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Eyes grow towards mild hyperopia rather than emmetropia in Chinese preschool children
Yingyan Ma1,2, Senlin Lin1, Ian G Morgan3,4
1Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China.
Insights
Preschool children
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Refractive Error Development
Background:
- Refractive development in preschool children is crucial for visual health.
- Understanding changes in refractive components aids in early detection and management of vision disorders.
- Longitudinal studies are essential to track refractive shifts and their underlying mechanisms.
Purpose of the Study:
- To document one-year changes in refraction and refractive components in preschool children aged 3-5 years.
- To investigate the relationship between baseline refractive status and subsequent refractive changes.
- To explore the interplay between axial length, corneal curvature, and lens power in refractive development.
Main Methods:
- A one-year longitudinal study of 458 preschool children (3-5 years old) in Shanghai.
- Measurements included axial length (AL), cycloplegic refraction (spherical diopters [DS], cylinder diopters [DC]), spherical equivalent refraction (SER), and corneal curvature radius (CR).
- Statistical analysis explored correlations between baseline refractive components and one-year changes.
Main Results:
- Mean one-year changes were minimal for DS (0.02 D), DC (-0.02 D), and SER (0.01 D).
- Mean changes included AL elongation (0.27 mm) and lens power (LP) loss (-0.93 D).
- SER change correlated with baseline SER (p<0.001) and baseline SER was associated with LP change (p=0.013).
Conclusions:
- Refractive development in preschool children demonstrates homeostatic mechanisms.
- Eyes with lower baseline SER (<+1.00 D) showed greater LP loss, leading to hyperopic shifts.
- Eyes with higher baseline SER showed reduced LP loss relative to axial elongation, leading to myopic shifts, favoring mild hyperopia.
Purpose:
To document one-year changes in refraction and refractive components in preschool children.
Methods:
Children, 3-5 years old, in the Jiading District, Shanghai, were followed for one year. At each visit, axial length (AL), refraction under cycloplegia (1% cyclopentolate), spherical dioptres (DS), cylinder dioptres (DC), spherical equivalent refraction (SER) and corneal curvature radius (CR) were measured.
Results:
The study included 458 right eyes of 458 children. The mean changes in DS, DC and SER were 0.02 ± 0.35 D, -0.02 ± 0.33 D and 0.01 ± 0.37 D, while the mean changes in AL, CR and lens power (LP) were 0.27 ± 0.10 mm, 0.00 ± 0.04 mm and - 0.93 ± 0.49 D. The change in the SER was linearly correlated with the baseline SER (coefficient = -0.147, p < 0.001). When the baseline SER was at 1.05 D (95% CI = 0.21 to 2.16), the change in SER was 0 D. The baseline SER was also linearly associated with the change in LP (coefficient = 0.104, p = 0.013), but not with the change in AL (p = 0.957) or with the change in CR (p = 0.263).
Conclusion:
In eyes with a baseline SER less than +1.00 D, LP loss was higher compared to axial elongation, leading to hyperopic shifts in refraction, whereas for those with baseline SER over this range, loss of LP compared to axial elongation was reduced, leading to myopic shifts. This model indicated the homeostasis of human refraction and explained how refractive development leads to a preferred state of mild hyperopia.
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