A Randomized, Clinical Trial Evaluating Ready-Made and Custom Spectacles Delivered Via a School-Based Screening Program in China

被引:54
作者
Zeng, Yangfa [1 ,2 ]
Keay, Lisa [3 ,4 ]
He, Mingguang [1 ,2 ]
Mai, Jingcheng [5 ]
Munoz, Beatriz [3 ]
Brady, Christopher [3 ]
Friedman, David S. [2 ,3 ]
机构
[1] Sun Yat Sen Univ, Zhongshan Ophthalm Ctr, State Key Lab Ophthalmol, Guangzhou 510275, Guangdong, Peoples R China
[2] Helen Keller Int, New York, NY USA
[3] Johns Hopkins Univ, Wilmer Eye Inst, Dana Ctr Prevent Ophthalmol, Baltimore, MD 21218 USA
[4] Univ Sydney, George Inst Int Hlth, Sydney, NSW 2006, Australia
[5] Guangzhou Sch Hlth Stn, Guangzhou, Guangdong, Peoples R China
基金
英国医学研究理事会;
关键词
REFRACTIVE ERROR; VISUAL IMPAIRMENT; CHILDREN; POPULATION; BLINDNESS; AFRICA; NEED;
D O I
10.1016/j.ophtha.2009.04.004
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Purpose: We sought to evaluate visual performance and satisfaction with ready-made spectacles (RMS) in Chinese school-aged children with uncorrected refractive error. Design: Randomized, double-blind, clinical trial. Participants: Junior high school students from urban Guangzhou, China, aged approximately 12 to 15 years with >= 1 diopter (D) of uncorrected spherical equivalent (SE) refractive error. Students were excluded with >= 2.00 D astigmatism, >= 2 D myopic anisometropia, and >= 1 D hyperopic anisometropia and ocular disease affecting vision. Methods: Refractive error was determined by cycloplegic subjective refraction. Students were randomly assigned to receive RMS or custom spectacles (CS) and assessed after 1 month of use. We required 175 students to complete in each arm to be able to measure a 15% difference in compliance. Main Outcome Measures: Compliance with spectacles lens wear, patterns of use, vision, symptoms, and perceived value. Results. Screening identified 965 of 4607 (20.9%) students with reduced distance vision; 212 of the 965 (22.0%) refused evaluation and 187 of the 965 (20.8%) had <1 D of SE refractive error. Sixty-one (6.3%) were referred for further evaluation and the remaining 495 (51.3%) participated. Social, demographic, and ocular parameters were similar in the 2 groups. Average SE refractive error was -2.57 +/- 1.31 (mean value standard deviation [SD]). Spectacle vision (Snellen acuity, mean SD) was worse with RMS in the eye with lower SE (20/25(-0.5) +/- 0.9 lines vs 20/25(+1) +/- 0.7 lines; P = 0.004) and higher SE (20/25(-2) +/- 1.2 lines vs 20/25(+1) +/- 0.8; P<0.001). There were no differences (P>0.05) in the rate of use (94.3% vs 92.2%), wearing to the 1-month visit (46.9% vs 51.5%), planned use (93.3% vs 93.7%), value (89.5% vs 91.7% "moderate or high value or most valued possession"), or symptoms (blur, 21.1% vs 19.4% [P = 0.8] and other symptoms [P>0.2]). Conclusions: Although visual acuity was better with CS, no difference was found in acceptability in this population of students with predominantly simple myopic refractive error. This study supports the use of RMS in a school-based refractive services program, saving costs and improving the logistics of service delivery. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references. Ophthalmology 2009; 116:1839-1845 (C) 2009 by the American Academy of Ophthalmology.
引用
收藏
页码:1839 / 1845
页数:7
相关论文
共 16 条
[1]   The possible effect of undercorrection on myopic progression in children [J].
Adler, Daniel ;
Millodot, Michel .
CLINICAL AND EXPERIMENTAL OPTOMETRY, 2006, 89 (05) :315-321
[2]   Cost-effectiveness of screening and correcting refractive errors in school children in Africa, Asia, America and Europe [J].
Baltussen, Rob ;
Naus, Jeroen ;
Limburg, Hans .
HEALTH POLICY, 2009, 89 (02) :201-215
[3]   Correction of refractive error in the adult population of Bangladesh: Meeting the unmet need [J].
Bourne, RRA ;
Dineen, BP ;
Huq, DMN ;
Ali, SM ;
Johnson, GJ .
INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, 2004, 45 (02) :410-417
[4]   Affordable ready-made spectacles for use in blindness prevention programmes: setting standards of quality [J].
Brian, Garry ;
du Toit, Renee ;
Wilson, David ;
Ramke, Jacqueline .
CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY, 2006, 34 (07) :722-724
[5]   The association between refractive cutoffs for spectacle provision and visual improvement among school-aged children in South Africa [J].
Congdon, Nathan G. ;
Patel, Nita ;
Esteso, Paul ;
Chikwembani, Florence ;
Webber, Fiona ;
Msithini, Robert Bongi ;
Ratcliffe, Amy .
BRITISH JOURNAL OF OPHTHALMOLOGY, 2008, 92 (01) :13-18
[6]  
FLEDELIUS HC, 1984, ACTA OPHTHALMOL, V62, P391
[7]  
Gilbert C, 2001, B WORLD HEALTH ORGAN, V79, P227
[8]  
He MG, 2005, OPTOMETRY VISION SCI, V82, P229, DOI 10.1097/01.OPX.0000159362.48835.16
[9]   Refractive error and visual impairment in urban children in southern China [J].
He, MG ;
Zeng, JW ;
Liu, YZ ;
Xu, JJ ;
Pokharel, GP ;
Ellwein, LB .
INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, 2004, 45 (03) :793-799
[10]   Factors associated with spectacle-wear compliance in school-aged Mexican children [J].
Holguin, AMC ;
Congdon, N ;
Patel, N ;
Ratcliffe, A ;
Esteso, P ;
Flores, ST ;
Gilbert, D ;
Rito, MAP ;
Munoz, B .
INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, 2006, 47 (03) :925-928