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Introducción. La evaluación de la visión en los niños durante el periodo preverbal, con un método fácil de usar y basado en la evidencia, permitiría el diagnóstico temprano y la intervención en los trastornos visuales. El objetivo del estudio fue determinar la utilidad y confiabilidad de la versión en idioma turco del cuestionario Preverbal Visual Assessment (PreViAs), desarrollado para evaluar la visión en niños preverbales. Población y métodos. El cuestionario PreViAs se administró a los cuidadores primarios de niños nacidos de término, antes de los 24 meses de edad. Se registraron sus respuestas. Resultados. Se analizaron los datos de 278 participantes para evaluar la consistencia interna del cuestionario PreViAs. Se encontró un alto nivel de consistencia con un alfa de Cronbach de 0,958 para el puntaje total, lo que sugiere una fuerte coherencia interna. Los valores del alfa de Cronbach para cada dominio fueron: 0,890 0,913 0,951 y 0,922 para la atención visual, la comunicación visual, el procesamiento visual y la coordinación visomotora respectivamente; esto indica una buena consistencia interna para cada subdominio. Conclusión. La versión en idioma turco del cuestionario PreViAs es útil y confiable para evaluar la visión durante el periodo preverbal.
Introduction: Evaluating the visual functions of children with an easy-to-use and evidence-based method during the preverbal period will enable early diagnosis and intervention of visual impairments. The aim of this study is to determine the utility and reliability of the Turkish version of the Preverbal Visual Assessment (PreViAs) questionnaire, which was developed to evaluate the visual functioning of preverbal infants. Population and Methods: The PreViAs questionnaire was administered to primary caregivers of term infants under 24 months of age, and their responses were recorded. Results: Data from the 278 participating infants were analyzed to assess the internal consistency of the PreViAs questionnaire. Results showed a high level of consistency with Cronbach's alpha value of 0.958 for the total score, suggesting strong internal coherence. In addition, the Cronbach's alpha values for each domain were 0.890, 0.913, 0.951, and 0.922 for visual attention, visual communication, visual processing, and visual-motor coordination, respectively, indicating good internal consistency for each subdomain. Conclusion: The Turkish version of the PreViAs questionnaire is useful and reliable for assessing functional vision during the preverbal period.
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Humanos , Recién Nacido , Lactante , Cuidados Paliativos , Desempeño Psicomotor , Turquía , Encuestas y Cuestionarios , Reproducibilidad de los ResultadosRESUMEN
ABSTRACT Purpose: Timely screening and treatment are essential for preventing diabetic retinopathy blindness. Improving screening workflows can reduce waiting times for specialist evaluation and thus enhance patient outcomes. This study assessed different screening approaches in a Brazilian public healthcare setting. Methods: This retrospective study evaluated a telemedicine-based diabetic retinopathy screening implemented during the COVID-19 pandemic and compared it with in-person strategies. The evaluation was conducted from the perspective of a specialized referral center in an urban area of Central-West Brazil. In the telemedicine approach, a trained technician would capture retinal images by using a handheld camera. These images were sent to specialists for remote evaluation. Patient variables, including age, gender, duration of diabetes diagnosis, diabetes treatment, comorbidities, and waiting time, were analyzed and compared. Results: In total, 437 patients with diabetes mellitus were included in the study (mean age: 62.5 ± 11.0 years, female: 61.7%, mean diabetes duration: 15.3 ± 9.7 years, insulin users: 67.8%). In the in-person assessment group, the average waiting time between primary care referral and specialist evaluation was 292.3 ± 213.9 days, and the referral rate was 73.29%. In the telemedicine group, the average waiting time was 158.8 ± 192.4 days, and the referral rate was 29.38%. The telemedicine approach significantly reduced the waiting time (p<0.001) and significantly lowered the referral rate (p<0.001). Conclusion: The telemedicine approach significantly reduced the waiting time for specialist evaluation in a real-world setting. Employing portable retinal cameras may address the burden of diabetic retinopathy, especially in resource-limited settings.
