Rural-urban differences in myopia prevalence among myopes presenting to Bhutanese retinal clinical services: a 3-year national study

Bahadur, Bhim; Ashby, Regan; French, Amanda; Maddess, Ted

doi:10.1007/s00417-020-04891-6

Cited by 18 publications

(16 citation statements)

References 38 publications

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“…This phenomenon persisted in the post-COVID-19 epidemic. This result is comparable to the results of previous studies ( 35 , 36 ). This finding suggests that environmental factors may play a major role in the development of myopia in Chinese children ( 37 ).…”

Section: Discussionsupporting

confidence: 92%

Trends of myopia development among primary and junior school students in the post-COVID-19 epidemic period

Zhou

Chen

et al. 2022

Front. Public Health

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PurposeTo investigate the trends of myopia among primary and junior school students in the post-COVID-19 epidemic period.MethodA prospective of cross-sectional study using spot photoscreenings in 123,538 children among primary and junior school students from 2019 to 2021 was conducted to evaluate the development of myopia in Xuzhou, China in the post-COVID-19 epidemic period. Equivalent refraction and the prevalence of myopia were recorded.ResultsThe spherical equivalent refraction of myopia decreased across all grades except grade 1 (0.23 ± 0.56 D in 2019, 0.24 ± 0.63 D in 2020) from 2019 to 2020. However, refraction exhibited a hyperopic shift in 2021 compared to 2020 for grades 1–5 (no significant decreased for grade 4). The prevalence of myopia in all grades increased in 2020 compared to 2019, and the most dramatic changes were observed from grades 2–5 and grades 7–8 (P < 0.05). The changes in myopia prevalence in grades 1–4 were mild, and the reduction in myopia for Grade 5 is significant from 2020 to 2021. Nevertheless, students in grades 6 and 9 exhibited the greatest growth in myopia prevalence (P < 0.01). All grades had higher myopia prevalence in 2021 compared with 2019, except grade 1 (P = 0.25). The prevalence of myopia in girls was higher compared with boys, and the urban myopia prevalence was higher than in rural areas over the 3 years except in 2019 (P = 0.18).ConclusionsThe prevalence of myopia increased during the COVID-19 epidemic. However, the spherical equivalent refraction of lower grade children drifted to hyperopia and the trends of myopia development remained stable in the post-COVID-19 epidemic period. We should be more concerned about the prevalence of myopia in graduating for the primary or junior grades in the future.

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Section: Discussionsupporting

confidence: 92%

Trends of myopia development among primary and junior school students in the post-COVID-19 epidemic period

Zhou

Chen

et al. 2022

Front. Public Health

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“…Majority of such cases were managed with retinal laser. Only a small percentage of anti-VEGF injections was given to mCNVM cases because the prevalence of mCNVM among the myopes in Bhutan was only 0.4% [33]. Other studies have reported that mCNVM occurs in approximately 5-10% of highly myopic patients, and 0.04-0.05% of the general population [34,35].…”

Section: Discussionmentioning

confidence: 99%

Surgical management of vitreoretinal diseases in Bhutan: A 3-year national study

Bahadur¹,

Morley²,

Zangmo³

et al. 2020

New Front Ophthalmol

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Purpose: To describe the pattern of vitreoretinal surgeries performed in Bhutan. This first national study informs policy making and resource development. Methods:We reviewed the surgical registers of the three hospitals in Bhutan providing VR operations or interventional procedures for VR diseases over three years. Patient demography, indications and types of vitreoretinal surgeries were logged and quantified. Comparisons of the expected and observed frequency used Chisquared tests.Results: A total of 214 patients received vitreoretinal surgeries, 36 paediatric cases received examination under anaesthesia for diagnostic confirmation followed by vitreoretinal surgery or retinal laser. Additionally, 381 cases received intravitreal anti-vascular endothelial growth factor injections in the operating theatres as mandated in Bhutan. The mean age was 56.2 ± 22.3 years. The majority, 375 cases (59.4%) were males (p<0.001). The common indications for VR surgery were retinal detachment (45.1%), vitreous haemorrhage (13.6%), and macular hole (7.7%). Retinal detachment surgery was the most common surgery performed, followed by silicon oil removal with cataract surgery. The common indications for anti-vascular endothelial growth factor injection were neovascular age-related macular degeneration (168 cases, 44.12%), retinal vein occlusion (132 cases, 34.6%), and diabetic macular oedema and retinopathy (50 cases, 13.1%). Conclusion:Performing high-tech vitreoretinal surgeries in a resource-limited setting is challenging. With an ever-increasing load of vitreoretinal diseases such as retinal detachment, age-related macular degeneration and macular hole, and the complications of systemic diseases such as retinal vein occlusion, vitreous haemorrhage, and diabetic macular oedema and retinopathy, there is a need to improve vitreoretinal services in Bhutan.

