State Key Laboratory of Ophthalmology, Zhongshan Opthalmic Center, Sun Yat-Sen University, Guangzhou, China.
Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia.
Invest Ophthalmol Vis Sci. 2019 Jul 1;60(8):3127-3134. doi: 10.1167/iovs.18-26435.
Moderate to high hyperopia is associated with visual deficits. Currently, to our knowledge no study has reported its longitudinal refraction change in a large sample of schoolchildren. We investigated the longitudinal changes in spherical equivalent (SE) refractive error among schoolchildren with moderate to high hyperopia.
Medical records of patients seeking refractions at Zhongshan Ophthalmic Center between 2009 and 2017 were reviewed retrospectively. Eligible criteria included hyperopia ≥+2.00 diopters (D) at an initial age of 6 to 8 years, at least three visits, and at least a 2-year follow-up. Individual pattern of refraction development was evaluated based on the mean rate of change in SE. Mixed-effect regression analysis was used to explore factors associated with the rate of change.
A total of 1769 cases were identified. Median initial age was 6.4 (interquartile range [IQR], 5.9 to 7.1) years and median age at the final visit was 10.1 (IQR, 8.9 to 11.5) years. Median initial SE was +3.13 (IQR, +2.38 to +5.25) D. On average, participants experienced a myopic shift of -0.35 ± 0.27 D/year. A considerable number of eyes (721, 40.8%) demonstrated a longitudinal change of less than ±0.25 D/year and approximately 1 of 3 (611/1769) eyes demonstrated a change of >-0.50 and ≤-0.25 D/year. Children with greater initial hyperopia (β = -0.02, P < 0.001) experienced significantly faster reduction in hyperopic refraction. Age and sex had statistically significant but clinically insignificant impacts on the rate of hyperopia reduction.
Variation exists in the refraction development of schoolchildren with moderate to high hyperopia. A considerable percentage of eyes demonstrates longitudinally stable refraction.
中高度远视与视觉缺陷有关。目前，据我们所知，尚无研究在大量学龄儿童中报告其远视的纵向屈光度变化。我们调查了中高度远视的学龄儿童的球镜等效（SE）屈光不正的纵向变化。
回顾性分析 2009 年至 2017 年间在中山眼科中心接受屈光检查的患者的病历。纳入标准包括初诊年龄为 6 至 8 岁时远视≥+2.00 屈光度（D），至少随访 3 次，随访时间至少 2 年。根据 SE 的平均变化率评估个体屈光发育模式。采用混合效应回归分析探讨与变化率相关的因素。
共纳入 1769 例患者。中位初诊年龄为 6.4（四分位距 [IQR]，5.9 至 7.1）岁，末次随访年龄为 10.1（IQR，8.9 至 11.5）岁。中位初始 SE 为+3.13（IQR，+2.38 至 +5.25）D。平均而言，患者每年经历-0.35±0.27 D 的近视漂移。相当数量的眼（721 只，40.8%）的纵向变化小于±0.25 D/年，大约 1/3（611 只/1769 只）的眼的变化大于-0.50 且≤-0.25 D/年。初始远视程度较高的儿童（β=-0.02，P<0.001）远视矫正的减少速度显著更快。年龄和性别对远视减少率有统计学意义但临床意义不大的影响。
中高度远视的学龄儿童的屈光发育存在差异。相当比例的眼表现出纵向稳定的屈光状态。
