Longitudinal Evaluation of Static and Dynamic Accommodation in Young Children

Area of Science:

• Ophthalmology
• Pediatric Optometry
• Myopia Research

Background:

• Myopia development is a growing concern in pediatric populations.
• Understanding factors influencing myopia onset is crucial for early intervention.
• Accommodation responses (ARs) have been investigated as potential predictors of myopia.

Purpose of the Study:

• To longitudinally evaluate accommodation responses (ARs) over three years in children at high risk (HR) or low risk (LR) for myopia.
• To determine if ARs predict myopia onset in children.
• To investigate the relationship between ARs, age, and refractive error in myopia development.

Main Methods:

• A cohort of 92 children (mean age 7.54 years) with functional emmetropia were studied over three years.
• Accommodation was measured using an open-field autorefractor under static and dynamic conditions.
• Linear mixed models and logistic regression were used to analyze group differences and the predictive role of ARs on myopia onset.

Main Results:

• Children in the LR group consistently showed greater static AR and dynamic amplitude compared to the HR group, even after adjusting for age.
• These differences in ARs became non-significant after further adjustment for refractive error (spherical equivalent), indicating refractive error's stronger influence.
• Logistic regression revealed AR was a significant predictor of myopia onset when age was included, but not when refractive error was accounted for.

Conclusions:

• A lower AR is associated with increased myopia risk, but its effect appears secondary to the influence of refractive error.
• Similar patterns were observed for dynamic amplitude, suggesting accommodation plays a role but is overshadowed by refractive error.
• Longitudinal evaluations suggest that differences in accommodation may emerge before clinical myopia onset, highlighting the importance of early monitoring.