Causas de la baja visión en los niños: revisión sistemática / Causes of low vision in children: A systematic review

Objetivo Identificar las enfermedades oculares que se reportan como causas de la baja visión en los niños. Material y métodos La búsqueda sistemática se realizó en Medline (PubMed), Embase y Lilacs. Se seleccionaron estudios observacionales con poblaciones entre 0-18 años de edad, que reportaran datos de agudeza visual entre 20/60-20/400, y que informaran sobre la frecuencia de enfermedades oculares. Se excluyeron los estudios en los que el diagnóstico de la condición no hubiera sido verificado por un profesional, o que abarcaran únicamente casos de ceguera, defectos refractivos no corregidos o ambliopía. La calidad metodológica de los artículos se evaluó mediante el instrumento del Instituto Joanna Briggs para estudios de prevalencia. Resultados Fueron incluidos 27 estudios realizados en Asia (13 publicaciones), África (6 estudios), Oceanía (4 estudios) y Europa y Sudamérica (2 estudios cada uno). Las causas de la baja visión más reportadas fueron: la catarata, con prevalencias comprendidas entre el 0,8 y el 27,2%; el albinismo desde el 1,1 al 47%; el nistagmo, con prevalencias entre el 1,3 y el 22%; las distrofias de retina entre el 3,5 y el 50%; la retinopatía del prematuro (ROP) con prevalencias entre el 1,1 y el 65,8%; la atrofia óptica entre el 0,2 y el 17,6% y el glaucoma entre el 2,4 y el 18,1%. Conclusiones La catarata, el albinismo y el nistagmo son las enfermedades oculares más mencionadas por los estudios como causas de la baja visión en los niños, también enfermedades de la retina tales como la ROP y del nervio óptico como la atrofia. Sin embargo, son numerosas las condiciones oculares que pueden causar la baja visión en la población pediátrica. (AU)

Objective To identify the ocular pathologies that are reported as causes of low vision in children. Material and methods The systematic search was carried out in Medline (PubMed), Embase and Lilacs. Observational studies with populations between 0-18 years of age, reporting visual acuity data between 20/60-20/400 and reporting the frequency of ocular pathologies were selected. Studies in which the diagnosis of the condition had not been verified by a professional, or which covered only cases of blindness, uncorrected refractive errors, or amblyopia, were excluded. The methodological quality of the articles was evaluated using the Joanna Briggs Institute instrument for prevalence studies. Results27 studies conducted in Asia (13 publications), Africa (6 studies), Oceania (4 studies), Europe and South America (2 studies each) were included. The most reported causes of low vision were: cataract, with prevalence between 0.8% and 27.2%; albinism with from 1.1% to 47%; nystagmus, with prevalence between 1.3% and 22%; retinal dystrophies between 3.5% and 50%; retinopathy of prematurity (ROP) with prevalence between 1.1% and 65.8%, optic atrophy between 0.2% and 17.6%, and glaucoma from 2.4% to 18.1%. Conclusions Cataract, albinism and nystagmus are the ocular pathologies most mentioned by studies as a cause of low vision in children, as well as retinal diseases such as ROP and optic nerve diseases such as atrophy. However, there are numerous eye conditions that can result in low vision in the pediatric population. (AU)

Causes of low vision in children: A systematic review.

OBJECTIVE: To identify the ocular pathologies that are reported as causes of low vision in children. MATERIAL AND METHODS: The systematic search was carried out in Medline (PubMed), Embase and Lilacs. Observational studies with populations between 0-18 years of age, reporting visual acuity data between 20/60-20/400 and reporting the frequency of ocular pathologies were selected. Studies in which the diagnosis of the condition had not been verified by a professional, or which covered only cases of blindness, uncorrected refractive errors, or amblyopia, were excluded. The methodological quality of the articles was evaluated using the Joanna Briggs Institute instrument for prevalence studies. RESULTS: 27 studies conducted in Asia (13 publications), Africa (6 studies), Oceania (4 studies), Europe and South America (2 studies each) were included. The most reported causes of low vision were: cataract, with prevalence between 0.8% and 27.2%; albinism with from 1.1% to 47%; nystagmus, with prevalence between 1.3% and 22%; retinal dystrophies between 3.5% and 50%; retinopathy of prematurity (ROP) with prevalence between 1.1% and 65.8%, optic atrophy between 0.2% and 17.6%, and glaucoma from 2.4% to 18.1%. CONCLUSIONS: Cataract, albinism and nystagmus are the ocular pathologies most mentioned by studies as a cause of low vision in children, as well as retinal diseases such as ROP and optic nerve diseases such as atrophy. However, there are numerous eye conditions that can result in low vision in the pediatric population.