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ABSTRACT Purpose: To assess the anterior and posterior segments of full-term neonates over a 1.5-year period. Methods: The findings of full-term neonates who underwent ophthalmological examinations between June 2019 and December 2020 were analyzed, and the results were retrospectively recorded. Results: The study comprised 2972 neonates with a mean birth week of 38.7 ± 1.2 weeks and a mean birth weight of 3235 ± 464 g. The neonates were examined on an average of 49.3 ± 18.9 postnatal days. Of the examined neonates, 185 (6.2%) showed abnormal ophthalmological findings, the most prevalent of which were retinal hemorrhage in 2.3% (n=68) and white changes in the peripheral retina in 1.9% (n=55) of the neonates. Cases of optic disc pathologies (n=20), choroidal nevus (n=10), iris-choroidal coloboma (n=5), subconjunctival hemorrhage (n=6), non-specific retinal pigmentary change (n=4), congenital cataract (n=3), posterior synechia (n=3), iris nevus (n=3), corneal opacity (n=1), choroidal coloboma (n=1), iris coloboma (n=1), buphthalmos (n=1), anophthalmos (n=1), microphthalmia (n=1), lid hemangioma (n=1), and vitreous hemorrhage (n=1) collectively accounted for approximately 2% of all neonates. Pathologies that could potentially impair vision, which were detected by ophthalmological examination, accounted for 1.2% of all neonates (n=37). Conclusion: The most prevalent finding of the ophthalmological examinations of neonates in the present study was retinal hemorrhage. Ophthalmological examinations of neonates can help in identifying diseases that may affect their vision and are curable or may lead to amblyopia in the long term.
RESUMO Objetivo: Avaliar os segmentos anterior e posterior em recém-nascidos a termo durante um período de 1,5 anos. Métodos: Foram analisados recém-nascidos a termo que tiveram os olhos examinados entre junho de 2019 e dezembro de 2020, e os resultados foram registrados retrospectivamente. Resultados: O estudo foi composto por 2.972 recém-nascidos com média de uma semana de nascimento de 38,7 ± 1,2 semanas e um peso médio ao nascer de 3235 ± 464 g. Os recém-nascidos foram examinados em média pós-natal de 49,3 ± 18,9 dias. Dos recém-nascidos, 185 (6,2%) apresentaram resultados oculares anormais. Os achados oculares anormais mais prevalentes foram hemorragia da retina em 2,3% (n=68) e alterações brancas na retina periférica em 1,9% (n=55) dos recém-nascidos. Casos de patologias de disco óptico (n=20), nevo de coroide (n=10), coloboma iris-coroide (n=5), hemorragia subconjuntival (n=6), alteração pigmentar da retina não específica (n=4), catarata congênita (n=3), Sinequia posterior (n=3), nevo da íris (n=3), opacidade da córnea (n=1), coloboma de coroide (n=1), coloboma de íris (n=1), buftalmos (n=1), anoftalmia (n=1), microftalmia (n=1), hemangioma de pálpebra (n=1) e hemorragia vítrea (n=1) contabilizaram coletivamente cerca de 2% dos recém-nascidos. As patologias que potencialmente prejudicam a visão, detectadas por exame ocular, representaram 1,2% dos recém-nascidos (n=37). Conclusão: O achado mais prevalente de exames oculares de recém-nascidos neste estudo foi hemorragia da retina. Exames oftalmológicos em recém-nascidos podem ser úteis na identificação de doenças que podem impactar a visão deles, podendo ser curáveis ou levar à ambliopia no longo prazo.
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RESUMEN Objetivo: Obtener la frecuencia de fatiga visual digital (FVD) mediante dos cuestionarios entre los estudiantes de una universidad privada en Lima, Perú; para estimar el grado de concordancia entre ambos métodos. Métodos: Se realizó un estudio transversal en una muestra de 345 participantes mayores de 18 años, estudiantes de una universidad en Lima, Perú y que completaron el instrumento de recogida de datos. Los dos métodos usados para la medición de FVD fueron el cuestionario de Hayes que define un caso positivo para FVD con un puntaje igual o mayor a 20; y el cuestionario CVS-Q de Seguí, que define como positivo para FVD con un puntaje mayor a 6. Se estimó el coeficiente kappa de Cohen con su intervalo de confianza al 95% para medir la concordancia global y por estratos. Resultados: El cuestionario de Hayes identificó a 167 (48,4%) participantes con un diagnostico presuntivo de FVD, el cuestionario de Seguí identificó a 247 (71,6%) estudiantes. En el análisis de concordancia, el coeficiente Kappa de Cohen fue 0,45 (IC95%; 0,37 - 0,53) (p < 0,01) en el análisis global, considerado como moderado. Conclusiones: El grado de concordancia entre ambos métodos fue moderado, el instrumento de Seguí identificó una mayor proporción de estudiantes universitarios con FVD.
