Gender differences in horizontal strabismus: Systematic review and meta-analysis shows no difference in prevalence, but gender bias towards females in the clinic.
Gender differences in horizontal strabismus: Systematic review and meta-analysis shows no difference in prevalence, but gender bias towards females in the clinic.
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DOI：
10.7189/jogh.13.04085
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发表时间：
2023-09-01
影响因子：
7.2
通讯作者：
von Bartheld CS
中科院分区：
文献类型：
--
作者：
Laughton SC;Hagen MM;Yang W;von Bartheld CS
斜视是一种视觉轴的错位，影响2-3%的人口，并可能导致双眼视力丧失。目前有争议的是，在最常见的视觉失调形式：水平斜视中是否存在性别差异。一些研究声称女性比男性有更多的向外偏斜（外斜视），而另一些研究则得出结论，没有显着的性别差异。以前的工作没有系统地探讨水平斜视的性别差异或比较基于人群的研究结果与基于临床的研究。我们对报告水平斜视患病率的研究进行了系统回顾和荟萃分析。我们纳入了73项基于人群的研究，并将其披露的性别人群与141项可比较的基于临床的研究进行了比较。我们根据性别、斜视类型（内斜视、外斜视）和地理区域/种族分析数据。汇总统计显示，水平斜视（男性2.558%，女性2.582%）、内斜视（男性1.386%，女性1.377%）和外斜视（男性1.035%，女性1.043%）的患病率几乎相同。Meta分析结果显示，这些差异在男性和女性之间没有统计学意义（OR = 1.01; 95%置信区间（CI）= 0.97-1.10），但女性明显更频繁（7.50%），调整人口性别比后，女性内斜视比男性多5.00%，女性外斜视比男性多12.20%。不同地理区域/社会的女性性别偏见程度不同，亚洲人对女性的偏见最低，拉丁美洲国家的偏见最强。男性和女性水平斜视的患病率相同，包括外斜视。患有斜视的女性寻求医疗保健或被带到诊所的次数远远多于男性。这是一个在医疗保健中偏向女性而不是男性的性别偏见的例子，显然是因为父母-错误地只担心外观上的后果-比儿子更关心女儿的斜视。社会对女性的态度，以及经济因素（保险状况），似乎是相关的因素，确定水平斜视的性别偏见的程度。
Strabismus is a misalignment of the visual axis that affects 2-3% of the population and can lead to loss of binocular vision. It is currently controversial whether there is a gender difference in the most common form of visual misalignment: horizontal strabismus. Some studies claimed that more females than males have an outward deviation (exotropia), while others concluded that there is no significant gender difference. No previous work has systematically explored gender differences in horizontal strabismus or has compared the results of population-based studies with those of clinic-based studies. We conducted a systematic review and meta-analysis of studies reporting the prevalence of horizontal strabismus. We included 73 population-based studies and compared their disclosed gender population with that in 141 comparable clinical-based studies. We analysed the data according to gender, strabismus type (esotropia, exotropia), and geographic region/ethnicity. Summary statistics showed a nearly identical prevalence of horizontal strabismus (2.558% for males, 2.582% for females), esotropia (1.386% males vs. 1.377% females), and of exotropia (1.035% males vs. 1.043% females). Meta-analysis results showed that these differences between males and females were not statistically significant (odds ratio (OR) = 1.01; 95% confidence interval (CI) = 0.97-1.10), but that females were significantly more frequent (by 7.50%) in clinic-based studies than males, with 5.00% more females for esotropia, and 12.20% more females for exotropia when adjusted for the population’s sex ratio. The extent of the female gender bias differed between geographic regions/societies, with Asians having the lowest bias towards females and Latin American countries having the strongest bias. Males and females have the same prevalence of horizontal strabismus, including exotropia. Females with strabismus seek health care or are brought to clinics significantly more often than males. This is an example of gender bias in health care in favour of females rather than males, apparently because parents – erroneously fearing only cosmetic consequences – are more concerned about strabismus in their daughters than their sons. Societal attitudes towards females, as well as economic factors (insurance status), appear to be relevant factors that determine the magnitude of the gender bias in horizontal strabismus.
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影响因子：
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