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“…Comparatively, there were very less cases of retinal break availing PLP. This could partly be explained by the low prevalence of myopia in Bhutan [11]. With increasing prevalence of myopia, including pathological myopia, in South-East Asia [27], and high prevalence of myopia, especially among urbanites in Bhutan [11], there is a growing need for screening and treating such complications to prevent vision threatening complications such as RD.…”

Section: Discussionmentioning

confidence: 99%

“…The aim of the current study was to report on the number, indications and types of RLT, including prophylactic laser photocoagulation (PLP) performed in the whole of Bhutan. This is a complementary article to other studies published by the same authors: first, the pattern of vitreoretinal (VR) diseases in Bhutan, which describes about the ocular comorbidities, associated systemic diseases, clinical data, diagnostic tests performed, and treatment strategies [10]; second, rural-urban difference in myopia prevalence in Bhutan, which gives additional information on patient demography [11]; and third, the surgical management of VR diseases in Bhutan [12]. Since this is the first study of RLT in Bhutan, the results have impacts for policy making on the management of VR diseases in Bhutan and other developing countries.…”

Section: Introductionmentioning

confidence: 97%

Retinal laser services in Bhutan: a 3-year national survey

et al. 2020

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Background We conducted this study to report on the indications and types of retinal laser therapy (RLT) performed in Bhutan, knowing which is critical for proper planning and successful delivery of the services. Methods We reviewed the laser registers maintained in the laser rooms and vitreoretinal (VR) operating theatres (including paediatric cases managed under anaesthesia) over three years at the national and the two regional referral hospitals (RRHs). Intraoperative laser treatments (endolaser) were excluded. Patient demography, indications and types of RLT were recorded and quantified. Comparisons of the expected and observed frequencies used Chi-squared tests. Results A total of 685 patients, including 8 cases of bilateral retinopathy of prematurity (ROP) received RLT. The majority of patients (411 cases, 60.0%, p < 0.0001) were males. The mean age was 54.1 ± 14.1 years, median 56 years. The most common indications for RLT were diabetic retinopathy (DR) and diabetic macular oedema (DMO) (542 cases, 66.0%), followed by retinal vein occlusion (RVO) (91 cases, 13.3%). Pan-retinal photocoagulation was the most common type of RLT performed (337 cases, 49.2%), followed by modified grid laser (207 cases, 30.2%), sectoral laser (41 cases, 6.0%), and prophylactic laser photocoagulation (33 cases, 4.8%). Conclusions The majority of patients were within working-age. Common indications for RLT were preventable such as DR, DMO and RVO, indicating need to control systemic diseases such as diabetes, hypertension, and dyslipidaemia. Currently, regular RLT is provided only at the national referral hospital in Thimphu, and periodically in the eastern and central RRHs when the retinal specialist visits. There is need to extend the retinal services to the eastern and central RRHs to improve accessibility and patient coverage in these regions challenged with difficult terrain and poor public transport system.

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Rural-urban differences in myopia prevalence among myopes presenting to Bhutanese retinal clinical services: a 3-year national study

Cited by 18 publications

References 38 publications

Trends of myopia development among primary and junior school students in the post-COVID-19 epidemic period

Trends of myopia development among primary and junior school students in the post-COVID-19 epidemic period

Surgical management of vitreoretinal diseases in Bhutan: A 3-year national study

Retinal laser services in Bhutan: a 3-year national survey

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