National cross sectional study of detection of congenital and infantile cataract in the United Kingdom: role of childhood screening and surveillance
National cross sectional study of detection of congenital and infantile cataract in the United Kingdom: role of childhood screening and surveillance
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DOI：
10.1136/bmj.318.7180.362
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发表时间：
1999-02-06
影响因子：
--
通讯作者：
Dezateux, C
中科院分区：
文献类型：
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作者：
Rahi, JS;Dezateux, C
目的 确定具有全国代表性的先天性和婴儿性白内障儿童群体的检测模式和眼科评估时机。设计横断面研究。背景为英国。受试者 1995 年 10 月至 1996 年 9 月期间，新诊断出先天性或婴儿性白内障的所有英国烧伤儿童，年龄为 15 岁或以下。主要结果指标 通过常规眼科检查发现的病例比例和眼科医生评估的比例3 个月和 1 岁。结果 248 名儿童中，235 名 (95%) 的数据是完整的。其中，83例（35%）在常规新生儿检查中检出，30例（12%）在6-8周检查时检出； 82 名儿童出现症状。 137 名 (57%) 儿童在 3 个月大时接受了眼科医生的评估，但 78 名 (33%) 儿童直到 1 岁之后才接受检查。在 91 例儿童的护理人员在诊断白内障之前就怀疑其眼睛有缺陷。结论 尽管全国建议对所有新生儿和幼儿进行常规眼科检查，但仍有相当大比例的先天性和婴儿性白内障儿童在 3 个月大时未被诊断出来。需要制定通过筛查和监测实现早期发现的策略。
Objectives To determine the mode of detection and timing of ophthalmic assessment of a nationally representative group of children with congenital and infantile cataract.Design Cross sectional study.Setting United Kingdom.Subjects All children burn in the United Kingdom and aged 15 years or under in whom congenital or infantile cataract was ne newly diagnosed between October 1995 and September 1996.Main outcome measures Proportion of cases detected through routine ocular examination and proportion assessed by an ophthalmologist by 3 months and 1 year of age.Results Data were complete for 235 (95%,) of 248 children identified. Of these, 83 (35%) were detected at the routine newborn examination and 30 (12%) at the 6-8 week examination; 82 children presented symptomatically. 137 (57%) children had been assessed by an ophthalmologist by the age of 3 months but 78 (33%) were not examined until after: 1 year of age. In 91 cases the child's carers suspected an eye defect before cataract was diagnosed.Conclusions A substantial proportion of children with congenital and infantile cataract are not diagnosed by 3 months of age, although routine ocular examination of all newborn and young infants is recommended nationally. Strategies to achieve earlier detection through screening and surveillance are required.