Analysis of Clinical Changes in Pediatric Low Vision Patients

Won Soo Kim; Nam Ju Moon

doi:10.3341/jkos.2015.56.8.1256

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Kim and Moon: Analysis of Clinical Changes in Pediatric Low Vision Patients

Original Article

J Korean Ophthalmol Soc 2015;56(8):1256-1262.

Published online: 29 August 2015

DOI: https://doi.org/10.3341/jkos.2015.56.8.1256

Analysis of Clinical Changes in Pediatric Low Vision Patients

Won Soo Kim, M.D., Nam Ju Moon, M.D., PhD

Department of Ophthalmology, Chung-Ang University College of Medicine, Seoul, Korea

Address reprint requests to Nam Ju Moon, MD, PhD Department of Ophthalmology, Chung-Ang University Hospital, #102 Heukseok-ro, Dongjak-gu, Seoul 156-755, Korea Tel: 82-2-6299-1687, Fax: 82-2-825-1666 E-mail: njmoon@chol.com

Received 13 March 201526 May 2015 Accepted 6 July 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To analyze the clinical changes in pediatric low-vision patients under 15 years of age. Methods: We compared pediatric low-vision patients under 15 years of age with subjects from 1995 to 2000 (past group, sub-jects from our previous study) and from 2004 to 2014 (present group). A retrospective chart review was performed of 109 pa-tients from the present group, including epidemiological characteristics and prescribed aids.

Results

The mean age in the present group was 8.6 years and decreased by 1.1 years compared with the past group. The per-centage of pediatric patients under 15 years of age increased from 31.9% to 36.1%; however, there was no statistical sig-nificance ( p = 0.241). The treatable or preventable diseases including congenital cataract and glaucoma decreased significantly from 23.4% to 11.9% ( p = 0.021). The percentage of 0.1 or better in near and distant visual acuity increased significantly from 60.5% and 54.0% to 85.4% and 67.9%, respectively ( p = 0.027 and p < 0.001, respectively). The number of subjects prescribed 2 or more low vision aids and new portable electronic magnifying devices was significant.

Conclusions

Recent changes including decreased mean age, reduced treatable or preventable diseases, and increased per-centage of pediatric patients might correlate to social services. Early detection is important for rehabilitation and quality of life in low vision patients, thus promotion and expansion of social services is necessary. In addition, because the proportion of novel low vision aids has increased, ophthalmologists should stay current on technology improvements.

Keywords: Clinical changes, Pediatric low vision

References

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Figure 1.

Electronic magnifying device (mouse type).

Table 1.

Demographics of participants

	Past (1995-2000)	Present (2004-2014)	p-value
Total subjects	137	109
M:F	85:52	59:50	1.567 ( p = 0.211)^∗
Mean age (years)
Male	9.8	8.7 ± 3.4	p = 0.337^†
Female	9.5	8.6 ± 3.8
Total	9.7	8.6 ± 3.6
Percentage of ≤15 years old	31.9%	36.1%	1.372 ( p = 0.241)^∗

Values are presented as mean ± SD unless otherwise indicated.

^∗ Chi-square ( p-value);

^† Student’s t-test between male and female of the present group.

Table 2.

Distribution of diagnosis

Diagnosis	Past (1995-2000)	Present (2004-2014)
Preventable or treatable (n, %)
Retinopathy of prematurity	10 (7.3)	7 (6.4)
Congenital cataract	17 (12.4)	6 (5.5)
Congenital glaucoma	2 (1.5)	0
Retinal detachment	2 (1.5)	0
Retinoblastoma	1 (0.7)	0
Total	32 (23.4)	13 (11.9)
Unpreventable or untreatable
Optic atrophy	57 (41.6)	30 (27.5)
Albinism	10 (7.3)	18 (16.5)
Macular dystrophy and degeneration	13 (9.5)	17 (15.6)
Nystagmus	0	13 (11.9)
Retinitis pigmentosa	1 (0.7)	4 (3.6)
Morning glory syndrome	0	3 (2.8)
LHON	0	3 (2.8)
Optic nerve hypoplasia	0	3 (2.8)
Cortical visual impairment	0	3 (2.8)
Aniridia	6 (4.4)	1 (0.9)
Stargardt’s disease	2 (1.5)	1 (0.9)
PHPV	6 (4.4)	0
Corneal opacity	3 (2.2)	0
Micropthalmos	3 (2.2)	0
Peter’s anomaly	1 (0.7)	0
Sixth nerve palsy	1 (0.7)	0
Retinal dystrophy	1 (0.7)	0
FEVR	1 (0.7)	0
Total ^∗	105 (76.6)	96 (88.1)
Chi-square test ( p-value)^∗	5.307 ( p = 0.021)

LHON = Leber’s hereditary optic neuropathy; PHPV = persistent hyperplastic primary vitreous; FEVR = familial exudative vitreoretinopathy.

^∗ Between ‘Preventable or Treatable’ and ‘Unpreventable or Untreatable’ of the past and the present.

Table 3.

Distribution of distant and near visual acuity

Visual acuity	Distant		Near
Visual acuity	Visual acuity	Past (1995-2000)	Present (2004-2014)	Past (1995-2000)	Present (2004-2014)
L.P(+)-0.01	18 (13.1%)	4 (3.7%)	2 (1.5%)	2 (1.8%)
0.02-0.04	19 (13.9%)	23 (21.1%)	13 (9.5%)	2 (1.8%)
0.05-0.09	26 (19.0%)	8 (7.3%)	39 (28.5%)	12 (11.0%)
0.1-0.29	64 (46.7%)	72 (66.1%)	65 (47.4%)	57 (52.3%)
0.3-0.5	10 (7.3%)	2 (1.8%)	18 (13.1%)	36 (33.1%)
Total	137 (100%)	109 (100%)	137 (100%)	109 (100%)
Chi-square test ( p-value)^∗	4.8796 ( p = 0.027)	17.103 ( p	< 0.001)

L.P = light perception.

^∗ Between L.P(+)-0.09 and 0.1-0.5 of the past and the present.

Table 4.

Low vision aids for near vision

	Past (1995-2000)	Present (2004-2014)
Conventional low vision aids
Magnifier (n, %)
Light gathering magnifier	41 (36.9)	26 (23.0)
Hand-held magnifier	21 (18.9)	41 (36.3)
Stand magnifier	12 (10.8)	4 (3.5)
Glasses (n, %)
Prismatic glasses	5 (4.5)	2 (1.8)
High plus reading glasses	2 (1.8)	1 (0.9)
Clip-on microscope	2 (1.8)	6 (5.3)
Clear image (n, %)	14 (12.6)	7 (6.2)
Telemicroscope (n, %)	12 (10.8)	0
CCTV (n, %)	2 (1.8)	3 (2.6)
Newly prescribed aids (n, %)
Electronic magnifying device (Pocket viewer)		15 (13.3)
Electronic magnifying device (mouse type)		2 (1.8)
Electronic magnifying device (other type)		5 (4.4)
Portable CCTV		1 (0.9)
Total (n, %)		111 (100)	113 (100)

CCTV = closed-circuit television.

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