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The evolution of refractive status in Chinese infants during the first year of life and its affected factors
Shu-Juan Yu1, Guo-Hua Liu1, Yi Liu2
1Department of Ophthalmology, Qilu Children's Hospital of Shandong University, Jinan 250022, Shandong Province, China.
Insights
Infant refractive status evolves significantly in the first year, peaking in hyperopia at 1-2 months. Boys exhibit more hyperopia than girls, with with-the-rule astigmatism being common in this large Chinese infant cohort.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Infant Vision Development
Background:
- Refractive status in infants is crucial for visual development.
- Understanding early refractive trends helps identify potential long-term vision issues.
- Limited data exists on infant refractive status in large Chinese populations.
Purpose of the Study:
- To investigate the longitudinal changes in refractive status in Chinese infants.
- To identify factors influencing refractive development during the first year of life.
- To analyze the prevalence and types of astigmatism in this cohort.
Main Methods:
- A cohort of 1258 infants (32 weeks gestational age to 1 year) was studied.
- Comprehensive eye examinations included orthoptic assessment, slit-lamp, fundus imaging, and cycloplegic retinoscopy.
- Neonatal histories were reviewed to correlate with refractive outcomes.
Main Results:
- Infants showed initial average hyperopia (+0.94±1.63 D), peaking at +2.43±1.46 D between 1-2 months, then decreasing to +0.59±1.41 D at 1 year.
- Astigmatism prevalence was 42.17%, predominantly hyperopic with-the-rule astigmatism (39.35%).
- Boys had significantly higher mean spherical equivalent (+1.97±1.57 D) than girls (+1.79±1.46 D).
Conclusions:
- Infant refractive status changes are influenced by age and sex within the first year.
- Hyperopia is most pronounced at 1-2 months, with boys showing greater hyperopic shifts.
- With-the-rule astigmatism is the predominant type in infants, and premature and full-term infants share similar refractive status when retinopathy of prematurity is excluded.
Aim:
To study the evolution of the refractive status and examine the affected factors in infants during the first year of life in a large sample size in China.
Methods:
A total of 1258 babies (2516 eyes) aged 32wk gestational age to 1y participated in the study, including 766 premature and 492 full-term infants. First, each baby received an orthoptic examination, slit-lamp checking and fundus imaging. Patients with diseases which might affect refractive status were excluded from the cohort. The cycloplegia retinoscopy was performed. Their neonatal histories were reviewed. Each measurement contained the refractive status and calculation of the spherical equivalent (SE).
Results:
Refractive state showed an average hyperopia of +0.94±1.63 D at early ages, followed by a trend toward more hyperopia. The refractive state reached the top (+2.43±1.46 D) at the age of one to two months. Then gliding till one year old when the refractive state reached +0.59±1.41 D. The prevalence of astigmatism was 42.17% in the study, being 2.82% myopic astigmatism and 39.35% hyperopic astigmatism. The 94.1% of hyperopic astigmatism was with-the-rule astigmatism and 71.83% of myopic astigmatism was with-the-rule astigmatism. Refractive state between boys and girls was different. The mean SE of boys was +1.97±1.57 D, while that of girls was +1.79±1.46 D, and the difference was significant.
Conclusion:
Before one year old, the change of refractive status is associated with checking age and sex. At the age of one to two months, the degree of hyperopia reaches the top. Boys have more hyperopic degree than girls, and with-the-rule astigmatism is predominant. Excluding premature infants with advanced retinopathy of prematurity, premature and full-term children have same refraction status.
