Long-term visual prognosis of infantile-onset high myopia

Abstract

Purpose To investigate the clinical course and changes of refractive status in infantile-onset myopic children who received fully corrected glasses and to determine their visual prognosis. Methods In all, 57 children with infantileonset high myopia (spherical equivalent over À5.0 D prior to the age of 5 years) were included in this study. All children received initial full-correction glasses at the mean age of 3.52 years. The cycloplegic refraction, axial length, and the best-corrected visual acuity were collected every 6 months. The mean follow-up time was 9.36 years. Results We noted that the tendency toward progression or regression of myopia appeared to be related to the degree of refractive error. Lower grades of high myopia (À5.0 to À7.75 D) showed a greater tendency to progress than those of the highest initial myopic refraction level (rÀ11.0 D). While the latter group exhibited a more-substantial regression rate than those cases of the lower initial refraction level. About 80% of infantile-onset high myopes demonstrated a final best-corrected vision of greater than 20/40, with 37% of children revealing a best-corrected vision level even better than 20/25. Conclusion Clinical course of infantile high myopia is different to school myopia. Usually, higher degree of high myopia showed a stable state of myopia, or even possible regression, whereas the lower grades of high myopia revealed a strong tendency to progress.

Eye size and shape in newborn children and their relation to axial length and refraction at 3 years

“…Unknown alterations in the embryonic or foetal environment could explain rare cases of congenital, non-progressive myopia, in which the eye grows excessively before birth but maintains a normal rate of growth after birth. 59 In our cohort, subjects with larger eyes and more prolate shapes at birth showed smaller increases in AL over the first 3 years of life. As the gestational ages and birth weights of the newborns were all within a fairly narrow range, differences in maturity at birth are unlikely to account for our findings.…”

“…As such, the determination of eye shape at birth might have both genetic and environmental factors. Unknown alterations in the embryonic or foetal environment could explain rare cases of congenital, non‐progressive myopia, in which the eye grows excessively before birth but maintains a normal rate of growth after birth . In our cohort, subjects with larger eyes and more prolate shapes at birth showed smaller increases in AL over the first 3 years of life.…”

Clinical characteristics of patients with congenital high myopia

“…This result seems compatible with the report by Shih and colleagues. 2 As young boys, all four patients showed very similar fundus changes: vertically oval optic discs; temporal conus; and, in three, a tessellated fundus and posterior staphyloma. All staphyloma cases were type II according to Curtin's classifi cation.…”

“…We recently examined the cases of four infant boys who met the above criteria for congenital high myopia, 1,2 and all showed very similar fundus changes following Curtin's classifi cation, 4 including a type II posterior staphyloma without any ocular or systemic abnormalities, which could have contributed to the development of congenital myopia. We present the clinical characteristics of these four boys and report the long-term changes of the axial length and fundus fi ndings in one case that was followed for 30 years.…”

The Role of Atropine Eye Drops in Myopia Control

“…"Congenital myopia" is a rare condition that usually has high amounts of dioptric error; as neo-nates are not usually refracted, it is generally discovered only later during the first years of life. This infantile-onset high myopia is often stationary (non progressive) [1,2]. "Simple myopia", usually less severe than -5 to -6 diopters (D), is the most common form.…”