ABSTRACT Objective: To obtain the frequency of digital visual fatigue (DVF) using two questionnaires among students of a private university in Lima, Peru; to estimate the degree of agreement between both methods. Methods: A cross-sectional study was conducted in a sample of 345 participants over 18 years old, students of a university in Lima, Peru and who completed the data collection instrument. The two methods used for the measurement of DVF were the Hayes questionnaire, which defines a positive case for DVF with a score equal to or greater than 20; and the Seguí CVS-Q questionnaire, which defines a positive case for DVF with a score greater than 6. The Cohen's kappa coefficient with its 95% confidence interval was estimated to measure the overall agreement and by strata. Results: The Hayes questionnaire identified 167 (48.4%) participants with a presumptive diagnosis of DVF, the Seguí questionnaire identified 247 (71.6%) students. In the concordance analysis, Cohen's Kappa coefficient was 0.45 (95%CI; 0.37 - 0.53) (p < 0.01) in the overall analysis, considered moderate. Conclusion: The degree of concordance between both methods was moderate, the Seguí instrument identified a higher proportion of university students with DVF.
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Purpose: To study the prevalence and determinants of compliance with spectacle wear among school?age children in South India who were given spectacles free of charge under a school vision screening program. Methods: A cross?sectional, descriptive study was performed. The participants were recruited from the school from Tirunelveli and Tuticorin districts of Tamil Nadu, where a school vision screening camp was conducted between January 2012 and October 2012. The school screening was performed under “Lavelle Pediatric Eye Care Project”. Of the 129,720 children examined of 249 schools, 4253 of children had refractive error and 3333 were prescribed and dispensed spectacles. A total of 683 children were interviewed, who were not wearing glasses on follow?up. Results: About 20% of the participants (683/3333) were not wearing their spectacles at examination. The most common reasons given for non?wear were lost (44.9%) or broken (35.3%) spectacles. There was no gender preference on compliance to spectacles. Conclusion: Compliance with spectacle wear is less even when spectacles are provided free of cost, particularly in children among the age group of 5–15 years. Because factors such as type of school, area (urban or rural), parent’s income, occupation, and their education were not significantly affecting the compliance of spectacle wear, proper encouragement and counseling of the parents and the child become extremely important.
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In January 2022, after an eight-year hiatus, the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) published the latest version of AAPOS uniform guidelines for instrument-based pediatric vision screen validation.Based on recent studies, the new guidelines have been updated and supplemented in many aspects, such as screening population, key points, methods and diagnosis criteria, including clinically significant refractive errors and myopia, simplified age subgroups, and adopted meridional refractive power.The updated guidelines will improve pediatric eye care, early detection of amblyopia and refractive screening, reduce excessive referral and ultimately improve the effectiveness of vision screening.In this article, the background and specific content of the updated guidelines were interpreted to guide clinical practice.
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Objective@#To understand the vision status of primary and secondary school students in Beijing, in order to provide scientific reference for myopia prevention and control.@*Methods@#From 2018 to 2021, a stratified cluster sampling method was used to monitor myopia among 191 293 primary and secondary school students selected from 6 urban areas and 10 suburban areas in Beijing. Myopic screening was in accordance with the "standards for children and adolescents myopic screening", and was measured by an automatic desktop computer optometer under non-cycloplegic conditions. Statistical analysis was used by Chi-square test.@*Results@#The total myopia rate of primary and middle school students in Beijing from 2018 to 2021 were 60.7%, 57.6%, 59.2% and 59.7%, respectively. In 2018, the myopia rates of primary school students, middle school students, regular high school students and vocational high school students were 38.3%, 77.3%, 88.3% and 73.2% respectively. In 2019, they were 34.7%, 76.4%, 87.7% and 72.0%, respectively; in 2020, they were 37.5%, 76.8%, 86.8%, 74.9%; in 2021, they were 38.7%, 77.4%, 86.5% and 74.9 % respectively. Significant differences in educational stage were observed ( χ 2=7 386.07, 11 104.28, 9 850.08, 9 714.59, P <0.01). From 2018 to 2021, the overall myopia rate of girls (62.1%) was higher than that of boys (56.5%)( χ 2=613.75, P <0.01). The myopia rate of girls were higher than that of boys in each year, and significant differences in educational stage were observed, respectively( χ 2=120.47, 163.47, 168.01, 162.24, P <0.01). The overall myopia rate of urban students(63.0%) was higher than that of suburban students (56.0%)( χ 2=978.82, P <0.01). The myopia rate of urban students were higher than that of suburban students every year, and significant differences in educational stage were observed, respectively ( χ 2=86.71, 240.96, 302.56, 409.30 , P < 0.01 ).@*Conclusion@#The detection rate of myopia rate of primary and middle school students in Beijing is still high. It is necessary to strengthen the publicity and intervention of poor visual acuity in primary and middle school students, especially among urban area students, with the aim of effectively control and reduction in the myopia rate, and the improvement of student visual health.
