Pseudomyopia as an independent risk factor for myopia onset: a prospective cohort study among school-aged children

Abstract

AimTo investigate whether pseudomyopia is an independent risk factor for myopia onset based on a population-based cohort study.MethodsNon-myopic children were recruited from schools in rural and urban settings of Shangdong province, China. Baseline examinations started in September 2020 and all participants were invited for a 6-month follow-up. Pseudomyopia was defined as spherical equivalent (SE) ≤−0.50 diopters (D) before cycloplegia and >−0.50D after cycloplegia. Myopia was defined as cycloplegic SE ≤−0.50D.ResultsA total of 2328 children (baseline age: 4–17 years) were included in the final analysis. During the 6-month follow-up, 21.1% (355/1680) pseudomyopic eyes developed myopia, and 3.8% (110/2879) non-myopic and non-pseudomyopic eyes developed myopia. After adjusting for multiple myopia risk factors, including baseline cycloplegic SE, near work and outdoor time, pseudomyopia was found to be an independent risk factor for myopia onset (relative risk=2.52, 95% CI 1.86 to 3.42). Additionally, pseudomyopic children with more myopic cycloplegic SE (p<0.001), smaller difference between cycloplegic and non-cycloplegic SE (DIFF, p<0.001), and higher binocular amplitude of accommodation (p<0.001) had higher risk of myopia development.ConclusionThis is an important longitudinal study to prove that pseudomyopia is an independent risk factor for myopia development among school-aged children.

The Relationship between Selected Parameters and the Occurrence of Premyopia in a Group of 1155 Children Aged 8 in Northwestern Poland

“…The generation of strong accommodative contraction during intense close-up work can result in myopia in the hyperopic or emmetropic eye [31], as well as increased myopia in the hitherto myopic eye. Children and young adults, due to their high amplitude of accommodation coefficient, are particularly prone to pseudomyopia (which is the result of an increase in the refractive power of the eye due to excessive stimulation of the accommodation mechanism), which, according to the literature, can occur with varying frequency [24,32,33].…”

Refractive and ocular biometric characteristics of non-myopic and pseudomyopic eyes in mild hyperopic Chinese children aged 3–12 years

“…Despite its status as an independent risk factor for myopia onset, ocular biometry in pseudomyopia has not been extensively explored [ 10 ]. In this present study, pseudomyopic eyes exhibited increased ALs compared with non-myopic eyes after adjusting for sex, age, and cycloplegic spherical equivalent.…”

“…Pseudomyopia is an independent risk factor for myopia onset; therefore, research on identifying pseudomyopia and exploring its underlying causes is required [ 10 ]. However, due to the limitations in measurement techniques, reporting on the distribution of ocular biometric parameters in individuals with pseudomyopia has been relatively limited.…”