Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.
Curr Eye Res. 2024 Jul;49(7):768-775. doi: 10.1080/02713683.2024.2336162. Epub 2024 Apr 14.
This study aims to elucidate the longitudinal refractive and ocular biometric alterations in preschool children with high hyperopia who underwent early interventions.
We conducted a retrospective analysis of preschool children diagnosed with high hyperopia at Tianjin Medical University Eye Hospital between 2011 and 2023. Inclusion criteria required an initial examination with cycloplegic refraction, bilateral spherical equivalent power (SE) ≥ +5.00D with a difference <1.00D, a minimum two-year follow-up, and at least three ocular biometric measurements. The annual axial growth rate evaluated emmetropization in highly hyperopic children. We applied Restricted Cubic Spline (RCS) models to explore potential nonlinear relationships between age and spherical equivalent, axial length, corneal curvature, and axial length-to-corneal curvature ratio. Additionally, Mixed-effects models were employed to investigate factors associated with changes in refractive error and axial length.
The study enrolled 60 eligible subjects, with a median initial diagnosis age of 3.5 years (IQR, 2.8-4.9 years) and a median last visit age of 9.3 years (IQR, 8.1-10.8 years). The average follow-up duration was 5.7 years. RCS analysis revealed notable nonlinear changes in spherical equivalent power, axial length, and axial length-to-corneal curvature ratio, although corneal curvature displayed no statistically significant nonlinear trend. Factors affecting SE changes included the presence of strabismus, the use of cycloplegia, baseline SE, and age. Conversely, changes in axial length solely correlated with baseline axial length and age.
Highly hyperopic preschool children undergoing early intervention display a marked emmetropization tendency, though most still remain moderately to highly hyperopic, with the progression of refractive changes showing non-uniform patterns with respect to age.
本研究旨在阐明早期干预的高度远视学龄前儿童的纵向屈光和眼生物测量变化。
我们对 2011 年至 2023 年在天津医科大学眼科医院诊断为高度远视的学龄前儿童进行了回顾性分析。纳入标准为：散瞳验光初始检查，双眼等效球镜（SE）≥+5.00D，差异<1.00D，至少两年随访，至少有三次眼生物测量。每年眼轴增长率评估高度远视儿童的正视化情况。我们应用限制三次样条（RCS）模型探索年龄与 SE、眼轴长度、角膜曲率和眼轴长度与角膜曲率比之间潜在的非线性关系。此外，还应用混合效应模型探讨与屈光不正和眼轴长度变化相关的因素。
该研究共纳入 60 名符合条件的受试者，中位初始诊断年龄为 3.5 岁（IQR，2.8-4.9 岁），中位最后一次就诊年龄为 9.3 岁（IQR，8.1-10.8 岁）。平均随访时间为 5.7 年。RCS 分析显示 SE、眼轴长度和眼轴长度与角膜曲率比的变化呈显著非线性，而角膜曲率无统计学意义的非线性趋势。影响 SE 变化的因素包括斜视的存在、睫状肌麻痹的使用、基线 SE 和年龄。相反，眼轴长度的变化仅与基线眼轴长度和年龄相关。
早期干预的高度远视学龄前儿童表现出明显的正视化趋势，但大多数仍为中高度远视，屈光变化的进展在年龄上呈现非均匀模式。