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Objective@#To evaluate the prevalence and consistency of screening myopia, non-cycloplegic myopia and cycloplegic myopia in children and adolescents, and to provide references for exploring the factors affecting the consistency of different definition methods.@*Methods@#A total of 3 868 children and adolescents aged 6 to 17 years from seven schools were included in a school based cross sectional study in Shandong Province in September 2020. The prevalence of screening myopia, non cycloplegic refraction, and cycloplegic refraction at different ages and all children and adolescents were analyzed. With cycloplegic spherical equivalent ≤-0.50 D as the gold standard for myopia, and Kappa test and area under the ROC curve were used to evaluate the consistency.@*Results@#The prevalence of cycloplegic myopia and screening myopia were 36.7% and 38.3% among children and adolescents. The prevalence of non cycloplegic myopia was 62.4%, which was significantly higher than screening myopia and cycloplegic myopia two methods in primary and junior high schools. Among 3 868 subjects, there were 3 628 (93.8%) subjects with screening myopia and 2 862 (74.0%) subjects with non cycloplegic myopia who were consistent with the gold standard for myopia. The Kappa values of screening myopia and non cycloplegic myopia were 0.87 and 0.51, and the area under the ROC curve was 0.94 (95% CI =0.93-0.95) and 0.79 (95% CI =0.78-0.81). Compared with other groups, children and adolescents aged 8 to 17 years, in junior or high school, urban residence, better presenting distance visual acuity, and astigmatism ≤1.50 D had a higher consistency in the application of screening myopia ( P <0.05).@*Conclusion@#The consistency between screening myopia and cycloplegic myopia is high, and the consistency between non cycloplegic objective myopia is low.
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Objective@#To investigate the influencing factors of preschoolers hyperopia reserve, and to provide a scientific basis for preschoolers to prevent myopia.@*Methods@#Visual screening and a questionnaire survey were conducted on 5 087 4-year old children in Suzhou High-tech Zone from September to December in 2020. The influencing factors of children s hyperopia reserve were analyzed by univariate analysis and Logistic regression model.@*Results@#A total of 997(19.6%) children had hyperopia reserve deficiency. Logistic regression showed that the negative factors associated with hyperopia reserve included being girl( OR=0.81, 95%CI =0.70-0.93), no food allergy( OR=0.78, 95%CI =0.63-0.96); and the positive factors included father myopia( OR=1.20, 95%CI =1.03-1.39), mother myopia( OR=1.17, 95%CI =1.01-1.36), exposure of night lights(for less than 1 hour: OR=1.53, 95%CI =1.21-1.92; for 1 to 3 hours: OR=1.48, 95%CI =1.09-2.00), insufficient vegetable intake( OR=1.26, 95%CI =1.07- 1.46 )( P <0.05).@*Conclusion@#Parental myopia, nighttime sleep environment and dietary factors have potential associations with hyperopia reserve deficiency among children. Corresponding measures should be actively taken to improve the preschoolers hyperopia reserve.
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AIM: To explore the characteristics of astigmatism in preschool children before, during and after the COVID-19 epidemic, so as to provide a reference for further prevention and control of children's vision.METHODS: In the consecutive four years from January 2018 to December 2021, a retrospective analysis of vision data was conducted on 2 273 preschool children(4 546 eyes)younger than 4 years old who participated in children's vision screening test in Baiyun district, Guangzhou. They were divided into 1-year old group(ages<1-year old, 420 cases), 2-year old group(1-year ≤ ages <2-year, 543 cases), 3-year old group(2-year ≤ages <3-year, 614 cases), and 4-year old group(3-year ≤ ages<4-year, 696 cases)according to ages. The analysis included astigmatic degrees of children's eyes as well as their conditions of astigmatism.RESULTS: In 2018, the astigmatic degrees of the both eyes of 1-year-old group were higher than those of other groups(P<0.05). The binocular astigmatic degrees of the preschool children in four groups were obviously higher in 2020 than 2019(P<0.05), while they were significantly decreased in 2021 when compared with 2020(P<0.05). From 2019 to 2020, the increase of astigmatic degrees of the right eye is more considerable than the left eye of preschool children in those four groups(P<0.001). Furthermore, the morbidity of astigmatism basically echoes with the changing tendency of astigmatic degrees from 2018 to 2021.CONCLUSIONS: Preschool children in Baiyun district, Guangzhou, have the highest degree of astigmatism and the fastest progression rate within 1 year old. Before COVID-19 epidemic, the changes in astigmatism and prevalence were relatively stable; during COVID-19 epidemic, the astigmatism and prevalence increased significantly and the astigmatic degrees of right eye increased more than that of the left eye; after the normalization of epidemic prevention and control, the astigmatism and prevalence decreased significantly.
