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Accommodative lag and juvenile-onset myopia progression in children wearing refractive correction.

ABSTRACT: The relationship between accommodative lag and annual myopia progression was investigated using linear models in 592 myopic children wearing a full refractive correction in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study. The mean (± SD) age and spherical equivalent refractive error at baseline were 10.4 ± 1.8 years and -2.13 ± 1.24 D, respectively. The mean annual progression of myopia was -0.45 ± 0.32 D, and the mean accommodative lag (for a 4-D Badal stimulus) was 1.59 ± 0.63 D. Neither lag at the beginning nor at the end of a yearly progression interval was associated with annual myopia progression (all p ? 0.12). These data suggest that foveal hyperopic retinal blur during near viewing may not drive juvenile-onset myopia progression.

SUBMITTER: Berntsen DA

PROVIDER: S-EPMC3111954 | biostudies-literature | 2011 May

REPOSITORIES: biostudies-literature

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Accommodative lag and juvenile-onset myopia progression in children wearing refractive correction.

Berntsen David A DA Sinnott Loraine T LT Mutti Donald O DO Zadnik Karla K

Vision research 20110220 9

The relationship between accommodative lag and annual myopia progression was investigated using linear models in 592 myopic children wearing a full refractive correction in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study. The mean (± SD) age and spherical equivalent refractive error at baseline were 10.4 ± 1.8 years and -2.13 ± 1.24 D, respectively. The mean annual progression of myopia was -0.45 ± 0.32 D, and the mean accommodative lag (for a 4-D Badal ...[more]

PMID: 21342658

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Project description:PurposeTo investigate monthly and seasonal variations in the progression of myopia in children enrolled in the Correction of Myopia Evaluation Trial (COMET).MethodsAn ethnically diverse cohort of 469 myopic 6- to <12 year-old children was randomized to single vision or progressive addition lenses and followed for 3 years with 98.5% retention. Progression of myopia was measured semiannually by noncycloplegic autorefraction (Nidek ARK 700A) and annually by cycloplegic autorefraction, with the former measurements used in these analyses. The semiannual progression rate was calculated as (change in spherical equivalent refraction between two consecutive semiannual visits/number of days between the two visits) times 182.5. Months were categorized as the midpoint between two visit dates. Seasons were classified as winter (October through March) or summer (April through September). The seasonal difference was tested using a linear mixed model adjusting for demographic variables (age, sex, ethnicity), baseline refraction, and treatment group.ResultsData from 358 children (mean [± SD] age = 9.84 ± 1.27 years; mean myopia = -2.54 ± 0.84 diopters [D]) met the criteria for these analyses. Myopia progression varied systematically by month; it was slower in April through September than in the other months. Mean progression in winter was -0.35 ± 0.34 D and in summer was -0.14 ± 0.32 D, a statistically significant difference (0.21 D, P < 0.0001). The same seasonal pattern was found by age, sex, ethnicity (except in the small sample of Asians), lens type, and clinical center.ConclusionsThe slower progression of myopia found in summer is likely related to children's spending more time outdoors and fewer hours in school. The data have clinical implications regarding the time of year and the frequency with which myopic children have eye examinations and the need for precise timing of visits in clinical trials testing new myopia treatments. (ClinicalTrials.gov number, NCT00000113.).

Project description:Accommodative esotropia (AE) is a convergent deviation due to an excess of the convergence linked to the innervational stimulus for accommodation and it is usually associated to the presence of hyperopia. The development of hyperopia over time has been widely described but the lack of comparative analysis among accommodative esotropia subtypes, does not allow to verify the existence of different developmental patterns. In this study we aimed to describe the long term changes of refractive error in patients affected by accommodative esotropia as a function of the strabismus type: refractive (RAE), non-refractive (NRAE) and partially accommodative esotropia (PAE). The medical records of 66 patients (24 RAE, 22 PAE, 20 NRAE), who wore the full correction of their cycloplegic refraction error during the entire follow up period, were retrospectively reviewed. Mean outcome was the analysis of the variations, among groups, of refractive error over time; differences between mild (≤3.00D) and high (≥5.00D) hyperopia, effects of amblyopia and relationship with AC/A ratio were also investigated. All patients were followed up from approximately 4 years of age to 20, with mean follow up of 16.06±0.29 years. Our results described similar non-linear trend of refractive error development among groups. The initial increase of hyperopia (up to 7-8 years) was followed by a decreasing trend persisting up to adulthood (approximately 20 years of age). During this period, spherical equivalent decreased at a lower mean annual rate in patients affected by RAE (-0.07D) compared to other groups (NRAE -0.11D, p = 0.003 and PAE 0.13D, p = 0.002). In all groups, however, significant amount of hyperopia was found at last examination; indeed the observed difference in SE values from baseline to the end of follow up, was not significant (RAE: +0.27D, 95% C.I. -0.49 to +1.04D, p = 0.472; PAE: -0.69D, 95% C.I. -1.67 to +0.28D, p = 0.154; NRAE: -0.39D, 95% C.I. -1.11 to +0.34D, p = 0.278). AC/A ratio, amblyopia and amount of initial hyperopia appeared to have no significant role in longitudinal change of the refractive error. In conclusion, this study provides a complete overview, from childhood to adulthood, of refractive error development in different form of accommodative esotropia.

Dataset Information

Accommodative lag and juvenile-onset myopia progression in children wearing refractive correction.

Publications

Accommodative lag and juvenile-onset myopia progression in children wearing refractive correction.

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