Purpose:

To compare visual acuity outcomes and loss to follow-up after initiation of treatment for unilateral amblyopia in children from different socioeconomic backgrounds.

Methods:

Medical records of children diagnosed as having unilateral amblyopia at an initial encounter between 2015 and 2018 were reviewed. Medicaid and private insurance were used as proxies for socioeconomic status (SES). Data points were collected at the patients' initial, follow-up, and final visits. Visual acuity improvement was the primary outcome variable in patients with at least one follow-up appointment. In a separate analysis, failure to attend a single follow-up appointment was examined for associations with SES, race, sex, and distance traveled to appointments.

Results:

Seventy-three patients met the inclusion criteria; of these, 28 had Medicaid and 45 had private insurance. Visual acuity improved by 2.86 lines in the Medicaid group and 2.98 lines in the private insurance group (P = .84). Number of missed appointments and distance traveled did not correlate with visual acuity improvement. In the loss to follow-up subanalysis, 40 of 141 (28.4%) patients with Medicaid and 11 of 107 (10.3%) patients with private insurance failed to attend a single follow-up visit (P = .001). No association was found between loss to follow-up and race, sex, or distance traveled.

Conclusions:

Visual acuity outcomes of treatment for amblyopia did not differ between patients with Medicaid and patients with private insurance who followed up. However, patients with Medicaid were much more likely to be immediately lost to follow-up. Measures should be taken by eye care providers and pediatricians to increase follow-up in patients from low SES populations.

[J Pediatr Ophthalmol Strabismus. 20XX;XX(X):XX–XX.]

目的：

比较不同社会经济背景的儿童单侧弱视开始治疗后的视力结果和失访情况。

方法：

审查了 2015 年至 2018 年初次接触时被诊断为患有单侧弱视的儿童的医疗记录。医疗补助和私人保险被用作社会经济地位（SES）的代理。在患者初次、随访和最终就诊时收集数据点。视力改善是至少有一次随访预约的患者的主要结果变量。在另一项分析中，检查了未能参加单一随访预约与 SES、种族、性别和预约旅行距离的关联。

结果：

73 名患者符合纳入标准；其中，28 人拥有医疗补助，45 人拥有私人保险。医疗补助组的视力提高了 2.86 线，私人保险组提高了 2.98 线（P = .84）。错过的约会次数和旅行距离与视力改善无关。在失访亚组分析中，141 名 Medicaid 患者中有 40 名 (28.4%) 和 107 名私人保险患者中有 11 名 (10.3%) 未能参加单次随访 ( P = .001)。没有发现失访与种族、性别或旅行距离之间存在关联。

结论：

弱视治疗的视力结果在接受医疗补助的患者和接受私人保险的随访患者之间没有差异。然而，医疗补助的患者更有可能立即失去随访。眼保健提供者和儿科医生应采取措施，增加对低 SES 人群患者的随访。

[ J 小儿眼科斜视。20XX;XX(X):XX–XX.]