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Aims: To assess current school vision screening guidelines of states spread across different regions of the United States to inform quality guideline parameters and help combat preventable pediatric vision loss.Study Design: Cross-sectional comparative analysis.Methodology: States were first ordered alphabetically and then selected using an online random number generator (Alphabet Inc., Mountain View, California). States were selected until 13 available screening guidelines were identified. Each guideline was assessed using a 10-point multi-factorial scoring criteria detailed in Table 1. Descriptive statistics (mean and standard deviation) were calculated for each scoring criteria using Microsoft® Excel (version 16.63.1, Redmond, WA).Results: Most state guidelines included what ages to screen (84.62%, 11/13), how to screen (84.62%, 11/13), and how to follow-up with students to arrange (92.31%, 12/13) and confirm eye care delivery (76.92%, 10/13). Sadly, only the minority of state guidelines described at least two main causes of amblyopia (46.15%, 6/13), and a less than one-third of school nurse vision screening guidelines discussed the window of time to save vision in amblyopia (30.77%, 4/12). Worse yet, very few nurse vision screening guidelines explained that subjectively a child can’t tell you if they are at risk of developing amblyopia (15.38%, 2/13), or included two treatments for amblyopia (7.69%, 1/13) in the vision screening educational program.Conclusion: This study found that most of the assessed vision screening guidelines outlined the process of screening and follow-up but failed to emphasize why screening is important, causes, and treatment options for amblyopia. Gaps in these training guidelines may contribute to delayed recognition and treatment for amblyopia¾the leading cause of irreversible pediatric vision loss. Further improvements to vision screening guidelines are needed for school nurses and paraprofessional staff in the majority of the states evaluated.
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Purpose: To understand/assess ocular and functional vision impairment in children with multiple disabilities with a functional vision assessment battery in addition to standard ophthalmic examinations in an outreach setting. Methods: Seven schools for children with special needs, 243 children in total, were screened for ocular disorders and functional vision impairment through school camps. Results: Among them, 37% had refractive errors needing spectacle correction. With standard ocular testing methods, the visual impairment was around 32%, but when functional vision was assessed, the functional vision impairment amounted to 70% in these children. The presence of functional vision impairment was found to be independent of the associated disability. Assessment of visual capacities such as visual closure, saccade pursuits, optic ataxia, and developmental milestones early on can help in suspecting the presence of CVI. Conclusion: Children with multiple disabilities are more at risk of functional vision impairment, which significantly impairs their ability to function in daily life. A complete functional vision assessment becomes essential to plan early intervention for these children. The significant proportion of vision impairment and functional vision loss in our study indicates the need for coordinated structured programs to address vision?related problems in children with multiple disabilities.
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Socio-ecological determinants of high myopia incidence among school students largely remain unexplored, especially in developing countries. A cross‑sectional study was conducted in rural schools in North India to assess the relationship between these determinants and myopia among adolescent students. A public health nurse used a pre-tested questionnaire (demographics, family ocular status, and screen time) and Snellen’s chart for testing visual acuity, and referred suspected cases for cycloplegic refraction assessment. Among the total of 955 students, the median (range) age was 14 (13–15) years. The prevalence of myopia was 5.03% (95% confidence interval [CI]: 4.99–5.07). Myopia was found to be associated with computer usage at school (P = 0.058), malnutrition (P = 0.001), and familial myopia (P = 0.079) in the bivariate analysis. Significant predictors of myopia in the regression model were females (odd ratio [OR]: 6.29; 95% CI: 2.69–14.72), higher maternal age (OR: 1.09; 95% CI: 1–1.17), and reading distance <20 cm (OR: 1.98; 95% CI: 1.01–3.87).
