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Jack Benjamin Margines, Andrew Young, Connie Huang, Fei Yu, Anne L Coleman; Epidemiological characteristics of astigmatism among a population of pre-school children in Los Angeles, California. Invest. Ophthalmol. Vis. Sci. 2019;60(9):4426.
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© ARVO (1962-2015); The Authors (2016-present)
Astigmatism is a major cause of visual impairment in children, and disparities among groups affected have previously been reported. We aim to characterize the prevalence of astigmatism among the heretofore largest published sample of preschool children, and to do so among different age, gender, and racial/ethnic subgroups.
This study leverages previous data which demonstrated that there is a high level of agreement between non-cycloplegic and cycloplegic cylinder measurements using the Retinomax autorefractor. The UCLA Preschool Vision Program screened preschoolers in Los Angeles county using a Retinomax autorefractor between 2012 and 2017. Children aged 3-5 years who were successfully screened were included in the study. Spherical and cylindrical refraction, with axis, was recorded. Astigmatism, defined as 1.50D or more of cylinder on non-cycloplegic autorefraction, was the dependent variable. Contingency tables were created to look at the following independent variables: age, race/ethnicity, gender. Chi-square analyses were performed.
Data from the right eyes of 80,422 preschoolers (49.1% female, 84.2% Latino, mean age 3.75 ± 0.61 years) were analyzed. Of this population, 12.3% were astigmatic. The prevalence of astigmatism among 3-, 4-, and 5-year-olds was 11.3%, 11.6%, and 10.6%, respectively; this change is statistically significant between the 4th and 5th years of age (p=0.01). The prevalence of astigmatism varied significantly by ethnicity as well: 13.5% for Latino, 9.7% for Black, 7.8% for Asian, and 5.3% for White (p<0.01). The prevalence among females was 12.5%, and among males 12.1% (p=0.03).
The prevalence of astigmatism decreases significantly between the 4th and 5th years of age and is slightly higher among females. The data further demonstrate that Latino children in Los Angeles have significantly higher rates of astigmatism, similar to research published by MEPEDS and VIP. As this population is known to experience more difficulty in accessing medical care, these results emphasize the need for comprehensive school-based screening, especially among Latino enclaves in Los Angeles.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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