Congenital cataract: prevalence and surgery age at Zhongshan Ophthalmic Center (ZOC)

Haotian Lin, Ye Yang, Jingjing Chen, Xiaojian Zhong, Zhaochuan Liu, Zhuoling Lin, Wan Chen, Lixia Luo, Bo Qu, Xinyu Zhang, Danying Zheng, Jiao Zhan, Hanfu Wu, Zhirong Wang, Yu Geng, Wu Xiang, Weirong Chen, Yizhi Liu, CCPMOH Study Group, Yizhi Liu, Weirong Chen, Haotian Lin, Jingjing Chen, Zhuoling Lin, Xiaoyan Li, Lixia Luo, Xinyu Zhang, Ye Yang, Danying Zheng, Bo Qu, Daming Deng, Jingchang Chen, Wan Chen, Xiaojian Zhong, Zhaochuan Liu, Jiao Zhan, Hanfu Wu, Zhirong Wang, Yu Geng, Wu Xiang, Haotian Lin, Ye Yang, Jingjing Chen, Xiaojian Zhong, Zhaochuan Liu, Zhuoling Lin, Wan Chen, Lixia Luo, Bo Qu, Xinyu Zhang, Danying Zheng, Jiao Zhan, Hanfu Wu, Zhirong Wang, Yu Geng, Wu Xiang, Weirong Chen, Yizhi Liu, CCPMOH Study Group, Yizhi Liu, Weirong Chen, Haotian Lin, Jingjing Chen, Zhuoling Lin, Xiaoyan Li, Lixia Luo, Xinyu Zhang, Ye Yang, Danying Zheng, Bo Qu, Daming Deng, Jingchang Chen, Wan Chen, Xiaojian Zhong, Zhaochuan Liu, Jiao Zhan, Hanfu Wu, Zhirong Wang, Yu Geng, Wu Xiang

Abstract

Congenital cataract (CC) is the primary cause of treatable childhood blindness. Population-based assessments of prevalence and surgery age of CC, which are critical for improving management strategies, have been unavailable in China until now. We conducted a hospital-based, cross-sectional study of the hospital charts of CC patients younger than 18 years old from January 2005 to December 2010 at Zhongshan Ophthalmic Center (ZOC) in Guangzhou, China. Residence, gender, age at surgery, hospitalization time, and the presence of other ocular abnormalities were extracted and statistically analyzed in different subgroups. The search identified 1314 patients diagnosed with CC from a total of 136154 hospitalizations, which accounted for 2.39% of all the cataract in-patients and 1.06% of the total in-patients over the six-year study period. Of the identified CC patients, 9.2% had ≥ 2 hospitalizations due to the necessity of additional surgeries, with a total ratio of boys to girls of 1.75 ∶ 1. Based on a subgroup analysis according to age, patients 2-6 years old constituted the highest proportion (29.22%) of all hospitalized CC patients, and those 13-18 years old constituted the lowest proportion (13.47%) of the total number. The average age at surgery was 27.62 ± 23.36 months, but CC patients ≤ 6 years old (especially ≤ 6 months old) became increasingly prevalent throughout the 6-year study period. A total of 276 cases (20.93%) of CC were associated with one or more other ocular abnormalities, the highest incidence rates were observed for exotropia (6.24%), nystagmus (6.16%), and refractive error (3.65%). In conclusion, CC patients accounted for 2.39% of all cataract in-patients in a review of 6 years of hospitalization charts from ZOC. The age at the time of surgery decreased over the 6-year study period, which probably reflects the continuing improvement of public awareness of children's eye care in China.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Analysis of the number of…
Figure 1. Analysis of the number of patients in and gender ratio of each age subgroup.
M = months, Y = years.
Figure 2. Numbers of hospitalized patients in…
Figure 2. Numbers of hospitalized patients in the age subgroups (age ≤6 years old vs. >6 years old) in different years (P
Figure 3. Total numbers of hospitalized patients…
Figure 3. Total numbers of hospitalized patients ≤6 months old in different years (P
Figure 4. Distribution of patients with other…
Figure 4. Distribution of patients with other ocular abnormalities.

