Does Ethnic Variation of the Orbit Determine the Prevalence of Horizontal Strabismus?

眼眶的种族差异是否决定了水平斜视的患病率？

基本信息

批准号：
10459569
负责人：
CHRISTOPHER S VON BARTHELD
金额：
$ 17.62万
依托单位：
UNIVERSITY OF NEVADA RENO
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-08-01 至 2024-07-31
项目状态：
已结题

项目摘要

The prevalence of horizontal strabismus differs dramatically between studies for reasons that are not clear. Our preliminary data show that ethnicity is a major factor: some populations have much more esotropia than exotropia, while other populations have much more exotropia than esotropia. Older literature suggested that differences in the interpupillary distance may be responsible for ethnic differences in strabismus, but this has never been systematically explored. Because of the largely undefined ethnic variations, the global prevalence of strabismus is currently unknown. Furthermore, the prevalence within the same ethnicity has never been longitudinally compiled and compared. This lack of information about local and global prevalence makes it impossible to determine trends and to compare them with trends of major risk factors and thus define underlying causes or predispositions for strabismus. This impedes the planning of health care that will be needed in the future. Here, we propose to solve these problems by conducting secondary data analyses. Aim 1: Compile ALL relevant studies and publish a systematic review of the prevalence of horizontal strabismus throughout the world, taking into account ethnic variations and methodology bias. This will provide a much-needed reference guide and allow to estimate the true global prevalence. Aim 2: Examine the distribution of three orbital parameters that are ethnically distinct: interpupillary distance, proptosis, and interorbital width, and discern which parameters (or combination of parameters) best explains the ethnic variation of horizontal strabismus prevalence and patterns. This will provide an evidence-based framework to understand the current ethnic variations and their evolutionary history. Aim 3: Determine the trends (over the last 50-150 years) in prevalence of horizontal strabismus and compare them with local trends for major risk factors of strabismus. This will identify effective risk factors in local populations – which is relevant for planning purposes and for targeted health care initiatives. Our multidisciplinary team of investigators will move the field forward by establishing population-based prevalence numbers for each of the major ethnicities. This is important to provide a comprehensive reference work for future studies. The true prevalence in different countries and ethnicities is important for health care planning purposes. The second aim will inform which key anatomical features of the orbit underlie ethnic differences, with evolutionary, developmental and clinical implications. This will provide a novel conceptual framework of the impact of orbital parameters for strabismus. Finally, consideration of a much larger number of studies and populations throughout the world (~500 vs. ~30 in previous reviews) will allow us to define trends in prevalence and to compare such trends with those of major risk factors of strabismus within those same populations. This will inform which risk factors (e.g., maternal smoking, Cesarean section) likely affect prevalence rates in distinct populations.

不同研究之间水平斜视的患病率存在显着差异，原因尚不清楚。我们的初步数据显示，种族是一个主要因素：某些人群的内斜视程度比其他人群高得多。外斜视，而其他人群的外斜视比内斜视多得多。瞳距的差异可能是导致斜视种族差异的原因，但这已经由于很大程度上未明确的种族差异，全球患病率从未被探索过。此外，斜视在同一种族中的患病率目前尚不清楚。由于缺乏有关当地和全球患病率的信息，因此进行了纵向汇编和比较。无法确定趋势并将其与主要风险因素的趋势进行比较，从而定义斜视的根本原因或倾向阻碍了医疗保健的规划。在这里，我们建议通过进行二次数据分析来解决这些问题。目标 1：汇编所有相关研究并发表对横向流行病学的系统评价考虑到种族差异和方法偏差，这将在世界各地进行。提供急需的参考指南，并可以估计真实的全球患病率。目标 2：检查种族不同的三个轨道参数的分布：瞳距、突眼和眶间宽度，并辨别哪些参数（或参数组合）最能解释这将提供基于证据的水平斜视患病率和模式的种族差异。框架来了解当前的种族差异及其进化历史。目标 3：确定水平斜视和斜视患病率的趋势（过去 50-150 年）将它们与当地斜视主要危险因素的趋势进行比较，这将确定斜视的有效危险因素。当地人口——这与规划目的和有针对性的医疗保健举措相关。我们的多学科研究团队将通过建立基于人口的每个主要种族的患病率数据对于提供全面的数据非常重要。未来研究的参考工作对于不同国家和种族的真实患病率非常重要。第二个目标是了解眼眶的哪些关键解剖特征。种族差异，具有进化、发育和临床意义，这将提供一种新颖的方法。最后，考虑轨道参数对斜视的影响。全世界范围内更多的研究和人群（约 500 项对比之前的评论中的约 30 项）将让我们能够定义流行趋势，并将这种趋势与主要风险因素的趋势进行比较这将揭示哪些危险因素（例如，母亲吸烟、剖腹产）可能会影响不同人群的患病率。