HOME | LOG IN | SIGN UP

High magnitude with-the-rule astigmatism and myopic progression in children

Adam E Sienkiewicz, Kara M Cavuoto, Sean P Donahue, Ta C Chang

Abstract


Purpose: To investigate high magnitude with-the-rule astigmatism (WTRA, plus cylinder with axis between 75 and 105 degrees) as a risk factor for myopic progression in children.

Methods: Retrospective case-control study.  Medical records were screened using CPT codes and age of visit. Subjects were included if the age at initial and final refractive visits were < 8 years and > 10 years, respectively, and had at least five years of follow up.  Exclusion criteria include a history of intraocular/oculoplastic pathologies, surgeries, lasers, presence of pathologic myopia (magnitude > 8 diopters). Eyes were categorized based on the initial refraction: no astigmatism (NA), non-WTRA (cylinder outside of 75-105 degree range), low-WTRA (cylinder < 2 D) or high-WTRA (cylinder > 2 D).
Results: A total of 2974 records were screened. 202 eyes of 110 patients were included; 79 (39%) were NA, 81 (40%) were low-WTRA, 24 (12%) eyes were high-WTRA, and 18 (9%) were non-WTRA.  High-WTRA had the least hyperopic initial spherical equivalence (0.5 +/- 6.4 D) compared to NA (2.2 +/- 3.0 D), non-WTRA (2.3 +/- 3.2 D), and low-WTRA (3.2 +/- 2.7 D, P = 0.009). When comparing the rates of myopic refractive change per year, patients with high-WTRA demonstrated a significantly greater rate (-0.24 +/- 0.21 D/year) than those without high-WTRA (-0.13 +/- 0.22 D/year, P = 0.0041).

Conclusions: Compared to cohorts with NA, non-WTRA or low-WTRA, children with high-WTRA show a significantly higher rate of myopic progression when followed for five or more years.


Full Text:

References


Brown MS, Siegel IM, Lisman RD. Prospective analysis of changes in corneal topography after upper eyelid surgery. Ophthal Plast Reconstr Surg. 1999; 15(6):378-383.

Downs JC, Burgoyne CF, Seigfreid WP, Reynaud JF, Strouthidis NG, Sallee V. 24-hour IOP telemetry in the nonhuman primate: implant system performance and initial characterization of IOP at multiple timescales. Invest Ophthalmol Vis Sci. 2011 Sep 21;52(10):7365-75.

Fan DS, Rao SK, Cheung EY, Islam M, Chew S, Lam DS. Astigmatism in Chinese preschool children: prevalence, change, and effect on refractive development. Br J Ophthalmol. 2004 Jul;88(7):938-41.

Hornbeak DM, Young TL. Myopia genetics: a review of current research and emerging trends. Curr Opin Ophthalmol 2009 Sep; 20(5):356-62.

Huang J, Maguire MG, Ciner E, Kulp MT, Cyert LA, Quinn GE, Orel-Bixler D, Moore B, Ying GS; Vision in Preschoolers (VIP) Study Group. Risk factors for astigmatism in the Vision in Preschoolers Study. Optom Vis Sci. 2014 May;91(5):514-21.

Hung LF, Crawford MLJ, Smith EL. Spectacle lenses alter eye growth and the refractive status of young monkeys. Nature Med 1995;f:761-5.

Lin LL, Shih YF, Hsiao CK, Chen CJ. Prevalence of myopia in Taiwanese schoolchildren: 1983 to 2000. Ann Acad Med Singapore 2004 Jan;33(1):27-33.

McKean-Cowdin R, Varma R, Cotter SA, Tarczy-Hornoch K, Borchert MS, Lin JH, Wen G, Azen SP, Torres M, Tielsch JM, Friedman DS, Repka MX, Katz J, Ibironke J, Giordano L. Risk factors for astigmatism in preschool children: the multi-ethnic pediatric eye disease and Baltimore pediatric eye disease studies. Ophtahlmology 2011;l118-1974-81.

Papadopoulos M, Brandt JD, Sugiyama K, Khaw PT, Chua J, Law S, Betinjane A, Abbott J, Strouthidis N, Chang TC. World Glaucoma Association Consensus Series – 9: Childhood Glaucoma. Section 2: Establishing the diagnosis and determining glaucoma progression. Amsterdam, The Netherlands: Kugler Publications; 2013. 15-41.

Pärssinen O. Astigmatism and school myopia. Acta Ophthalmol (Copenh). 1991 Dec;69(6):786-90.

Saw SM. A synopsis of the prevalence rates and environmental risk factors for myopia. Clin Exp Optom. 2003 Sep;86(5):289-94.

Saw SM, Katz J, Schein OD, Chew SJ, Chan TK. Epidemiology of myopia. Epidemiol Rev 1996;18:175-87.

Sperduto RD, Seigel D, Roberts J, et.al. Prevalence of myopia in the United States. Arch Ophthalmolog 1983; 101: 405-7.

Wallman J, McFadden S. Monkey eyes grow into focus. Nature Med 1995; 1:737-9.

Wang Q, Kelin BE, Klein R, et al. Refractive status in the Beaver Dam Eye Study. Invest Ophthalmol Vis Sci 1994;35:4344-7.




DOI: http://dx.doi.org/10.18103/mra.v0i3.246

Refbacks

  • There are currently no refbacks.