| Part Ⅰ: A retrospective study of 10-year visits of amblyopic children in Affiliated Hospital of Qingdao UniversityPurpose:To review 10 years of amblyopia patient visits and analyze the trends in the number of initial visits of amblyopia patients in different years and months,the differences in the number and proportion of initial visits by gender and age,and the changes in the follow-up interval,so as to provide a reference for guiding amblyopia screening,follow-ups,and the allocation of medical resources for amblyopia specialties in tertiary hospitals.Method:1.The medical records of amblyopic patients attending the ophthalmology department of the Affiliated Hospital of Qingdao University from July 2012 to September 2021 were extracted using the "data process & application platform(DPAP)" of YIDUCLOUD,and a retrospective study of the basic information and follow-up visits of amblyopic patients was conducted.2.Trend charts were used to observe the trends in the number of initial amblyopia cases,age at initial visits,and follow-up interval,and to develop an autoregressive integrated moving average(ARIMA)model for prediction.3.The Chi-square test was used to analyze differences in the sex ratio between years in the number of initial amblyopia cases.4.The Kruskal-Wallis H-test was used to analyze differences in the number of initial amblyopia cases compared between months,and we built a seasonal ARIMA model to observe its seasonality.5.The ANOVA and the two-comparison method LSD-t test were used to analyze the interval differences in amblyopia follow-up between years.Result:1.The number of initial amblyopia cases showed an upward trend from 2013—2017 and a downward trend from 2017—2020.2.The number of initial amblyopia cases showed a seasonal pattern,with differences between months(P=0.001),with the highest number of cases in the summer months of July(106.20±32.39)and August(116.30±38.78),both significantly higher than in all other groups(P<0.05).3.The mean age at initial visits of amblyopia patients gradually decreased during the 10-year period 2012–2021,with a percentage of 22.24% of children over 8 years old and 16.27% in2021.4.The follow-up interval was significantly shorter in 2012 than in 2013–2021(P<0.05),the difference was not significant in 2014—2018,and it was significantly longer in 2019,2020, and 2021 than in 2012–2018(P<0.05).The follow-up interval in 2020(145.05±94.54)was the longest,with a statistically significant difference compared to the other years(P<0.05).5.There was an overall upward trend in the number of people with a follow-up interval of more than one year from 2013 to 2019,with the highest number of people(402 cases)and the highest percentage(40.52%)in 2019.Conclusion:1.The initial visits of amblyopia patients at the Affiliated Hospital of Qingdao University gradually became younger during the 10-year period from 2012—2021,but about 1/5 of the patients were still not seen and treated in time before the critical period,suggesting the need to improve the screening system and strengthen the popularization of science.2.Summer holidays(July and August)are the peak period for initial visits of amblyopia,suggesting that medical institutions need to make full use of holidays and rationalize the allocation of specialist doctors and the vision screening schedules.3.The longest follow-up interval was in 2020,and the highest proportion of people with a follow-up interval of more than one year was in 2019,the main factor being the epidemic of Corona Virus Disease 2019(COVID-19).Part Ⅱ: Obervation and reflection on follow-up time and the curative effect of amblyopia in children during the epidemic period of COVID-19Purpose:To investigate whether the follow-up interval for amblyopia can be appropriately extended by comparing the improvement in best corrected visual acuity(BCVA)in both eyes of patients who had extended follow-up due to COVID-19 with those who had regular follow-up and the factors associated with the improvement in patients’ visual acuity during extended follow-up.Method:1.Medical records of children with refractive and strabismic amblyopia who were followed up at Qingdao University Hospital from January to December 2020 for extended follow-up intervals of 6 months or more for amblyopia occlusion treatment due to the impact of the COVID-19 epidemic were collected.2.The Wilcoxon paired rank test was used to compare the difference in BCVA improvement at extended follow-up(≥6 months)versus routine follow-up(2~3 months).3.The Kruskal-Wallis H test was used to assess the difference in improvement of BCVA in amblyopic eyes at extended follow-up under different classifications of amblyopia and treatment periods.4.The Wilcoxon rank test was used to assess the difference in BCVA improvement in amblyopic eyes during the extended follow-up period under different compliance classifications.5.Spearman’s correlation analysis was used to assess the relationship between BCVA improvement and age,treatment period,follow-up interval,and compliance.Result:1.There was no significant difference in BCVA improvement between extended and routine follow-up intervals for the amblyopic and dominant eyes(P=0.896,0.820).2.There was no significant difference in BCVA improvement between the extended and routine follow-up intervals in the amblyopic and dominant eyes for patients with different classifications of amblyopia and treatment periods(P>0.05).3.BCVA improvement was greater at extended follow-up than at regular follow-up for those with good compliance,with a statistically significant difference(P=0.031);BCVA improvement was worse at extended follow-up than at regular follow-up for those with fair or poor compliance(P=0.002).4.There was no significant difference in the improvement of BCVA in amblyopic eyes with different classifications of amblyopia and different treatment periods during extended follow-up(P>0.05).5.BCVA improvement in amblyopic eyes was greater in those with good compliance than in those with fair or poor compliance during extended follow-up(P<0.001).6.BCVA improvement in amblyopic eyes was not correlated with age(rs=-0.192,P=0.111),not correlated with treatment periods(rs=0.174,P=0.090),not correlated with follow-up interval(rs=0.054,P=0.549)and moderately correlated with patient compliance(rs=0.395,P<0.001).Conclusion:1.For patients with good compliance,even if the classification of amblyopia is moderate to severe,a clinically appropriate extension of the follow-up interval can still be considered.2.For patients with poor compliance,close clinical follow-up is required. |
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