Sociodemographic Disparities in Uncorrectable Visual Impairment Among US Adolescents

IF 4.1 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology Pub Date : 2025-02-24 DOI:10.1016/j.ajo.2025.02.032

Owais Fazal , Natalie Slopen , Alison A. Galbraith , David G. Hunter , Eric D. Gaier , Isdin Oke

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引用次数: 0

Abstract

Purpose

To estimate the prevalence of uncorrectable visual impairment and to identify sociodemographic factors associated with such impairment among US adolescents.

Design

Cross-sectional study.

Setting

1999 to 2008 National Health and Nutrition Examination Survey.

Study population

Adolescents (age 12-19 years).

Observation

Best-corrected visual acuity.

Outcome Measures

Prevalence of unilateral uncorrectable visual impairment, defined as best-corrected visual acuity of 20/40 or better in one eye with greater than 2 lines of visual acuity asymmetry, and of bilateral uncorrectable visual impairment, defined as best-corrected visual acuity worse than 20/40 in both eyes. Multivariable logistic regression was used to identify sociodemographic factors (race and ethnicity, caregiver education, household income, food security, citizenship status, health insurance type, and healthcare access) associated with uncorrectable visual impairment, adjusting for age and sex.

Results

The survey identified 9949 participants (mean [SD] age, 15.86 [2.27] years; 4914 female participants [49%]). The prevalence estimate of uncorrectable visual impairment was 4.0% (491 participants, 95% confidence intervals [CI] 3.4%-4.7%). After adjusting for age and sex, there were increased odds of uncorrectable visual impairment among those with family income below poverty level (odds ratio [OR], 1.59; 95% CI, 1.14-2.22) compared to poverty level and above, those with Mexican-American ethnicity (OR, 1.64; 95% CI, 1.18-2.29) or non-Hispanic Black race (OR, 1.43; 95% CI, 1.03-1.99) compared to non-Hispanic White race, those with food insecurity (OR, 1.67; 95% CI, 1.21-2.32), those with caregiver education below high school (OR, 1.68; 95% CI, 1.24-2.28), those with public insurance (OR, 1.67; 95% CI, 1.21-2.30), and those with no insurance (OR, 1.71; 95% CI, 1.12-2.59) compared to those with private insurance.

Conclusions

Socioeconomic disparities in the prevalence of uncorrectable visual impairment are evident by adolescence. Interventions to treat amblyopia, the most common cause of uncorrectable vision loss, have limited efficacy in late childhood. Efforts are needed to identify and treat amblyopia in socioeconomically disadvantaged populations at an earlier age to prevent permanent vision loss.

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美国青少年中无法矫正视力障碍的社会人口差异。

目的：估计美国青少年中不可矫正性视力损害的患病率，并确定与这种损害相关的社会人口因素。设计：横断面研究。方法：背景：1999-2008年全国健康与营养调查（NHANES）研究人群：青少年（12-19岁）观察：最佳矫正视力结果测量：单侧不可矫正视力障碍的患病率，定义为单眼最佳矫正视力为20/40或更好，视力不对称大于2线，双侧不可矫正视力障碍的患病率，定义为双眼最佳矫正视力低于20/40。采用多变量logistic回归确定与不可矫正视力障碍相关的社会人口因素（种族和民族、照顾者教育程度、家庭收入、食品安全、公民身份、健康保险类型和医疗保健获取），并对年龄和性别进行调整。结果：共纳入9949名参与者(平均[SD]年龄15.86[2.27]岁；4914名女性参与者[49%])。不可矫正性视力损害的患病率估计为4.0%（491名参与者，95% CI 3.4-4.7%）。在调整了年龄和性别后，家庭收入低于贫困水平的人群出现不可矫正视力障碍的几率增加(OR, 1.59；95% CI, 1.14-2.22)与墨西哥裔美国人(OR, 1.64；95% CI, 1.18-2.29)或非西班牙裔黑人种族(or, 1.43；95% CI, 1.03-1.99)与非西班牙裔白人相比，那些有食物不安全的人(OR, 1.67；95% CI, 1.21-2.32)，照顾者受教育程度低于高中(OR, 1.68；95% CI, 1.24-2.28)，公共保险患者(OR, 1.67；95% CI, 1.21-2.30)和无保险(OR, 1.71；95% CI, 1.12-2.59)。结论：不可矫正性视力障碍患病率的社会经济差异在青少年中是明显的。弱视是导致无法矫正的视力丧失的最常见原因，治疗弱视的干预措施在儿童晚期的疗效有限。需要努力在社会经济条件较差的人群中及早发现和治疗弱视，以防止永久性视力丧失。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.