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Simultaneous Changes in Astigmatism with Noncycloplegia Refraction and Ocular Biometry in Chinese Primary
Yaoyao Lin1, Dandan Jiang2, Chunchun Li2
1School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China.
Insights
Astigmatism prevalence slightly decreased in Chinese schoolchildren over two years. Longer axial lengths (AL) and higher AL/corneal radius of curvature (CRC) ratios are key risk factors for developing astigmatism.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Biometry
Background:
- Astigmatism is a common refractive error affecting visual acuity.
- Understanding astigmatism progression in children is crucial for early intervention.
- Ocular biometry plays a role in refractive error development.
Purpose of the Study:
- To evaluate changes in astigmatism among Chinese schoolchildren.
- To investigate the relationship between astigmatism progression and ocular biometric parameters.
Main Methods:
- A two-year longitudinal study of 1,463 Chinese children aged 6-9 years.
- Annual measurements of noncycloplegic refraction, axial length (AL), and corneal radius of curvature (CRC).
- Definition of clinically significant astigmatism (CSA) as ≤-0.75 diopters (D).
Main Results:
- The prevalence of CSA slightly decreased from 22.4% to 20.3% over two years.
- Longer baseline AL (>23.58 mm) and higher AL/CRC ratio (>2.99) were significant predictors for developing CSA.
- Increased astigmatism was associated with greater AL growth, increased AL/CRC ratio, and myopic shift.
Conclusions:
- A slight decrease in astigmatism prevalence was observed in the study cohort.
- Longer axial length and higher AL/CRC ratio are identified as independent risk factors for developing clinically significant astigmatism.
- Astigmatism progression in children is linked to axial elongation and myopic development.
Purpose:
To assess the changing profile of astigmatism in Chinese schoolchildren and the association between astigmatism changes and ocular biometry.
Methods:
We examined and followed up 1,463 children aged 6-9 years from Wenzhou, China. We measured noncycloplegic refraction twice each year and tested axial length (AL) and corneal radius of curvature (CRC) annually for two years. We defined clinically significant astigmatism (CSA) as ≤-0.75 diopter (D) and non-CSA astigmatism as ≤0 to >-0.75 D.
Results:
Prevalence of CSA at baseline was 22.4% (n = 327) and decreased to 20.3% (n = 297) at the two-year follow-up (P = 0.046). Ninety-two (8.1%) non-CSA children developed CSA. In multiple regression, after adjusting for age, gender, baseline cylinder refraction, and axis, children who had longer baseline ALs (>23.58 mm; odds ratio (OR) = 5.19, 95% confidence interval (CI): 2.72-9.90) and longer baseline AL/CRC ratio (>2.99, OR = 4.99, 95% CI: 2.37-10.51) were more likely to develop CSA after two years. Four-hundred and two (27.5%) children had increased astigmatism, 783 (53.5%) had decreased, and 278 (19.0%) had no change during the two-year follow-up. Children with increased astigmatism had longer baseline ALs (23.33 mm, P < 0.001), higher AL/CRC ratios (2.99 mm, P < 0.001), and more negative spherical equivalent refraction (SER) (-0.63 D, P < 0.001) compared with the decreased and no astigmatism change subgroups. Also, children in the increased astigmatism subgroup had more AL growth (0.68 mm, P < 0.001), higher increases in AL/CRC ratio (0.08, P < 0.001), and more negative SER change (-0.86 D, P < 0.001) compared with the decreased and no astigmatism change subgroups.
Conclusions:
The prevalence of astigmatism decreased slightly over the two-year study period. Longer ALs and higher AL/CRC ratios were independent risk factors for developing CSA. Increased astigmatism was associated with AL growth, AL/CRC ratio increases, and the development of myopia. This trial is registered with ChiCTR1800019915.
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