with 12~17 age group, with the prevalence rate 18.2 per 1000 (CI, 11.52~23.61). Astigmatism was detected in 27.2 per 1000 male children with 6~11 age group (CI: 19.12-30.68).

Conclusions

Prevalence of URE available data within these sub-regions are widely disparate. Myopia and astigmatism in young age children continue as the leading cause of URE worldwide. Providing appropriate refractive correction to those individuals whose vision can be improved is an important public health endeavor with implications for safety and quality of life.

SUBMITTER: Cao H

PROVIDER: S-EPMC9249246 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ImportanceThere is substantial socioeconomic and individual burden from uncorrected refractive error (URE) and chronic ocular disease. Understanding the association of visual acuity (VA) reduction with URE and the adults most likely to benefit from refraction may help support clinical decision-making in ophthalmologic care and maximize patient outcomes.ObjectivesTo assess the magnitude of VA improvement associated with URE among adults under ophthalmic care who obtain low vision rehabilitation (LVR) services and identify the characteristics of the patients who are most likely to experience improvement.Design, setting, and participantsThis retrospective case series assessed patients 20 years or older who were new to the LVR clinics from August 1, 2013, to December 31, 2015, and who had habitual VA between 20/40 and counting fingers (not including) and underwent refraction. Data analysis was performed from April 4, 2018, to December 20, 2019.ExposuresPatient demographics and clinical data, including habitual and refraction VA, refraction, and disease diagnosis. Habitual VA was categorized as mild (VA worse than 20/40 and at least 20/60), moderate (VA worse than 20/60 and better than 20/200), severe (VA 20/200 or worse and better than 20/500), and profound (VA 20/500 or worse) vision impairment (VI).Main outcomes and measuresAt least 2-line VA improvement and any VA improvement (≥1-line) by refraction.ResultsAmong the 2923 patients new to LVR clinics, 1773 (mean [SD] age, 70 [18.2] years; 1069 [60.3%] female) were included in these analyses. The mean habitual VA was 20/100 (mean [SD], 0.67 [0.36] logMAR). At least 2-line improvement was observed in 493 patients (27.8%), and any VA improvement was seen in 1023 patients (57.7%). At least 2-line improvement was observed in 54 patients (34.8%) with corneal disorders and was more likely seen among patients aged 40 to <65 years compared with those aged 20 to <40 years (odds ratio [OR], 1.57; 95% CI, 1.02-2.41), African American patients compared with white patients (OR, 1.41; 95% CI, 1.08-1.85), or patients with moderate VI compared with mild VI (OR, 1.36; 95% CI, 1.07-1.72).Conclusions and relevanceThe findings suggest that URE is prevalent among patients with ocular disease and accessing LVR and that refractive evaluation should be considered for patients with ocular disease and reduced VA, especially working-age adults aged 40 to <65 years, African American patients, and those with moderate VI.

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