Significant Axial Elongation with Minimal Change in Refraction in 3- to 6-Year-Old Chinese Preschoolers

Guo, Xinxing; Fu, Min; Ding, Xiaohu; Morgan, Ian G.; Zeng, Yonghong; He, Mingguang

doi:10.1016/j.ophtha.2017.05.030

Cited by 100 publications

(144 citation statements)

References 39 publications

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“…Recently, Guo et al . reported that an increase of 1 mm in AL was associated with only 0.45D of myopic change in a group of pre‐school Chinese children with low prevalence of myopia . Despite not able to estimate lens power accurately by the present data, the variation of the ratios might be account for the differences in the amount of compensation by lens, as the CR did not change much in this age‐group of children, thus indicating an important role of lens in the onset and progression of myopia …”

Section: Discussionsupporting

confidence: 72%

Cohort study with 4‐year follow‐up of myopia and refractive parameters in primary schoolchildren in Baoshan District, Shanghai

Zou

Lin

et al. 2018

Clinical Exper Ophthalmology

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ImportanceCohort studies could not only reveal associations between change of refractive components and onset/progression of myopia, but also risk factors, which is important for understanding mechanism and providing strategies.BackgroundPrevalence of myopia is high in Shanghai, being reported to be 52.2% in children aged 10 years old.DesignCohort study.ParticipantsA total of 1856 students from six randomly selected primary schools in Baoshan District, Shanghai.MethodsChildren underwent comprehensive ocular measurement, including axial length (AL), corneal curvature radius and cycloplegic auto‐refraction. Questionnaires about eye usage time were collected. Grade 1 students were followed for 4 years, and grade 2 and 3 students for 2 years.Main Outcome Measures(i) Change of spherical equivalent (SE) and AL and (ii) risk factors for progression and incidence of myopia.ResultsThe average 2‐year progress of SE was 0.91D, 0.91D and 1.11D for grade 1, 2 and 3, respectively, and the average elongation of AL was 0.70 mm, 0.64 mm and 0.71 mm, respectively. Only parental myopia, but not near work time, near work diopter time, outdoor activity time or attending tutoring classes, was associated with myopia incidence and progression in the present population. Using baseline SE could be a simple and effective indicator for myopia prediction.Conclusions and RelevanceIncidence and progression of myopia is relatively high in schoolchildren in Shanghai compared with children of Western countries, East Asia and other parts of China. Effective strategies to control myopia prevalence are in urgent need.

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Section: Discussionsupporting

confidence: 72%

Cohort study with 4‐year follow‐up of myopia and refractive parameters in primary schoolchildren in Baoshan District, Shanghai

Zou

Lin

et al. 2018

Clinical Exper Ophthalmology

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“…Therefore, decreases in intraocular compensation will induce the myopic shift that normally would be associated with increases in AL. 25 In the current population at the age of 7 to 8, an increase in AL of 0.13 mm was accompanied with À0.06 D of myopic shift in the non-non group. This was comparable to previous studies where a 1 mm increase in AL was associated with a À0.38 to À0.45 change in SE in preschool children.…”

Section: Discussionmentioning

confidence: 66%

Role of Parental Refractive Status in Myopia Progression: 12-Year Annual Observation From the Guangzhou Twin Eye Study

Liao

Ding

Han

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. We investigate the impact of parental myopia on spherical equivalent (SE) progression and axial length (AL) elongation. METHODS. Children and their parents were invited for annual examinations from 2006 (baseline). Cycloplegic autorefraction and AL were measured at each visit. Parental refractive status was determined using refraction data from their baseline visit. Children were classified into five groups: no myopic parents (non-non), only one moderately myopic parent (nonmoderate), only one highly myopic parent (non-high), two moderately myopic parents (moderate-moderate), and one moderately myopic or more severe and one highly myopic parent (moderate-high/high-high). The relationship between progression of SE and AL with parental refractive status was estimated by linear mixed-effects models. Data from 2006 to 2017 were analyzed in the current study. RESULTS. A total of 1831 children were enrolled (mean age, 11 6 2.7 years; mean standard error, À0.49 6 2.16 diopters [D] at baseline. Myopia progressed faster for children with parental myopia (non-non group as reference, all P < 0.05), while AL elongation mirrored the change in SE (all P < 0.001 except for non-mod group P ¼ 0.12). As for the age-specific change in SE and AL, children in the mod-high/high-high group presented with the fastest progression. Children with highly myopic parents were at higher risks of being highly myopic during adulthood (odds ratio ¼ 13.98 and 25.71 for non-high and mod-high/high-high groups; both P < 0.001). CONCLUSIONS. SE progresses and AL elongates at a faster rate at an earlier age in children with parental myopia. Children with highly-myopic parents have higher risks of being highly myopic during adulthood.

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“…Therefore, the detection of total astigmatism and anisometropia through parameters pertaining to corneal astigmatism and interocular differences in axial length is a rational approach. Relationships among corneal power, axial length, and refraction have been reported in several earlier studies [35][36][37], and AL/ CR ratio (i.e., the value of axial length divided by corneal curvature radius) is strongly correlated with cycloplegic refraction. Thus, an abnormal relationship between corneal power and axial length indicates abnormal refraction.…”

Section: Discussionmentioning

confidence: 56%

“…Children with mild myopia of less than 1.50 D may have been excluded from the reference group. Guo et al [36] reported that the prevalence of myopia was 0% at 3 years of age and 3.7% at 6 years of age. This fact may not have had a substantial effect on the present results.…”

Section: Discussionmentioning

confidence: 99%

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Biometry: a tool for the detection of amblyopia risk factor in children

Satou

Niida

Ito

2019

Graefes Arch Clin Exp Ophthalmol

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Purpose To determine optical biometry data criteria for the detection of abnormal refraction in preschool children, and to evaluate the accuracy of these criteria for detecting amblyopia refractive risk factor (ARF), as defined in the 2013 guidelines of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS). Methods The present study included 200 eyes of 100 preschool children with normal eyes for the experimental determination of criteria and 142 eyes of 71 preschool children for validation of these criteria. Statistical data from normal eyes were used to determine both Bhigh sensitivity failure criterion^and Bhigh specificity failure criterion^associated with corneal astigmatism, interocular difference in axial length, and the prediction interval of a regression formula for predicting corneal power from axial length. Ophthalmological examination of children for validation included testing cycloplegic refraction and optical biometry testing. Outcomes from optical biometry criteria were compared with determination via ophthalmological examination, and the accuracy of the criteria for detecting ARF was evaluated. Results Sensitivity of the Bhigh sensitivity failure criterion^for detecting 2013 AAPOS ARF was 100%, while the specificity was 80.5%. The sensitivity of the Bhigh specificity failure criterion^was 93.3%, while the specificity was 95.1%. Conclusions The criteria derived from optical biometry data in this study exhibited excellent sensitivity and specificity for detecting ARF. This study may lead to a new approach to vision screening in preschool children.

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Significant Axial Elongation with Minimal Change in Refraction in 3- to 6-Year-Old Chinese Preschoolers

Cited by 100 publications

References 39 publications

Cohort study with 4‐year follow‐up of myopia and refractive parameters in primary schoolchildren in Baoshan District, Shanghai

Cohort study with 4‐year follow‐up of myopia and refractive parameters in primary schoolchildren in Baoshan District, Shanghai

Role of Parental Refractive Status in Myopia Progression: 12-Year Annual Observation From the Guangzhou Twin Eye Study

Biometry: a tool for the detection of amblyopia risk factor in children

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