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Published on: November 28, 2012
Descriptive epidemiology of infantile cataracts in metropolitan Atlanta, GA, 1968-1998
Tricia R Bhatti1, Mary Dott, Paula W Yoon
1Medical College of Georgia School of Medicine, Augusta, USA.
Insights
Infantile cataracts, a key cause of childhood vision loss, are more common in low-birth-weight and preterm infants. Early red reflex examination is crucial for timely diagnosis and improved outcomes in these vulnerable newborns.
Area of Science:
- Ophthalmology
- Pediatrics
- Public Health
Background:
- Infantile cataract is a significant cause of visual impairment in children.
- Early surgical intervention, ideally before 6 weeks of age, is critical for optimal visual outcomes.
- Understanding the epidemiology of infantile cataracts aids in managing this condition.
Purpose of the Study:
- To identify populations at higher risk for infantile cataracts.
- To facilitate timely and effective treatment for affected infants.
- To inform public health strategies for early detection and intervention.
Main Methods:
- Utilized the Metropolitan Atlanta Congenital Defects Program data from 1968-1998.
- Analyzed a cohort of infants diagnosed with cataracts within their first year of life.
- Examined factors including birth weight, gestational age, and age at diagnosis.
Main Results:
- Identified 199 infants with cataracts, a rate of 2.03 per 10,000 births.
- Higher rates were observed in low-birth-weight (RR, 6.01) and preterm infants (RR, 1.70).
- Cataracts occurred as isolated defects in 59% of cases, with 38% diagnosed after the recommended 6-week window.
Conclusions:
- This population-based study highlights key risk factors for infantile cataracts over 31 years.
- A notable proportion of infants are diagnosed late, underscoring diagnostic delays.
- Routine red reflex examinations in newborns are essential for early detection and improved visual prognoses.
Background:
Infantile cataract is an important cause of childhood visual impairment. Surgery before 6 weeks of age is recommended for optimal visual outcome. Description of the epidemiologic characteristics of cataracts is important for an improved understanding of the condition.
Objectives:
To identify at-risk populations and facilitate successful treatment of patients with infantile cataracts.
Methods:
Infants with cataracts diagnosed in the first year of life were identified using the Metropolitan Atlanta Congenital Defects Program, a birth defects surveillance program with active methods of case ascertainment, for the years 1968-1998. Several factors were analyzed, including year of birth, sex, race, maternal age, plurality (single vs multiple gestation), gestational age, birth weight, laterality, seasonality, and age at diagnosis.
Results:
A total of 199 infants with cataracts were identified, for a rate of 2.03 per 10 000 births. In 117 infants (59%), cataracts occurred as an isolated defect; in 43 infants (22%), cataracts occurred as part of a syndrome; and in 39 infants (20%), additional, unrelated, major birth defects were also present. Rates were higher for low-birth-weight infants (those weighing <1500 g; risk ratio [RR], 6.01; 95% confidence interval [CI], 3.83-9.43) and preterm infants (RR, 1.70; 95% CI, 1.21-2.40). Of the cases that occurred as an isolated defect, 38% were diagnosed after 6 weeks.
Conclusions:
This population-based study provides 31 years of data from a diverse US population and allows identification of risk factors for infantile cataracts. The finding that a number of infants with cataracts continue to have their conditions diagnosed after 6 weeks of age emphasizes the need for direct ophthalmoscopic examination of the red reflex in the newborn period to facilitate early detection and improve outcomes.