Riesgo de catarata en fumadores: metaanálisis de estudios observacionales / Risk of cataract in smokers: A meta-analysis of observational studies

Objetivo: El propósito del estudio fue comparar el riesgo de catarata en fumadores y exfumadores. Métodos: La búsqueda sistemática de estudios observacionales se realizó en las bases de datos Medline, Embase y Lilacs. Se seleccionaron estudios que hubieran evaluado la asociación entre fumar cigarrillos y cualquier tipo de catarata diagnosticada clínicamente. Se extrajeron los estimadores de asociación ajustados al menos por edad y se combinaron mediante modelos de efectos aleatorios, por tipo de estudio observacional (cohorte, casos y controles y transversal), por tipo de catarata (nuclear, cortical o subcapsular posterior) y de exposición (fumador actual o exfumador). Se evaluaron heterogeneidad estadística, análisis de meta-regresión y sesgo de publicación. Resultados: Fueron seleccionados 13 estudios de cohortes, 12 de casos y controles y 18 de corte transversal. Se encontró riesgo de catarata en fumadores actuales: cohortes (OR: 1,41; IC 95%: 1,24-1,60), casos y controles (OR: 1,45; IC 95%: 1,08-1,96) y transversales (OR: 1,21; IC 95%: 1,09-1,34) y riesgo de catarata nuclear: cohortes (OR: 1,71; IC 95%: 1,47-1,98), casos y controles (OR: 1,79; IC 95%: 1,43-2,25) y corte transversal (OR: 1,45; IC 95%: 1,27-1,65). No se observó riesgo de catarata cortical ni subcapsular posterior en exfumadores. Conclusiones: En fumadores existe riesgo de catarata, especialmente de tipo nuclear. Con estudios transversales se obtienen resultados similares a los obtenidos con cohortes y casos y controles

Objective: The aim of the study was to compare the risk of cataract in smokers and ex-smokers. Methods: A systematic search of observational studies was carried out in Medline, Embase, and Lilacs databases. Studies that have evaluated the association between cigarette smoking and any type of clinically diagnosed cataract were selected. The association estimators were extracted, adjusted at least by age, and were combined using random-effects models, by subtype of study (cohort, case control and cross sectional), subtype of cataract (nuclear, cortical, and posterior subcapsular), and exposure (current smoker or ex-smoker). Statistical heterogeneity, meta-regression analysis and publication bias were assessed. Results: A total of 13 cohort studies, 12 case-control studies, and 18 cross-sectional studies were selected. A risk of cataract was found in current smokers: cohort (OR: 1.41; 95% CI: 1.24-1.60), cases and controls (OR: 1.45; 95% CI: 1.08-1.96), and cross-sectional studies (OR: 1.21; 95% CI: 1.09-1.34); risk of nuclear cataract: cohort (OR: 1.71; 95% CI: 1.47-1.98), case-control (OR: 1.79; 95% CI: 1.43-2.25), and cross sectional studies (OR: 1.45; 95% CI: 1.27-1.65). There was no risk of cortical or posterior subcapsular cataract in ex-smokers. Conclusions: There is a risk of cataract in smokers, particularly nuclear type. With cross-sectional studies, similar results are obtained with cohorts and cases and controls

Risk of cataract in smokers: A meta-analysis of observational studies. / Riesgo de catarata en fumadores: metaanálisis de estudios observacionales.

OBJECTIVE: The aim of the study was to compare the risk of cataract in smokers and ex-smokers. METHODS: A systematic search of observational studies was carried out in Medline, Embase, and Lilacs databases. Studies that have evaluated the association between cigarette smoking and any type of clinically diagnosed cataract were selected. The association estimators were extracted, adjusted at least by age, and were combined using random-effects models, by subtype of study (cohort, case control and cross sectional), subtype of cataract (nuclear, cortical, and posterior subcapsular), and exposure (current smoker or ex-smoker). Statistical heterogeneity, meta-regression analysis and publication bias were assessed. RESULTS: A total of 13 cohort studies, 12 case-control studies, and 18 cross-sectional studies were selected. A risk of cataract was found in current smokers: cohort (OR: 1.41; 95%CI: 1.24-1.60), cases and controls (OR: 1.45; 95%CI: 1.08-1.96), and cross-sectional studies (OR: 1.21; 95%CI: 1.09-1.34); risk of nuclear cataract: cohort (OR: 1.71; 95%CI: 1.47-1.98), case-control (OR: 1.79; 95%CI: 1.43-2.25), and cross sectional studies (OR: 1.45; 95%CI: 1.27-1.65). There was no risk of cortical or posterior subcapsular cataract in ex-smokers. CONCLUSIONS: There is a risk of cataract in smokers, particularly nuclear type. With cross-sectional studies, similar results are obtained with cohorts and cases and controls.