{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T03:18:11Z","timestamp":1781579891465,"version":"3.54.5"},"reference-count":93,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"content-version":"vor","delay-in-days":76,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001262","name":"Baily Thomas Charitable Fund","doi-asserted-by":"publisher","award":["TRUST\/VC\/AC\/SG\/5844-8996"],"award-info":[{"award-number":["TRUST\/VC\/AC\/SG\/5844-8996"]}],"id":[{"id":"10.13039\/501100001262","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Ophthalmology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Down syndrome (DS) is the most common genetic cause of intellectual disability. Ocular manifestations occur frequently in people with DS (pwDS) but to date, there is no systematic review or meta\u2010analysis of these conditions across the lifespan.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    PubMed, Medline, Embase, Web of Science and Scopus were searched for observational studies reporting ocular manifestations in pwDS, without limiting publication date. The proportion of pwDS with specific ocular manifestations were meta\u2010analysed to obtain a pooled incidence using a random effects model. Sources of heterogeneity were assessed using a meta\u2010regression analysis. For manifestations reported, but without sufficient prevalence data available, a narrative approach was adopted.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    The search identified 1208 papers. Reviewers independently screened the abstracts, and 54 studies were found to fit the criteria. The age range of the individuals was birth to 88.7\u2009years. Ocular manifestations from highest to lowest prevalence included refractive errors (69.97%, 95% CI 59.95%\u201379.13%), strabismus (31.41%, 95% CI 24.66%\u201338.57%), lens opacities (13.79%, 95% CI 8.61%\u201319.86%), nystagmus (12.72%, 95% CI 9.02%\u201316.92%) and keratoconus (9.34%, 95% CI 2.47%\u201319.26%). Alterations of lens and corneal morphology, posterior segment anomalies (including glaucoma) and Brushfield spots were also identified.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    The ocular manifestations of pwDS are common but varied. Age and\/or ethnicity may influence the prevalence of certain ocular manifestations. The level of intellectual disability may also affect the prevalence of ocular manifestations as the prevalence of ocular disorders is known to increase with the severity of intellectual disability in pwDS.\n                  <\/jats:p>","DOI":"10.1155\/joph\/2317959","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:33:51Z","timestamp":1742344431000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Ocular Manifestations of Individuals With Down Syndrome: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5068-5675","authenticated-orcid":false,"given":"Jessica A.","family":"Beresford-Webb","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4036-2300","authenticated-orcid":false,"given":"Emily","family":"Charlesworth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2377-8387","authenticated-orcid":false,"given":"Shahina","family":"Pardhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7160-2170","authenticated-orcid":false,"given":"Megan","family":"Vaughan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Igbineweka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahid H.","family":"Zaman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,18]]},"reference":[{"key":"e_1_2_13_1_2","doi-asserted-by":"publisher","DOI":"10.1177\/1755738019886612"},{"key":"e_1_2_13_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-019-0143-7"},{"key":"e_1_2_13_3_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2788.2001.00350.x"},{"key":"e_1_2_13_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2003.12.051"},{"key":"e_1_2_13_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(02)08092-3"},{"key":"e_1_2_13_6_2","doi-asserted-by":"publisher","DOI":"10.3104\/reports.317"},{"key":"e_1_2_13_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/2046-4053-4-1"},{"key":"e_1_2_13_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2018.07.015"},{"key":"e_1_2_13_9_2","unstructured":"Study Quality Assessment Tools 2013 National Heart Lung and Blood Institute"},{"key":"e_1_2_13_10_2","doi-asserted-by":"publisher","DOI":"10.1214\/aoms\/1177729756"},{"key":"e_1_2_13_11_2","doi-asserted-by":"publisher","DOI":"10.1080\/00031305.1978.10479283"},{"key":"e_1_2_13_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_2_13_13_2","article-title":"Robust Variance Meta-Regression","volume":"2","author":"Fisher Z.","year":"2017","journal-title":"R package version"},{"key":"e_1_2_13_14_2","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v036.i03"},{"key":"e_1_2_13_15_2","unstructured":"WickhamH. FrancoisR. HenryL. andMullerK. A Grammer Data Manip 2022."