10-Year Overview of the Hospital-Based Prevalence and Treatment of Congenital Cataracts: The CCPMOH Experience

Abstract

A review of 6 years of hospitalization charts from Zhongshan Ophthalmic Center (ZOC) revealed that congenital cataracts (CC) accounted for 2.39% of all cataract in-patient cases and that the age at surgery was decreasing before the establishment of the Childhood Cataract Program of the Chinese Ministry of Health (CCPMOH) in December 2010. We aimed to investigate data from the 4 years (January 2011 to December 2014) following the establishment of the CCPMOH, compared, and combined with data from the previous study period (January 2005 to December 2010) to generate a 10-year overview of the hospital-based prevalence and treatment of CC. In the 4-year period after CCPMOH establishment, the prevalence of CC was 2.01% in all hospitalizations, and was 2.78% in all cataract in-patients. Most of the eligible CC in-patients (71%) lived in south China. The ratio of boys to girls was 1.42:1. Nearly 2/3 of the patients underwent cataract extraction with primary intraocular lens (IOL) implantation at a mean age of 78.40±51.45 months, and cataract extraction surgeries without IOL implantation were performed in the remaining 1/3 of patients at a mean age of 10.03±15.92 months. After CCPMOH establishment, an increased incidence of CC was revealed, and the CC in-patients were younger than the patients in the previous period. The 10-year overview (2421 CC in-patients from 206630 hospitalizations) revealed upward trends in both the number and the prevalence of CC and a further reduction in age at surgery. In conclusion, the data from 4-year period after CCPMOH establishment and the 10-year overview showed upward trends in the hospital-based prevalence of CC cases and a further reduction in age at surgery, likely reflecting the effects of the CCPMOH establishment and providing useful information for further CC studies and a valuable foundation for the prevention and treatment of this cause of childhood blindness.

Automatic diagnosis of imbalanced ophthalmic images using a cost-sensitive deep convolutional neural network

“…First, the number of positive samples requiring Nd-YAG (neodymium-doped yttrium aluminum garnet) laser surgery in retro-illumination images is much smaller than the number of negative samples [14]. Second, it is difficult to add additional positive sample images because pediatric cataract images are limited [15, 16]. Third, the high FNR caused by the imbalanced dataset leads to delays in treatment onset, Obstacles to vision development, irreversible amblyopia and even severe vision loss [17].…”

Application of machine learning in ophthalmic imaging modalities

“…Slit-lamp images are essential in the diagnosis of congenital cataracts, a major cause of childhood blindness [101][102][103]. Compared with senile cataract, the phenotype of congenital cataract is far more complicated.…”

Practice patterns in pediatric cataract management: Time for real world data

“…Pediatric cataract management has gained tremendous focus in the past decade. [ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 ] There is a renewed sense that while cataract surgery in adults appears to be evolving at a furious pace that pediatric cataract surgery is perhaps lagging in our understanding of the basic physiological and anatomical issues that play a role in a successful outcome.…”

“…If we look at the numerous papers published on the subject of pediatric cataract, we begin to see that there have been numerous retrospective papers, survey data, one or two randomized control trials, some meta-analysis studies, and a Delphi consensus paper. [ 2 3 5 6 7 8 9 10 11 12 13 14 ] Do we indeed have enough data already to help answer some questions about pediatric cataract management? Maybe so but to develop RWD that leads to RWE the clinical question that we want to ask must be framed appropriately.…”