References

    1. Pi LH, Chen L, Liu Q, Ke N, Fang J, et al. (2012) Prevalence of eye diseases and causes of visual impairment in school-aged children in Western China. J Epidemiol. 22: 37–44.
    1. Foster A, Gilbert C, Rahi J (1997) Epidemiology of cataract in childhood: a global perspective. J Cataract Refract Surg. 23: 601–604.
    1. Bhatti TR, Dott M, Yoon PW, Moore CA, Gambrell D, et al. (2003) Descriptive epidemiology of infantile cataracts in Metropolitan Atlanta, GA, 1968–1998. Arch Pediatr Adolesc Med. 157: 341–347.
    1. Haargaard B, Wohlfahrt J, Fledelius HC, Rosenberg T, Melbye M (2004) A nationwide Danish study of 1027 cases of congenital/infantile cataracts. Ophthalmology. 111: 2292–2298.
    1. Nie WY, Wu HR, Qi YS, Zhang M, Hou Q, et al. (2008) A pilot study of ocular diseases screening for neonates in China. Zhonghua Yan Ke Za Zhi. 44: 497–502. Chinese.
    1. Hu DN (1987) Prevalence and mode of inheritance of major genetic eye diseases in China. J Med Genet. 24: 584–8.
    1. Zhu JF, Zou HD, He XG, Lu LN, Zhao R, et al. (2012) Cross-sectional investigation of visual impairing diseases in Shanghai blind children school. Chin Med J (Engl). 125: 3654–9.
    1. You C, Wu X, Zhang Y, Dai Y, Huang Y, et al. (2011) Visual impairment and delay in presentation for surgery in chinese pediatric patients with cataract. Ophthalmology. 118: 17–23.
    1. Rahi JS, Dezateux C (1999) National cross sectional study of detection of congenital and infantile cataract in the United Kingdom: role of childhood screening and surveillance. BMJ. 318: 362–365.
    1. Ruddle JB, Staffieri SE, Crowston JG, Sherwin JC, Mackey DA (2013) Incidence and predictors of glaucoma following surgery for congenital cataract in the first year of life in Victoria, Australia. Clin Experiment Ophthalmol. 41: 653–61.
    1. Randrianotahina HC, Nkumbe HE (2014) Pediatric cataract surgery in Madagascar. Niger J Clin Pract. 17: 14–7.
    1. Birch EE, Cheng C, Stager DR Jr, Weakley DR Jr, Stager DR Sr (2009) The critical period for surgical treatment of dense congenital bilateral cataracts. J AAPOS. 13: 67–71.
    1. Lin HT, Luo LX, Chen WR, Liu YZ (2012) Eye health is everyone’s responsibility: China’s first Western-style eye hospital improves in the prevention of blindness. Int J Ophthalmol. 5: 638–40.
    1. Lin H, Chen W, Luo L, Congdon N, Zhang X, et al. (2012) Effectiveness of a short message reminder in increasing compliance with pediatric cataract treatment: a randomized trial. Ophthalmology. 119(12): 2463–70.
    1. Luo L, Lin H, Chen W, Wang C, Zhang X, et al. (2013) In-the-bag intraocular lens placement via secondary capsulorhexis with radiofrequency diathermy in pediatric aphakic eyes. PLoS One. 24 8: e62381.
    1. Lin H, Chen W, Luo L, Zhang X, Chen J, et al. (2013) Ocular hypertension after pediatric cataract surgery: baseline characteristics and first-year report. PLoS One. 29 8: e69867.
    1. Chen W, Chen X, Hu Z, Lin H, Zhou F, et al. (2013) A missense mutation in CRYBB2 leads to progressive congenital membranous cataract by impacting the solubility and function of βB2-crystallin. PLoS One. 28 8: e81290.
    1. Muir KW, Gupta C, Gill P, Stein JD (2013) Accuracy of international classification of diseases, ninth revision, clinical modificationbilling codes for common ophthalmic conditions. JAMA Ophthalmol. 131(1): 119–20.
    1. Trumler AA (2011) Evaluation of pediatric cataracts and systemic disorders. Curr Opin Ophthalmol. 22: 365–79.
    1. Chak M, Wade A (2006) Rahi JS. British Congenital Cataract Interest Group (2006) Long-term visual acuity and its predictors after surgery for congenital cataract: Findings of the British Congenital Cataract Study. Invest Ophthalmol Vis Sci 47: 4262–9.
    1. Shah MA, Shah SM, Shah AH, Pandya JS (2014) Visual outcome of cataract in pediatric age group: does etiology have a role. Eur J Ophthalmol. 24: 76–83.
    1. Skalicky SE, White AJ, Grigg JR, Martin F, Smith J, et al. (2013) Microphthalmia, anophthalmia, and coloboma and associated ocular and systemic features: understanding the spectrum. JAMA Ophthalmol. 131: 1517–24.
    1. France TD, Frank JW (1984) The association of strabismus and aphakia in children. J Pediatr Ophthalmol Strabismus 21: 223–226.
    1. Hiles DA, Sheridan SJ (1977) Strabismus associated with infantile cataracts. Int Ophthalmol Clin 17: 193–202.
    1. Robin AL, Thulasiraj RD (2012) Cataract blindness. Arch Ophthalmol. 130: 1452–5.
    1. Rahi JS, Dezateux C (2000) Congenital and infantile cataract in the United Kingdom: underlying or associated factors. British Congenital Cataract Interest Group. Invest Ophthamol Vis Sci 41: 2108–2113.
    1. Fallaha N, Lambert SR (2001) Pediatric cataracts. Ophthalmol Clin North Am 14: 479–492.
    1. Bronsard A, Geneau R, Shirima S, Courtright P, Mwende J (2008) Why are children brought late for cataract surgery? Qualitative findings from Tanzania. Ophthalmic Epidemiol 15: 383–388.
    1. Sisk RA, Berrocal AM, Feuer WJ, Murray TG (2010) Visual and anatomic outcomes with or without surgery in persistent fetal vasculature. Ophthalmology 117: 2178–83.
    1. Garza RM, Rodriguez AM, Ramirez OMA (2000) Long-term visual results in congenital cataract surgery associated with preoperative nystagmus. Arch Med Res 31: 500–504.

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