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Resumen La retinopatía diabética es uno de los grandes problemas que enfrenta la salud pública en el siglo XXI. La prevalencia mundial se encuentra en constante aumento; sin embargo, poco se conoce sobre la frecuencia de esta enfermedad en la Argentina. Los programas de tele-oftalmología han ayudado a combatir y a comprender mejor esta enfermedad, principalmente en áreas rurales. El objetivo del siguiente tra bajo fue estimar la prevalencia de la retinopatía diabética en la provincia de La Pampa. Se realizó un estudio observacional de corte transversal, evaluando las características de la población asistida por un programa de tele-oftalmología en la zona rural de la provincia. Se evaluaron imágenes de retina obtenidas con un retinógrafo no midriático, la presión intraocular y características generales de la población. Se estimó una prevalencia del 21.5% y un 14.1% de estas personas tenían una amenaza visual grave. Además, se observó que el 5.0% tenían glaucoma, 63.4% hipertensión arterial y 42.6% dislipemia. Estos resultados son similares a los presentados en otros países del mundo. Son datos fundamentales para comprender detalles de la situación epidemiológica en esta región y poder armar estrategias sanitarias para enfrentar a esta enfermedad.
Abstract Diabetic retinopathy is one of the major problems public health is facing in the 21st century. The worldwide prevalence is increasing; however, little is known about the frequency of this disease in Argentina. Tele-ophthalmology programs have helped to face and to better understand this disease, mainly in rural areas. The aim of this study was to estimate the prevalence of diabetic retinopathy in the province of La Pampa. A cross-sectional observational study was carried out, evaluating the characteristics of the population assisted by a tele-ophthalmology program in a rural area of the province. The images, taken with a non-mydriatic retinal camera, the intraocular pressure and general characteristics of the population were evaluated. A disease prevalence of 21.5% was estimated and 14.1% of them had a vision-threatening diabetic retinopathy. In addition, it was observed that 5.0% had glaucoma, 63.4% hypertension and 42.6% dyslipidemia. These findings are similar to those reported in other countries around the world. These data are fundamental to understand the details of the epidemiological situation in this region and to be able to develop health strategies to deal with this disease.
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Purpose: Community volunteers like Accredited Social Health Activists (ASHAs) could be utilized for linking community and eye care services. Research is needed to effectively utilize them. This study was to assess whether ASHAs could imbibe new knowledge in eye care and conduct vision screening. Methods: Settings and Design: A pre?post?intervention study in South Delhi Integrated Vision Centres. It was conducted from January 2016 to March 2017. One day of conceptual training followed by hands?on training in vision screening was imparted to ASHAs. The knowledge was assessed thrice: before, immediately after, and following 1 year after training. The vision screening skill was assessed twice. Descriptive analysis using percentages, mean and standard deviations. Paired t?test was used for assessing the change in scores. Results: A total of 102 ASHAs were recruited. A significant increase in the knowledge score of ASHAs before (14.96) and after training (25.38) (P < 0.001) was noted. The knowledge score was sustained at 1 year (21.75). The satisfactory skill of vision screening was seen in 88 (86.3%) ASHAs after training, while 79 (77.5%) ASHAs still retained it after 1 year. Conclusion: The potential to involve ASHAs in community?based frontline eye care activities: awareness generation of eye diseases, identification of referrable conditions, and facilitating individuals to seek eye care facilities. This study informs about the duration, frequency, and content of the training. It also provides evidence on the improvement and sustainability of eye care knowledge and skills by ASHAs after conceptual and hands?on training
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Objective @# To analyze the adverse drug reaction（ADR） reports of hydroxychloroquine for clinical medication safety. @* Methods@#The ADR reports of hydroxychloroquine between May 2019 and May 2021 were analyzed. Age, reasons for drug use, time of ADR, combined drug use, and ADR outcomes were statistically analyzed. @*Results@# No severe ADR was reported. Patients over 60 years old accounted for 53.85% of the total cases, and the time of ADR appearance was significantly earlier among those under 60 years old. A total of 61.54% of ADRs were involved in multiple organs, and optic neurotoxicity was reported in 46.15% of cases. @*Conclusion@# In the treatment of oral lichen planus with hydroxychloroquine, adverse drug reactions should be monitored, and increased attention should be given to patients over 60 years old to ensure the safety of this medication.