},{"key":"e_1_2_13_16_2","unstructured":"CoburnK. M.andVeveaJ. L. Weight. Estim. Weight. Model. Publ. Bias 2019."},{"key":"e_1_2_13_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/ebmental-2019-300117"},{"key":"e_1_2_13_18_2","unstructured":"WickhamH.andSeidelD. Scales: Scale Functions for Visualization 2020."},{"key":"e_1_2_13_19_2","unstructured":"BatesD.andMaechlerM. Matrix: Sparse and Dense Matrix Classes and Methods 2021."},{"key":"e_1_2_13_20_2","article-title":"numDeriv: Accurate Numerical Derivatives","volume":"2016","author":"Gilbert P.","year":"2019","journal-title":"R package version"},{"key":"e_1_2_13_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-24277-4"},{"key":"e_1_2_13_22_2","unstructured":"WhiteT. NobleD. SeniorA. HamiltonK. W. andViechtbauerW. Metadat: Meta-Analysis Datasets 2022."},{"key":"e_1_2_13_23_2","unstructured":"HigginsJ. Cochrane Handbook for Systematic Reviews of Interventions 2022 https:\/\/www.training.cochrane.org\/handbook."},{"key":"e_1_2_13_24_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2018.2373"},{"key":"e_1_2_13_25_2","doi-asserted-by":"publisher","DOI":"10.3109\/13816810.2011.592175"},{"key":"e_1_2_13_26_2","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S36685"},{"key":"e_1_2_13_27_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2013.644"},{"key":"e_1_2_13_28_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40662-022-00315-0"},{"key":"e_1_2_13_29_2","doi-asserted-by":"publisher","DOI":"10.3928\/01913913-20090301-04"},{"key":"e_1_2_13_30_2","doi-asserted-by":"publisher","DOI":"10.5301\/ejo.5000304"},{"key":"e_1_2_13_31_2","doi-asserted-by":"publisher","DOI":"10.3109\/13816819609057864"},{"key":"e_1_2_13_32_2","doi-asserted-by":"publisher","DOI":"10.1177\/1120672119883594"},{"key":"e_1_2_13_33_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-66108-4"},{"key":"e_1_2_13_34_2","doi-asserted-by":"publisher","DOI":"10.1080\/09273972.2019.1699582"},{"key":"e_1_2_13_35_2","doi-asserted-by":"publisher","DOI":"10.5935\/0004-2749.20200058"},{"key":"e_1_2_13_36_2","doi-asserted-by":"publisher","DOI":"10.4274\/tjo.galenos.2020.52959"},{"key":"e_1_2_13_37_2","doi-asserted-by":"publisher","DOI":"10.1080\/02713683.2019.1597128"},{"key":"e_1_2_13_38_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1444-0938.2010.00458.x"},{"key":"e_1_2_13_39_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2021-244343"},{"key":"e_1_2_13_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0887-8994(97)00029-5"},{"key":"e_1_2_13_41_2","doi-asserted-by":"publisher","DOI":"10.2147\/opth.s169107"},{"key":"e_1_2_13_42_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2012-302327"},{"key":"e_1_2_13_43_2","first-page":"14","article-title":"Ocular Findings in Malaysian Children with Down Syndrome","volume":"47","author":"Liza-Sharmini A. T.","year":"2006","journal-title":"Singapore Medical Journal"},{"key":"e_1_2_13_44_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10384-018-0565-x"},{"key":"e_1_2_13_45_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.61845"},{"key":"e_1_2_13_46_2","doi-asserted-by":"publisher","DOI":"10.1080\/0065955x.1997.11982134"},{"key":"e_1_2_13_47_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0002-9394(14)72015-x"},{"key":"e_1_2_13_48_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12886-023-02863-y"},{"key":"e_1_2_13_49_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2010.185827"},{"key":"e_1_2_13_50_2","first-page":"1115","article-title":"The Ophthalmic Anomalies in Children with Down Syndrome in Split-Dalmatian County","volume":"35","author":"Karlica D.","year":"2011","journal-title":"Collegium