Does Ethnic Variation of the Orbit Determine the Prevalence of Horizontal Strabismus?

水平斜视的患病率在不同的研究中有很大的不同，原因尚不清楚。 我们的初步数据显示，种族是一个主要因素：一些人群的内斜视比 外斜视，而其他人群的外斜视比内斜视多得多。更古老的文献表明 斜视的种族差异可能与瞳孔间距离的差异有关，但这一点 从未被系统地探索过。由于很大程度上没有定义的种族差异，全球流行 斜视的病因目前尚不清楚。此外，在同一种族中的流行率从来没有 纵向汇编和比较。由于缺乏有关当地和全球流行情况的信息，因此 无法确定趋势并将其与主要风险因素的趋势进行比较，从而确定 斜视斜视的根本原因或倾向。这阻碍了医疗保健的规划，这将是 未来所需要的。在这里，我们建议通过进行二次数据分析来解决这些问题。 目标1：汇编所有相关研究，并发表一份系统的横向研究报告 世界各地的斜视，考虑到种族差异和方法偏见。这将是 提供急需的参考指南，并允许估计真实的全球流行率。 目标2：检查三个不同种族的眼眶参数的分布：瞳孔间距离， 凸度和眶间宽度，并辨别哪些参数(或参数组合)最能解释 水平斜视患病率及模式的民族差异。这将提供一个以证据为基础的 为了解当前的种族变异及其演化史而建立的框架。 目标3：确定(过去50-150年间)水平斜视患病率的趋势和 将它们与当地斜视主要危险因素的趋势进行比较。这将确定有效的风险因素 当地人口--这与规划目的和有针对性的卫生保健倡议有关。 我们的多学科调查团队将通过建立以人口为基础的 各主要种族的患病率数字。这一点很重要，可以提供全面的 为今后的研究做了参考工作。不同国家和种族的真实流行率对 医疗保健计划的目的。第二个目的将告知眼眶的哪些关键解剖特征是基础。 种族差异，具有进化、发展和临床意义。这将提供一部小说 眼眶参数对斜视影响的概念框架。最后，考虑一个 世界各地更多的研究和人群(约500项，而以前的综述为约30项)将 使我们能够确定流行率的趋势，并将这些趋势与#主要风险因素的趋势进行比较。 相同人群中的斜视。这将告知哪些风险因素(例如，母亲吸烟， 剖腹产)可能会影响不同人群的患病率。

The prevalence of horizontal strabismus differs dramatically between studies for reasons that are not clear. Our preliminary data show that ethnicity is a major factor: some populations have much more esotropia than exotropia, while other populations have much more exotropia than esotropia. Older literature suggested that differences in the interpupillary distance may be responsible for ethnic differences in strabismus, but this has never been systematically explored. Because of the largely undefined ethnic variations, the global prevalence of strabismus is currently unknown. Furthermore, the prevalence within the same ethnicity has never been longitudinally compiled and compared. This lack of information about local and global prevalence makes it impossible to determine trends and to compare them with trends of major risk factors and thus define underlying causes or predispositions for strabismus. This impedes the planning of health care that will be needed in the future. Here, we propose to solve these problems by conducting secondary data analyses. Aim 1: Compile ALL relevant studies and publish a systematic review of the prevalence of horizontal strabismus throughout the world, taking into account ethnic variations and methodology bias. This will provide a much-needed reference guide and allow to estimate the true global prevalence. Aim 2: Examine the distribution of three orbital parameters that are ethnically distinct: interpupillary distance, proptosis, and interorbital width, and discern which parameters (or combination of parameters) best explains the ethnic variation of horizontal strabismus prevalence and patterns. This will provide an evidence-based framework to understand the current ethnic variations and their evolutionary history. Aim 3: Determine the trends (over the last 50-150 years) in prevalence of horizontal strabismus and compare them with local trends for major risk factors of strabismus. This will identify effective risk factors in local populations – which is relevant for planning purposes and for targeted health care initiatives. Our multidisciplinary team of investigators will move the field forward by establishing population-based prevalence numbers for each of the major ethnicities. This is important to provide a comprehensive reference work for future studies. The true prevalence in different countries and ethnicities is important for health care planning purposes. The second aim will inform which key anatomical features of the orbit underlie ethnic differences, with evolutionary, developmental and clinical implications. This will provide a novel conceptual framework of the impact of orbital parameters for strabismus. Finally, consideration of a much larger number of studies and populations throughout the world (~500 vs. ~30 in previous reviews) will allow us to define trends in prevalence and to compare such trends with those of major risk factors of strabismus within those same populations. This will inform which risk factors (e.g., maternal smoking, Cesarean section) likely affect prevalence rates in distinct populations.