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Objective To analyze the prevalence of myopic refractive error and its associated risk factors among primary school students in Shanghai Minhang Distict. Methods A total of 11 356 primary school students who participated in the children's refraction screening project in Meilong Community， Minhang District， Shanghai from January 1 to December 31， 2019 were selected for visual inspection and computer optometry Results The detection rate of myopic refractive error among 6-10 year-old students was 45.59%， with a higher rate in girls and older age group. The detection rates of 6-10 year-old students were 22.88% （6 year-old）， 31.77% （7 year-old）， 47.62% （8 year-old）， 60.53% （9 year-old） and 69.84% （10 year-old）， respectively， showing a linear trend（χ 2=1.31， P<0.001）. Multivariate logistic regression revealed that myopic refractive error was statistically significantly associated with gender， age and parents' myopic. Birth weight， preterm birth and body mass index （BMI） had no influence on refractive myopic in primary school students. Conclusion Myopic refractive error is still a major public health problem in primary school students. A combined strategies for myopic refractive error reduction should be called to focus on high risk persons and behaviors.
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ABSTRACT Objective: The main aim of this study was to evaluate the performance of a platform designed for pediatricians to screen amblyopia using a smartphone. Methods: The medical records of consecutive children who received visual screening using a smartphone platform were retrospectively reviewed. The smartphone was used with a flash concentrator case and a software for capturing images of both eyes simultaneously by a photorefraction mechanism. The platform performance was compared to the comprehensive ophthalmological examination, which is considered the gold standard for detecting amblyopia. Sensitivity, specificity, positive predictive value, and negative predictive value of the software in detecting amblyopia risk factors were calculated. Results: A total of 157 children were included, with a mean age of 6.0±.5 years (range 5-7). In 94% of the cases, the software was able to analyze the images and release a result, determining whether or not the child presented with amblyopia risk factors. Compared to the ophthalmological examination, the smartphone platform sensitivity in detecting amblyopia risk factors was 84%, the specificity was 74%, the positive predictive value was 86%, and the negative predictive value was 70%. Conclusions: The sensitivity and specificity of the smartphone photoscreening platform to detect amblyopia risk factors were within the range of traditional instrument-based vision screening technology. A smartphone photorefraction platform appears to be a promising cost-effective alternative to assist pediatricians and minimize obstacles to vision screening and amblyopia detection. Future studies are needed to gather additional comparative data.
RESUMO Objetivo: Avaliar a performance de uma plataforma desenvolvida para pediatras para triagem de ambliopia utilizando um smartphone. Métodos: Os prontuários consecutivos de crianças submetidas a triagem visual usando uma plataforma no smartphone foram analisados retrospectivamente. Uma capa concentradora de flash foi utilizada no smartphone com um software para capturar imagens simultâneas dos dois olhos por um mecanismo de fotorrefração. A performance da plataforma foi comparada ao exame oftalmológico completo, considerado o padrão ouro para detecção de ambliopia. Foram calculados sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo do software em detectar fatores de risco para ambliopia. Resultados: Foram incluídas 157 crianças com idade média de 6.0±0.5 anos (variação de 5 a 7 anos). Em 94% dos casos, o software foi capaz de analisar as imagens e fornecer um resultado, determinando se a criança apresentava ou não fatores de risco para ambliopia. Comparados ao exame oftalmológico, a sensibilidade da plataforma no smartphone em detectar fatores de risco para ambliopia foi de 84%, a especificidade foi de 74%, o valor preditivo positivo foi de 86% e o valor preditivo negativo foi de 70%. Conclusões: A plataforma de triagem por fotorrefração usando o smartphone apresentou sensibilidade e especificidade para detectar fatores de risco para ambliopia semelhantes às encontradas em instrumentos tradicionais de triagem por fotorrefração. Uma plataforma no smartphone é uma alternativa custo-efetiva promissora para auxiliar pediatras a minimizar os obstáculos para triagem visual e detecção da ambliopia. Estudos futuros são necessários a fim de reunir dados comparativos adicionais.
