Related Experiment Video
Updated: May 17, 2025
Binocular Dynamic Visual Acuity in Eyeglass-Corrected Myopic Patients
Published on: March 29, 2022
[Age dependent refractive compensation for axial elongation in children modulated by follow-up duration and myopic
1Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Tongji University, Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of ocular fundus diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai University of Traditional Chinese Medicine, School of Public Health, Shanghai 201103, China.
Insights
Refractive compensation in children decreases over time and with age, especially in myopic eyes. This highlights the need for dynamic formulas to accurately assess myopia progression risk.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Myopia Research
Context:
- Childhood refractive development is crucial for visual health.
- Understanding axial elongation's impact on refraction is key to myopia management.
- Existing models may not fully capture age-related refractive compensation dynamics.
Purpose:
- To investigate age-related refractive compensation for axial elongation in children aged 6-9 years.
- To examine how follow-up duration, baseline age, and refractive status modulate this compensation.
- To analyze the temporal attenuation of refractive compensation per millimeter of axial elongation.
Summary:
- Axial elongation strongly correlates with refractive changes in children.
- Refractive compensation per millimeter of axial elongation significantly decreases over 1-4 years.
- Older baseline age and non-myopic status reduce compensation magnitude and efficiency.
Impact:
- Pediatric refractive compensation exhibits dual attenuation influenced by age and time.
- Myopic eyes show more pronounced compensation loss.
- Dynamic adjustment of axial length-to-refraction formulas is necessary for accurate myopia risk assessment.
Abstract:
Objective: To investigate age-related dynamics of refractive compensation for axial elongation in children aged 6-9 years, and examine the modulating effects of follow-up duration, baseline age, and refractive status. Methods: This prospective cohort study analyzed data from the Shanghai Time Outside to Reduce Myopia Trial (2016-2020), including 1 805 non-myopic or low-myopic children [mean age (6.77±0.35) years; 52.0% male]. Quantile regression analysis characterized spherical equivalent changes (ΔSE) per millimeter of axial elongation (ΔAL) across different observation periods (1-4 years). Mixed-effects models evaluated moderating factors including age and baseline refractive status. Results: Axial elongation demonstrated strong positive correlations with refractive changes across all follow-up durations (r:0.79-0.91, P<0.001). The median refractive compensation per millimeter axial elongation exhibited significant temporal attenuation: 2.06 D (1.84-2.31 D) at 1-year follow-up decreasing to 1.50 D (1.25-1.75 D) over 3-4 years (P-trend<0.001). Each additional baseline year reduced compensation magnitude by 0.19-0.31 D (P<0.05), with 6-year-olds showing 30.1% reduction in compensation efficiency (2.06 -1.44 D) over 4 years. Non-myopic eyes demonstrated 28.0% lower baseline compensation (1.44 D vs. 2.00 D, P<0.001) with slower annual attenuation (0.03 D vs. 0.19 D) compared to myopic eyes. Conclusions: Pediatric refractive compensation follows a dual attenuation pattern modulated by both age and time, with more pronounced compensation loss in myopic eyes. These findings emphasize the necessity for dynamic adjustment of axial length-to-refraction conversion formulae incorporating follow-up duration, baseline age, and refractive status to enhance myopia progression risk assessment.