Antropologicum"},{"key":"e_1_2_13_51_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-66642-1"},{"key":"e_1_2_13_52_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1755-3768.2009.01676.x"},{"key":"e_1_2_13_53_2","doi-asserted-by":"publisher","DOI":"10.3390\/jpm11020082"},{"key":"e_1_2_13_54_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2019-314939"},{"key":"e_1_2_13_55_2","doi-asserted-by":"publisher","DOI":"10.4103\/djo.djo_59_22"},{"key":"e_1_2_13_56_2","doi-asserted-by":"publisher","DOI":"10.3109\/09273972.2010.529232"},{"key":"e_1_2_13_57_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00508-015-0750-6"},{"key":"e_1_2_13_58_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.oftale.2021.01.002"},{"key":"e_1_2_13_59_2","doi-asserted-by":"publisher","DOI":"10.1177\/112067210701700521"},{"key":"e_1_2_13_60_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2006.090639"},{"key":"e_1_2_13_61_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0420.2001.790613.x"},{"key":"e_1_2_13_62_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2788.1991.tb01052.x"},{"key":"e_1_2_13_63_2","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.03-0951"},{"key":"e_1_2_13_64_2","doi-asserted-by":"publisher","DOI":"10.1111\/opo.12974"},{"key":"e_1_2_13_65_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00221-011-2820-y"},{"key":"e_1_2_13_66_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9394(88)90611-3"},{"key":"e_1_2_13_67_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2019.06.006"},{"key":"e_1_2_13_68_2","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.15-18532"},{"key":"e_1_2_13_69_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00221-011-2834-5"},{"key":"e_1_2_13_70_2","doi-asserted-by":"publisher","DOI":"10.1016\/s1091-8531(98)90061-1"},{"key":"e_1_2_13_71_2","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/974253"},{"key":"e_1_2_13_72_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2010.01.012"},{"key":"e_1_2_13_73_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0010659"},{"key":"e_1_2_13_74_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaapos.2011.05.003"},{"key":"e_1_2_13_75_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00417-015-3088-x"},{"key":"e_1_2_13_76_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.32729"},{"key":"e_1_2_13_77_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2006.02.019"},{"key":"e_1_2_13_78_2","doi-asserted-by":"publisher","DOI":"10.1080\/09273972.2016.1242639"},{"key":"e_1_2_13_79_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.158.10.1659"},{"key":"e_1_2_13_80_2","doi-asserted-by":"publisher","DOI":"10.3928\/01913913-20161021-02"},{"key":"e_1_2_13_81_2","first-page":"177","article-title":"Statistical Analysis of Esotropia Surgery: Factors Influencing Therapy and Prognosis","volume":"11","author":"Edwards W. C.","year":"1974","journal-title":"Journal of Pediatric Ophthalmology"},{"key":"e_1_2_13_82_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0039-6257(97)00119-7"},{"key":"e_1_2_13_83_2","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.61.12.23"},{"key":"e_1_2_13_84_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2007.124248"},{"key":"e_1_2_13_85_2","doi-asserted-by":"publisher","DOI":"10.1093\/hmg\/ddt125"},{"key":"e_1_2_13_86_2","doi-asserted-by":"publisher","DOI":"10.1186\/1745-0179-3-26"},{"key":"e_1_2_13_87_2","unstructured":"Strabismus Farlex Partner Medical Dictionary 2012 https:\/\/medical-dictionary.thefreedictionary.com\/strabismus."},{"key":"e_1_2_13_88_2","unstructured":"Nystagmus Farlex Partner Medical Dictionary 2012 https:\/\/medical-dictionary.thefreedictionary.com\/nystagmus."},{"key":"e_1_2_13_89_2","unstructured":"Farlex Partner Medical Dictionary 2012 Cataract"},{"key":"e_1_2_13_90_2","unstructured":"Refractive error McGraw-Hill Concise Dictionary of Modern Medicine 2002 https:\/\/medical-dictionary.thefreedictionary.com\/refractive+error."},{"key":"e_1_2_13_91_2","unstructured":"Keratoconus Farlex Partner Medical Dictionary 2012."},{"key":"e_1_2_13_92_2","unstructured":"Brushfield spots Farlex Partner Medical Dictionary 2012."},{"key":"e_1_2_13_93_2","unstructured":"Glaucoma Farlex Partner Medical Dictionary 2012."}],"container-title":["Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/joph\/2317959","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/joph\/2317959","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/joph\/2317959","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T11:57:14Z","timestamp":1777636634000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/joph\/2317959"}},"subtitle":[],"editor":[{"given":"Shengjie","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":93,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1155\/joph\/2317959"],"URL":"https:\/\/doi.org\/10.1155\/joph\/2317959","archive":["Portico"],"relation":{},"ISSN":["2090-004X","2090-0058"],"issn-type":[{"value":"2090-004X","type":"print"},{"value":"2090-0058","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2024-04-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"2317959"}}