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Published on: April 26, 2019
[Analysis of fundus examination results in 8 808 pediatric patients in Northwest China]
1Department of Ophthalmology, Eye Institute of Chinese PLA, Xijing Hospital, Fourth Military MedicalUniversity, Xi'an 710032, China.
Insights
The incidence of pediatric fundus abnormalities in northwest China is increasing, primarily affecting infants under six months. Retinopathy of prematurity (ROP) is the most common condition found in this age group.
Area of Science:
- Ophthalmology
- Pediatrics
- Public Health
Background:
- Pediatric fundus abnormalities present a significant health concern.
- Understanding the incidence and age distribution is crucial for early detection and intervention.
Purpose of the Study:
- To investigate the incidence and age-specific distribution of fundus abnormalities in pediatric patients (0-3 years) in northwest China.
- To analyze trends in detection rates over a 12-year period.
Main Methods:
- Retrospective study of 8808 pediatric patients (0-3 years) from January 2008 to December 2019.
- Utilized wide-field digital retinal imaging and indirect ophthalmoscopy.
- Employed joinpoint regression to analyze annual detection rate trends.
Main Results:
- Fundus abnormalities were detected in 28.74% of patients.
- The positive detection rate showed an upward trend (+7.2% annually, +30.09% from 2016-2019).
- Developmental diseases (66.30%), particularly retinopathy of prematurity (ROP, 58.36%), were most common. Abnormalities varied by age, with ROP and other developmental/hereditary diseases prevalent in infants 0-6 months, and tumors more common after 1 year.
Conclusions:
- The detection rate of pediatric fundus abnormalities is increasing in northwest China.
- Developmental and hereditary lesions are the primary abnormalities, with a distinct age distribution.
- Early detection and understanding of infant fundus diseases, especially ROP, are essential.
Abstract:
Objective: To explore the incidence and age distribution of fundus abnormalities in pediatric patients aged 0-3 years in northwest China. Methods: A retrospective study of the clinical data of 8808 pediatric patients aged 0-3 years who underwent fundus examination with a wide-filed digital retinal imaging system and an indirect ophthalmoscope in our hospital from January 2008 to December 2019 were performed. There were 5092 males and 3716 females, with a median age of 1 month (range, 3 days to 3 years), a mean gestational age of 34.32 (SD 2.92) weeks (range, 24 to 42 weeks) and a mean birth weight of 2006.92 (SD 709.23) g (range, 490 to 5500 g), from Shaanxi Province (7415 cases, 84.18%), Gansu Province (770 cases, 8.74%), Ningxia Hui Autonomous Region (94 cases, 1.07%), Qinghai Province (53 cases, 0.60%), Xinjiang Uygur Autonomous Region (14 cases, 0.16%) and other neighboring areas (462 cases, 5.25%). The fundus condition of the enrolled pediatric patients was documented to calculate the annual detection rate. The joinpoint regression model was drawn to estimate the annual percent change and average annual percent change. The constituent ratios and age distribution of different types of fundus abnormalities were finally analyzed. Results: Fundus abnormalities were detected in 2 531 cases (28.74%). During the 12 years, the number of pediatric patients undergoing fundus examination each year in our center increased rapidly in the first 7 years, and then kept almost stable, while the number of fundus abnormality cases increased year by year. The positive detection rate showed an overall upward trend with an average annual percent change of +7.2%, and it was +30.09% from 2016 to 2019. Among all the pediatric patients with fundus abnormalities, there were 1 678 cases with developmental diseases (66.30%), 232 cases with hereditary diseases (9.16%), 140 cases with ocular tumor (5.53%), 64 cases with ophthalmic manifestations of systemic diseases (2.53%), 31 cases with ocular trauma (1.23%), 12 cases with infectious diseases or inflammation (0.48%) and 438 cases with other ocular abnormalities (17.31%). The top 5 abnormalities were retinopathy of prematurity (ROP; 1477 cases, 58.36%), gray patchy retinopathy (225 cases, 8.89%), retinal hemorrhage (157 cases, 6.20%), retinoblastoma (137 cases, 5.41%) and familial exudative vitreoretinopathy (77 cases, 3.04%). Fundus abnormalities varied with age. ROP, developmental diseases other than ROP, hereditary diseases, ocular trauma and infectious diseases were mostly detected in pediatric patients at 0-6 months old, while tumors were mostly detected after 1 year old. Conclusions: The detection rate of fundus abnormalities in the Department of Ophthalmology of Xijing Hospital of Air Force Medical University, a tertiary referral center in northwest China, increased notably year by year. The abnormalities were mainly developmental and hereditary lesions as well as of certain age distribution. They occurred with the highest frequency between birth and 6 months of age, in which ROP was in the ascendancy. Meanwhile, the detection rate of other developmental, hereditary and neoplastic disorders increased with age. Therefore, a comprehensive and objective understanding of the fundus disease in infants is essential. (Chin J Ophthalmol, 2021, 57: 777-783).
