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差异，原因尚不清楚。 我们的初步数据显示，种族是一个主要因素：一些人群有更多的内斜视， 外斜视，而其他人群有更多的外斜视比内斜视。较早的文献表明， 瞳孔间距离的差异可能是斜视的种族差异的原因，但这 从未被系统地研究过。由于在很大程度上不确定的种族差异， 斜视的病因目前尚不清楚。此外，同一种族内的患病率从未 纵向整理和比较。由于缺乏关于当地和全球流行率的信息， 无法确定趋势并将其与主要风险因素的趋势进行比较， 斜视的潜在原因或倾向。这阻碍了医疗保健的规划， 未来需要的。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，并发表一份关于横向运动患病率的系统综述。 斜视在世界各地，考虑到种族差异和方法的偏见。这将 提供了一个急需的参考指南，并使人们能够估计真正的全球流行率。 目的2：检查种族不同的三个眼眶参数的分布：瞳孔间距， 眼球突出和眶间宽度，并辨别哪些参数（或参数组合）最能解释 水平斜视患病率和模式的种族差异。这将提供基于证据的 了解当前种族差异及其进化历史的框架。 目标3：确定水平斜视患病率的趋势（在过去50-150年）， 与本港斜视的主要危险因素趋势比较。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举措有关。 我们的多学科研究团队将通过建立基于人群的 每个主要种族的患病率数字。这对于提供全面的 为今后的研究提供参考。不同国家和种族的真实患病率对于 保健规划的目的。第二个目标将告知眼眶的哪些关键解剖特征是 种族差异，具有进化、发育和临床意义。这将提供一个新的 轨道参数对斜视影响的概念框架。最后，考虑到 全世界有更多的研究和人群（约500例，而以前的综述中约30例）将 使我们能够确定流行趋势，并将这些趋势与主要危险因素的趋势进行比较， 斜视的人。这将告知哪些风险因素（例如，母亲吸烟， 剖腹产）可能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.