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Long-term development of refractive error in refractive, nonrefractive and partially accommodative esotropia.

ABSTRACT: 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.

SUBMITTER: Esposito Veneruso P

PROVIDER: S-EPMC6152953 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:We investigate the changes in refractive error and clinical evaluation in partially accommodative esotropia(PAET) after surgery. A total of 68 patients PAET who received at least 2 years of follow-up after surgery were enrolled in this study. We performed a retrospective study in patients who underwent unilateral or bilateral medial rectus recession for a non-accommodative component of PAET between January 2005 and March 2013. Patients were divided into groups according to the presence of dominancy (dominant, non-dominant, alternative eye), and presence of amblyopia (amblyopic, fellow, normal eye). Changes and changing pattern in SE refractive error were analyzed in all patients and compared between groups. Patients were divided into two groups, those weaned off of hyperopic glasses and those who continued using them, then factors that significantly influenced the continued use of glasses were analyzed. The changes and changing pattern in SE refractive error according to time after operation and presence of amblyopia or dominancy. The mean length of follow-up was 4.89±1.74 years after surgery and the mean change in SE refractive error rate per year was -0.284±0.411 diopters (D). The pattern of changes in the mean SE refractive error for those with dominant, non-dominant, and alternative eyes was not significantly different (p = 0.292). The pattern of changes in the mean SE refractive error for those with amblyopic, fellow, and normal eyes was significantly different (p = 0.0002). Patients were successfully weaned off of hyperopic glasses at an average age of 9.41±2.74 years. The average SE refractive error in the group weaned off of hyperopic glasses was significantly lower than that in the group maintained on hyperopic glasses (p = 0.0002). The change of SE refractive error in amblyopic eyes decreased less than that in fellow or normal eyes, which may be correlated with the presence of amblyopia. Patients with a smaller esodeviated angle without hyperopic correction, a lower degree of hyperopia, and who were older at the time of disease onset were discontinued from hyperopic glasses sooner after surgery.

Project description:This study aims to investigate the development of pitch-matching, rhythmic entrainment, and socioemotional skills in children who received formal music instruction and other non-music based after school programs. Eighty-three children, averaging 6.81 years old at baseline, were enrolled in either a music, sports, or no after-school program and followed over four years. The music program involved formal and systematic instruction in music theory, instrumental technique, and performance. Most control participants had no music education; however, in some instances, participants received minimal music education at school or at church. Musical development was measured using a pitch-matching and drumming-based rhythmic entrainment task. Sharing behavior was measured using a variation of the dictator game, and empathy was assessed using three different assessments: the Index of Empathy for Children and Adolescence (trait empathy), the Reading the Mind in the Eyes Test (theory of mind), and a Fiction Emotion-Matching task (state empathy). Results revealed no time-related associations in pitch-matching ability; however, formal music instruction improved pitch-matching relative to controls. On the contrary, improvements in rhythmic entrainment were best explained by age-related changes rather than music instruction. This study also found limited support for a positive association between formal music instruction and socioemotional skills. That is, individuals with formal music instruction exhibited improved emotion-matching relative to those with sports training. In terms of general socioemotional development, children's trait-level affective empathy did not improve over time, while sharing, theory of mind, and state empathy did. Additionally, pitch-matching and rhythmic entrainment did not reliably predict any socioemotional measures, with associations being trivial to small. While formal music instruction benefitted pitch-matching ability and emotion-matching to an audiovisual stimulus, it was not a significant predictor of rhythmic entrainment or broader socioemotional development. These findings suggest that the transfer of music training may be most evident in near or similar domains.

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Long-term development of refractive error in refractive, nonrefractive and partially accommodative esotropia.

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