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Longitudinal changes in refractive error of children with infantile esotropia
E E Birch1, D R Stager, J Wang
1Pediatric Eye ResearchLaboratory, Retina Foundation of the Southwest, Dallas, TX 75231, USA. ebirch@retinafoundation.org
Insights
Children with infantile esotropia (ET) do not follow typical refractive development patterns. Long-term follow-up is crucial for managing refractive changes in these children.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Refractive Error Development
Background:
- Infantile esotropia (ET) is a common condition affecting eye alignment in infants.
- Understanding refractive development in children with ET is crucial for early intervention and management.
- Previous studies have not fully elucidated the long-term refractive trajectories in this population.
Purpose of the Study:
- To quantify refractive status changes over time in children with infantile ET.
- To analyze clinical factors influencing refractive development and emmetropization in infantile ET.
- To compare refractive development in infantile ET with normative data.
Main Methods:
- Prospective study of 143 children with infantile ET, followed for 5-12 years.
- Longitudinal cycloplegic refraction data collected from 6 months of age.
- Statistical analysis (ANOVA, t-tests) used to evaluate the influence of amblyopia, undercorrection, accommodation, and binocular factors on emmetropization.
Main Results:
- Children with infantile ET lack the typical early hypermetropia decrease seen in normal development.
- Refractive development in infantile ET mirrors normative patterns after 9 months of age, with minimal change until age 7.
- A decline in hypermetropia of approximately -0.5 D/year begins around age 8; clinical factors did not significantly impact refractive changes.
Conclusions:
- Infantile ET is associated with an atypical pattern of refractive development compared to normative cohorts.
- The observed long-term refractive changes necessitate extended clinical monitoring for children with infantile ET.
- Early identification and consistent follow-up are vital for optimizing visual outcomes in infantile ET.
Aim:
the aim of this study was to quantify changes in refractive status over time in children with infantile esotropia (ET) and to analyse a number of clinical factors associated with infantile ET to determine how they may affect emmetropisation.
Methods:
longitudinal cycloplegic refraction data were collected for 5-12 years from 143 consecutive children enroled in a prospective study of infantile ET by 6 months of age. Changes in refractive error with age were summarised with descriptive statistics and the influence of amblyopia, undercorrection of hypermetropia, accommodation, and binocular factors on emmetropisation were evaluated by analysis of variance and t-tests.
Results:
most had low to moderate hypermetropia on the initial visit (55% had <+3.00 D). Although the initial refractive error is similar to normative data, the rapid decrease in hypermetropia that characterises normal development during the first 9 months of life is absent in children with infantile ET. After 9 months of age, children with infantile ET follow a developmental course, which is similar to the normative course; there is little change in hypermetropia during years 1-7, followed by a decline of approximately -0.5 D/year beginning at age 8 years. None of the clinical factors examined had a statistically significant effect on the course of refractive changes with age.
Conclusion:
children with infantile ET exhibit a different pattern of refractive development than that seen in normative cohorts. The long-term changes in refraction observed in children with infantile ET suggest that there is a need for long-term clinical follow-up of these children.
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