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ABSTRACT Introduction Blood donor screening is an important stage of quality control in blood banks. Turbidity caused by increased levels of triglycerides is detected by visual inspection, but there is no consensus on its threshold at which plasma should be considered inappropriate for donation. Objective Compare triglycerides dosage and visual turbidity in decision making for the disposal of plasma. Material and methods Plasma bags (n=205) were classified by visual inspection as clear, moderately turbid or turbid and triglyceride concentration were determined in serum and plasma with enzimatic-colorimetric methodology by automation. Results Our results show a positive correlation between serum and plasma triglycerides levels (r=0,94) but we observed a higher concentration in serum when compared to plasma samples (p<0,03). Most of the plasma were classified as moderately turbid or turbid (75%). Visual inspection and triglycerides levels were moderately correlated in serum (rb=0,57) and plasma (rb=0,52). However, moderately turbid samples showed discordance between serum or plasma triglyceride levels and the visual inspection. Discussion Our findings corroborate with the literature data, supporting the subjectivity of the visual inspection. We recommend further studies to determine which triglyceride threshold should be used for the disposal of plasma bags combined with automated methods to enhance visual classification accuracy. Conclusion Quality improvement actions are critical for standardization of the screening in order to avoid unnecessary disposal of the plasma bags.
RESUMO Introdução A triagem das bolsas de plasma é uma etapa importante do controle de qualidade nos hemocentros. A turbidez causada pelo aumento de triglicerídeos é detectada por inspeção visual, mas não há consenso acerca do limite no qual o plasma deve ser considerado inadequado para doação. Objetivo Comparar a dosagem de triglicerídeos e a turbidez visual na tomada de decisão para o descarte do plasma. Material e métodos As bolsas de plasma (n=205) foram classificadas pela inspeção visual como límpidas, moderadamente turvas ou turvas e as concentrações de triglicerídeos foram determinadas no soro e plasma com metodologia enzimática-colorimétrica por automação. Resultados Nossos resultados mostraram uma correlação positiva entre soro e plasma (r=0,94) mas observamos que a concentração de triglicerídeos foi mais alta no soro do que no plasma (p<0,03). A maioria das bolsas foi classificada como moderadamente turva ou turva (75%). A inspeção visual e a concentração de triglicerídeos apresentaram uma correlação moderada para o soro (rb=0,57) e plasma (rb=0,52). Entretanto, no grupo moderadamente turvo, houve uma divergência significativa entre as concentrações de triglicerídeos no soro/plasma e a inspeção visual. Discussão Nossos achados corroboram com a literatura, reforçando a subjetividade da inspeção visual. Nós recomendamos a realização de estudos futuros para determinar o limite dos níveis de triglicerídeos para o descarte de plasma em conjunto com a combinação de métodos automatizados para aumentar a acurácia da classificação visual. Conclusão As ações voltadas para a melhoria da qualidade são críticas para a padronização da triagem e evitar o descarte desnecessário de plasma.
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Objective:To analyze the prevalence of poor vision and spatial distribution characteristics among primary school students in Shenzhen.Methods:A cross-sectional study was conducted.Vision screening among primary school students in Shenzhen was carried out by myopia screening hospitals organized by Shenzhen Myopia Prevention and Control Center for Children and Adolescents using the logarithmic visual acuity chart in 2019.The prevalence of poor vision in different districts, different genders and different grades was calculated.Spatial distribution of the prevalence of poor vision was analyzed with Arcgis 10.2 software.This study adhered to the Declaration of Helsinki.Written informed consent was obtained from guardian of each subject.The study protocol was approved by an Ethics Committee of Shenzhen Eye Hospital (No.20201230-06).Results:A total of 1 044 545 students received the visual acuity examination.The prevalence of poor vision among primary school students in Shenzhen in 2019 was 53.4%(557 748/1 044 545). The prevalence of poor vision among primary school students in the former Shenzhen Special Economic Zone was 56.7%(172 771/304 532), which was higher than 52.0%(384 977/740 013) in areas outside the former Shenzhen Special Economic Zone, and the prevalence of poor vision among girls was 56.7%(268 201/473 164), which was higher than 50.7%(289 547/571 381) among boys, and the differences were statistically significant ( χ2=192.412, 375.434; both at P<0.001). As the grade increased, the prevalence of poor vision firstly decreased and then increased, showing an increasing tendency in general.The prevalence rate of poor vision among primary school students among grade 1 to 6 was 49.8%(99 615/200 203), 44.0%(86 521/196 800), 47.2%(82 848/175 331), 54.5%(89 737/164 731), 60.8%(96 271/158 298), and 68.9%(102 756/149 182), respectively, and a significant difference was found ( χ2=2 871.017, P<0.001). The global Moran I index in Shenzhen was 0.278.The local Moran I index and Geary coefficient in Guangming District were 0.933 and 0.78, respectively.The prevalence of poor vision in Guangming District and its surrounding areas was a low-low cluster. Conclusions:The prevalence of poor vision among primary school students in Shenzhen is spatially aggregated.