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Correlation of Refractive Error with Anisometropia Development in Early Childhood
Michael Kinori1, Itay Nitzan2, Naava Sadi Szyper3
1Department of Ophthalmology (M.K.), Assuta Medical Center Ashdod, Israel and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Insights
Children with increasing refractive errors like myopia or hyperopia are more prone to developing anisometropia. Regular eye exams are crucial for early detection and prevention of vision problems in young children.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Public Health
Background:
- Refractive errors are common in preschool children.
- Anisometropia, a significant difference in refractive error between eyes, can lead to amblyopia.
- Understanding risk factors for anisometropia is crucial for early intervention.
Purpose of the Study:
- To investigate the association between refractive error type and severity and the development of anisometropia in preschool children.
- To identify specific refractive error patterns that increase the risk of anisometropia.
Main Methods:
- A retrospective cohort study analyzed data from 33,496 isometropic children aged 1-6 years.
- Children were followed for a mean of 5.1 years, with anisometropia defined as a ≥1 diopter interocular difference.
- Logistic regression models, adjusted for sociodemographic factors, assessed the relationship between baseline refractive error and anisometropia development.
Main Results:
- 7.7% of children developed anisometropia during the follow-up period.
- Increased severity of myopia, hyperopia, and astigmatism at baseline significantly correlated with higher odds of developing anisometropia.
- Severe myopia showed the highest odds ratio (13.90) for anisometropia development.
Conclusions:
- Preschool children with progressive myopia, hyperopia, or astigmatism are at a higher risk of developing anisometropia.
- Routine monitoring of refractive status in young children is essential for timely diagnosis and management of anisometropia.
- Early detection and treatment can prevent potential visual complications associated with anisometropia.
Purpose:
This study aims to investigate the relationship between the type and severity of refractive error and anisometropia development in preschool children.
Design:
Retrospective cohort study.
Methods:
Data from Maccabi Healthcare Services, Israel's second-largest Health Maintenance Organization (HMO), were analyzed. The study included all isometropic children aged 1 to 6 years, re-examined for refraction at least 2 years following their initial examination between 2012 and 2022. Anisometropia was defined as a ≥1 diopter interocular difference in spherical equivalent. Relationships were assessed using logistic regression models adjusted for key sociodemographic factors.
Results:
Among 33,496 isometropic children (51.2% male, mean age 3.2 ± 1.5 years), the prevalences of emmetropia, myopia, and hyperopia were 26.7% (n = 8944), 4.2% (n = 1397), and 69.1% (n = 23,155), respectively. Over a mean follow-up period of 5.1 ± 2.4 years, 2593 children (7.7%) were diagnosed with anisometropia. Adjusted odds ratios (ORs) for anisometropia gradually increased with baseline refractive error severity, reaching 13.90 (5.32-36.34) in severe myopia and 4.19 (3.42-5.15) in severe hyperopia. This pattern was also evident in cylindrical anisometropia, where ORs increased with greater baseline astigmatism, peaking at 12.10 (9.19-15.92) in children with high astigmatism (≥3 D). Associations remained consistent in sensitivity and subgroup analyses including across both sexes and when using a stricter anisometropia criterion.
Conclusions:
Children aged 1 to 6 years, initially without anisometropia but showing increasing severity of myopia, hyperopia, or astigmatism, are more likely to develop anisometropia. This underscores the importance of follow-up refractive measurements within this population to promptly diagnose and treat anisometropia and prevent potential visual complications.
