From the Department of Ophthalmology (J.Y.W., B.G.H.), Mayo Clinic, Rochester, Minnesota.
Department of Quantitative Heath Sciences (D.O.H.), Mayo Clinic, Jacksonville, Florida, USA.
Am J Ophthalmol. 2022 Feb;234:183-187. doi: 10.1016/j.ajo.2021.07.029. Epub 2021 Jul 31.
To compare visual outcomes in children with moderate bilateral astigmatism treated with glasses with those who were merely observed.
Retrospective case series.
The medical records of all children 1 to <7 years of age who were diagnosed with moderate bilateral astigmatism (+1.25 to +3.25 diopters [D]) at a single institution over a 12-year period were retrospectively reviewed. Children with anisometropia ≥1.00 D, hyperopia ≥+3.00 D, myopia ≥-3.00D, amblyopia, or strabismus at diagnosis were excluded. Observation or full spectacle correction of astigmatism was at the provider's discretion. Kaplan-Meier rates of developing amblyopia and strabismus were assessed over a minimum follow-up of 18 months.
Eighty-five (6.9%) of 1235 subjects met the inclusion criteria; 58 (68.2%) were prescribed glasses while 27 (31.8%) were observed. The groups differed by mean age at diagnosis (3.56 ± 1.42 years for observed vs 4.31 ± 1.36 years for glasses [P = .03]) and mean amount of astigmatism (1.73 ± 0.43 D for observed vs 2.00 ± 0.51 D for glasses [P = .02]). By 4 years of follow-up, the Kaplan-Meier rate of developing amblyopia was 8.3% (95% confidence interval [CI] 0%-19.4%) in the observed group and 10.3% (95% CI 1.5%-19.1%) in the glasses group [P = .74] while strabismus was 7.1% (95% CI 0%-20.6%) among those observed and 7.1% (95% CI 0.4%-13.8%) of those prescribed glasses [P = .60].
Rates of amblyopia and strabismus were similar and modest in this cohort of children with moderate bilateral astigmatism treated with glasses vs observation. These results suggest that prescribing glasses for these children may be no better than observation in preventing the development of amblyopia or strabismus.
比较中度双侧散光儿童戴眼镜治疗与单纯观察的视力结果。
回顾性病例系列。
回顾性分析了一家机构在 12 年期间诊断为中度双侧散光（+1.25 至+3.25 屈光度[D]）的所有 1 至<7 岁儿童的病历。排除有屈光不正≥1.00 D、远视≥+3.00 D、近视≥-3.00 D、弱视或斜视的儿童。散光的观察或全眼镜矫正由提供者决定。评估了至少 18 个月的随访后发生弱视和斜视的 Kaplan-Meier 率。
1235 名受试者中有 85 名（6.9%）符合纳入标准；58 名（68.2%）被处方眼镜，27 名（31.8%）被观察。两组在诊断时的平均年龄（观察组为 3.56 ± 1.42 岁，眼镜组为 4.31 ± 1.36 岁[P =.03]）和平均散光量（观察组为 1.73 ± 0.43 D，眼镜组为 2.00 ± 0.51 D[P =.02]）上存在差异。在 4 年的随访中，观察组弱视的 Kaplan-Meier 发生率为 8.3%（95%置信区间[CI] 0%-19.4%），眼镜组为 10.3%（95% CI 1.5%-19.1%）[P =.74]，而斜视在观察组中为 7.1%（95% CI 0%-20.6%），在配镜组中为 7.1%（95% CI 0.4%-13.8%）[P =.60]。
在中度双侧散光儿童中，戴眼镜治疗与单纯观察相比，弱视和斜视的发生率相似且适中。这些结果表明，为这些儿童配眼镜可能并不优于观察，无法预防弱视或斜视的发生。
