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Maria del Pilar Gonzalez Diaz, Agnes Wong; The Prevalence of Infantile Esotropia in Children of Chinese Descent. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5664.
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The prevalence of strabismus varies according to the population studied, ethnicity, and geographic area. Previous studies in Asian population have found that, unlike those in western countries, esotropia is much less common (2.5x) than exotropia. Because of the homogeneous nature of the population studied, however, it is difficult to ascertain whether there is a real difference in the epidemiology among ethnic groups. The aim of the study is to determine the prevalence of infantile esotropia (IET), in otherwise healthy cohort of Chinese and non-Chinese children referred to a tertiary eye center in a large center in North America that serves a ethnically-diverse population of over 8 million. We hypothesize that the prevalence of IET is significantly lower in patients of non-Chinese descent than those of Chinese descent.
A retrospective chart review was conducted on patients referred for possible IET between January 2004 and June 2012. Demographic data including gender, age at referral, family history of strabismus, medical history, refractive error, final diagnosis, and strabismus surgery history were recorded. Patients were classified as Chinese and non-Chinese based on their last names. Analysis of last names has been used in epidemiology and population-based studies to identify people of Chinese origin. Patients who were referred after age 2 or those with comorbidities (e.g., low birth weight, prematurity, neurological disorders, Down syndrome, developmental delay) were excluded. Patients were divided into two groups based on the final diagnosis: IET and no IET.
256 patients were included in the analysis. There were 20 (7.8%) patients of Chinese descent and 236 (92.2%) of non-Chinese decent. Of these 20 children, only one was diagnosed with IET, giving a prevalence of IET of 5.0% (1/20) in patients of Chinese descent. IET was diagnosed in 129 patients of non-Chinese descent, giving a prevalence of IET of 54.6% (129/236), which is significantly higher than that in Chinese patients (Fisher’s exact, p<0.001).
The prevalence of IET is significantly higher in healthy patients of non-Chinese descent (54.6%) than those of Chinese descent (5.0%). With growing global immigration, the ethnic composition of developed countries will continue to change. Improved understanding of racial variations in epidemiology and disease features will allow us to better serve our increasingly diverse population.
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