Poverty predicts amblyopia treatment failure.
Poverty predicts amblyopia treatment failure.
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DOI：
10.1016/s1091-8531(97)90040-9
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发表时间：
1997-12-01
期刊：
影响因子：
--
通讯作者：
Magoon, E H
中科院分区：
文献类型：
--
作者：
Hudak, D T;Magoon, E H
目的：临床印象提出一种假设，即贫困与弱视治疗效果较差有关。为了验证这一假设，我们将接受医疗补助的弱视患者与未接受医疗补助的患者进行了比较。
方法：在眼科中心计算机记录的1272名弱视患者中，280名符合纳入标准，即首次就诊年龄在10岁以下，开始接受治疗，并记录了当时以及后续随访时的视力。其中71名患者接受医疗补助，209名未接受。首次就诊年龄、末次就诊年龄、首次就诊时视力所衡量的弱视严重程度以及就诊次数在统计学上均无差异。但在末次视力、错过就诊次数以及家长对依从性的评估方面发现存在很大差异。
结果：医疗补助组末次视力达到20/30或更好的可能性为26.8%，而非医疗补助组为58%。医疗补助组末次视力达到20/70或更差的可能性为33.8%，而非医疗补助组为11.5%。
结论：这些结果表明，以是否符合医疗补助资格来衡量的社会经济地位是弱视治疗成功的一个重要预测因素。目前正在开展工作，以更好地了解更具体的因素，并应对儿童弱视治疗的挑战。
OBJECTIVE: Clinical impressions suggested a hypothesis that poverty is associated with poorer results in amblyopia therapy. To test this hypothesis, we compared patients with amblyopia who had Medicaid assistance with those who did not.METHODS: Of 1272 patients recorded to have amblyopia in the eye center computer, 280 met inclusion criteria of first visit under age 10 years and had treatment instituted and visual acuities recorded then and at follow-up visits. Seventy-one had Medicaid assistance, and 209 did not. Age at first visit, age at final visit, severity of amblyopia as measured by visual acuity at the first visit, and number of visits were all statistically indistinguishable. A large difference in final visual acuity, number of missed visits, and the parent's estimate of compliance was found.RESULTS: The likelihood of good final visual acuity of 20/30 or better was 26.8% in the Medicaid group and 58% in the non-Medicaid group. The likelihood of a poor final visual acuity of 20/70 or worse was 33.8% in the Medicaid group versus 11.5% in the non-Medicaid group.CONCLUSION: These results established socioeconomic status, measured by qualification for Medicaid assistance, to be an important predictor for success for amblyopia therapy. Work is in progress to better understand more specific factors and to meet the therapeutic challenge of amblyopia therapy for children.