The difference between the cycloplegic and noncycloplegic refractive error may be an indicator for the myopia progression in myopic children

Abstract

Aim:We aimed to evaluate the relationship between the subjective and objective refractive error measurement difference and myopia progression in this study. Material and Method:Children between 6-18 year-old at the beginning of the follow-up period having myopia and who were followed up regularly every six months and for a total of at least 36 months were included in the study. All children underwent a detailed ophthalmologic examination. An autorefractor (TOPCON KR1/RM1, Topcon, Oakland, New Jersey), was used to evaluate the refractive error. Those with a refractive error difference of less than 0.50 D (spherical equivalent) before and after cycloplegia were included in group 1. Those with a refractive error difference of higher than 0.50 D were included in group 2. Myopic progression of the groups was compared.Results: This study comprised 44 patients (male, 23; female, 21) in group 1 and 42 patients (male, 22; female, 20) in group 2. The age range and mean age±SD of patients in group 1 were 6-17 years and 11.4±3.0 years, respectively, whereas that of patients in group 2 was 6-17 years and 12.6±3.3 years, respectively. Both groups were followed for similar periods (p= 0.141). It was 37.5±2.4 (range 36-48) months in group 1 and 36.8±1.6 (range 36-42) months in group 2. The range and mean of the cycloplegic refractive error at the beginning of the following period in group 1 were -2.37±1.15 D, and -1.75±0.99 D in group 2 respectively (p= 0.010). At the end of the following period, the mean cycloplegic refractive error were -2.73±1.11 D in group 1, and -3,33±0.91 D in group 2 respectively (p= 0.008). During follow-up, the change in cycloplegic refractive error was 0.36±0.16 D in group 1, and 1.57±0.46 D in group 2. It was significantly lower in group 1 than group 2 (p< 0.0001). Conclusion:We demonstrated that myopic children having high baseline difference between the objective and subjective spheric equivalent measurements had more myopia progression.