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Pediatric blepharokeratoconjunctivitis: findings and outcomes in Hispanic vs. Non-Hispanic patients
Maxwell Wilberding1,2, Elizabeth M Bolton1,2, Brenda Bohnsack3,4
1Division of Ophthalmology, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave, Box 70, Chicago, IL, 60611, USA.
Insights
Hispanic pediatric patients with blepharokeratoconjunctivitis (BKC) experienced worse visual acuity outcomes compared to non-Hispanic patients. Corneal scarring also negatively impacted vision, irrespective of ethnicity.
Area of Science:
- Ophthalmology
- Pediatric Health
- Public Health
Background:
- Blepharokeratoconjunctivitis (BKC) is a common pediatric eye condition.
- Understanding ethnic variations in BKC presentation and outcomes is crucial for targeted interventions.
Purpose of the Study:
- To compare the clinical presentation and visual outcomes of BKC in Hispanic versus non-Hispanic pediatric patients.
- To identify factors associated with visual outcomes in pediatric BKC.
Main Methods:
- Retrospective review of pediatric patients (<18 years) diagnosed with BKC between 2018-2022.
- Data collected included self-reported race/ethnicity, best-corrected visual acuity (BCVA), slit lamp findings, and treatments.
- Statistical analysis compared outcomes between Hispanic and non-Hispanic groups.
Main Results:
- Hispanic patients (68%) had significantly worse initial and final LogMAR BCVA compared to non-Hispanic patients.
- No significant differences were found in age at presentation, visit frequency, or follow-up duration.
- Ethnicity did not correlate with specific BKC diagnoses or slit lamp findings; corneal stromal scarring was linked to worse initial BCVA.
Conclusions:
- Hispanic pediatric patients with BKC exhibit poorer visual acuity outcomes despite similar clinical presentations and treatments.
- Corneal stromal scarring is an independent risk factor for worse visual acuity in pediatric BKC.
- Further research may explore underlying reasons for ethnic disparities in BKC outcomes.
Objective:
Determine blepharokeratoconjunctivitis (BKC) presentation and outcomes in Hispanic vs. Non-Hispanic pediatric patients.
Methods:
Retrospective review of pediatric patients (< 18 years old) with BKC and at least 2 examinations (2018-2022). Details obtained were self-reported race/ethnicity, best-corrected visual acuity (BCVA), slit lamp findings, and prescribed treatments.
Results:
Ninety-five patients (59 Females) presented at a median of 8.1 [IQR 5.7, 10.9] years of age and had 4 (IQR 3, 4) visits over 1.3 ([QR 0.8, 2.2] years. Sixty-five (68%) patients identified as Hispanic. There was no difference in age at presentation, number of visits, or follow-up between Hispanic and non-Hispanic patients. Initial (0.22 [IQR 0.10, 0.40] vs. 0.06 [IQR 0.00, 0.18], p < 0.01) and final (0.13 [IQR 0.10, 0.40] vs. 0.02 [IQR 0.00, 0.18], p < 0.01) LogMAR BCVA were significantly worse in Hispanic vs. Non-Hispanic patients. Logistic analysis showed an association between Hispanic ethnicity and worse initial and final BCVA. However, ethnicity did not correlate with any subset of BKC diagnoses (e.g. corneal scar or ulcer, chalazion, marginal or superficial keratitis) or slit lamp findings. The presence of corneal stromal scarring was associated with worse initial BCVA, regardless of ethnicity. There were no differences in prescribed treatments between Hispanic and Non-Hispanic patients, and no treatments were associated with visual outcomes.
Conclusions:
BKC was common in Hispanic patients and despite no difference in slit lamp findings or prescribed treatments, Hispanic patients had worse initial and final BCVA. The presence of corneal stromal scarring was also associated with worse visual outcomes.
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