The effect of optical correction on refractive development in children with accommodative esotropia

Biler, Elif Demirkilinc; Üretmen, Önder; Köse, Süheyla

doi:10.1016/j.jaapos.2010.01.017

Cited by 13 publications

(13 citation statements)

References 24 publications

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“…The emmetropization mechanisms in esotropic patients and the effects of optical correction on the eye-growth remain, although extensively studied, an unresolved issue. Birch et al reported a slower emmetropization process in esotropic children compared to healthy controls [ 9 , 10 ]; although some Authors suggested the emmetropization process might be prevented by using full optical correction of hyperopia [ 11 , 12 ], Demirkilinç Biler et al described no significant differences between the development of refractive error in children treated with partial and full spectacles correction [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Long-term development of refractive error in refractive, nonrefractive and partially accommodative esotropia

Veneruso¹,

Bruzzese

Magli

2018

PLoS ONE

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Accommodative esotropia (AE) is a convergent deviation due to an excess of the convergence linked to the innervational stimulus for accommodation and it is usually associated to the presence of hyperopia. The development of hyperopia over time has been widely described but the lack of comparative analysis among accommodative esotropia subtypes, does not allow to verify the existence of different developmental patterns. In this study we aimed to describe the long term changes of refractive error in patients affected by accommodative esotropia as a function of the strabismus type: refractive (RAE), non-refractive (NRAE) and partially accommodative esotropia (PAE). The medical records of 66 patients (24 RAE, 22 PAE, 20 NRAE), who wore the full correction of their cycloplegic refraction error during the entire follow up period, were retrospectively reviewed. Mean outcome was the analysis of the variations, among groups, of refractive error over time; differences between mild (≤3.00D) and high (≥5.00D) hyperopia, effects of amblyopia and relationship with AC/A ratio were also investigated. All patients were followed up from approximately 4 years of age to 20, with mean follow up of 16.06±0.29 years. Our results described similar non-linear trend of refractive error development among groups. The initial increase of hyperopia (up to 7–8 years) was followed by a decreasing trend persisting up to adulthood (approximately 20 years of age). During this period, spherical equivalent decreased at a lower mean annual rate in patients affected by RAE (-0.07D) compared to other groups (NRAE -0.11D, p = 0.003 and PAE 0.13D, p = 0.002). In all groups, however, significant amount of hyperopia was found at last examination; indeed the observed difference in SE values from baseline to the end of follow up, was not significant (RAE: +0.27D, 95% C.I. -0.49 to +1.04D, p = 0.472; PAE: -0.69D, 95% C.I. -1.67 to +0.28D, p = 0.154; NRAE: -0.39D, 95% C.I. -1.11 to +0.34D, p = 0.278). AC/A ratio, amblyopia and amount of initial hyperopia appeared to have no significant role in longitudinal change of the refractive error. In conclusion, this study provides a complete overview, from childhood to adulthood, of refractive error development in different form of accommodative esotropia.

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Section: Introductionmentioning

confidence: 99%

Long-term development of refractive error in refractive, nonrefractive and partially accommodative esotropia

Veneruso¹,

Bruzzese

Magli

2018

PLoS ONE

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“…According to these studies, eliminating the retinal blur with appropriate lenses could remove the stimulus for the myopic shift toward emmetropia in hyperopic children. In contrast, Demirkilinç et al7 suggested that partial or full correction of hyperopia has similar effects on refractive development as in accommodative esotropia. Thus, it is possible that the way of correction for hyperopia may influence on the refractive development.…”

Section: Discussionmentioning

confidence: 94%

“…However, there is substantial variability in the extent of emmetropization in infants with hyperopia. It is reported that the most hyperopic infants, those in excess of +5 diopters (D), tend not to emmetropize effectively 7. Thus, the mechanisms of emmetropization remain unclear.…”

Section: Introductionmentioning

confidence: 99%

Relationship between lenticular power and refractive error in children with hyperopia

Tomomatsu

Kono²,

Arimura³

et al. 2013

OPTH

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ObjectivesTo evaluate the contribution of axial length, and lenticular and corneal power to the spherical equivalent refractive error in children with hyperopia between 3 and 13 years of age, using noncontact optical biometry.MethodsThere were 62 children between 3 and 13 years of age with hyperopia (+2 diopters [D] or more) who underwent automated refraction measurement with cycloplegia, to measure spherical equivalent refractive error and corneal power. Axial length was measured using an optic biometer that does not require contact with the cornea. The refractive power of the lens was calculated using the Sanders-Retzlaff-Kraff formula. Single regression analysis was used to evaluate the correlation among the optical parameters.ResultsThere was a significant positive correlation between age and axial length (P = 0.0014); however, the degree of hyperopia did not decrease with aging (P = 0.59). There was a significant negative correlation between age and the refractive power of the lens (P = 0.0001) but not that of the cornea (P = 0.43). A significant negative correlation was observed between the degree of hyperopia and lenticular power (P < 0.0001).ConclusionAlthough this study is small scale and cross sectional, the analysis, using noncontact biometry, showed that lenticular power was negatively correlated with refractive error and age, indicating that lower lens power may contribute to the degree of hyperopia.

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“…These clinical experiences led us to analyze our data for the evaluation of factors related to spectacles discontinuation among RAE patients whose refractive errors were ≥+2.00 D at the initial visit, but became mild hyperopic (<+2.00 D) or even myopic after refractive shift. Previous studies have reported various results of clinical courses of RAE and associated factors related to the discontinuation of spectacles [1,6,7]. Mohney et al [1] reported an association of full term birth and low hyperopic error with early discontinuation of spectacles.…”

Section: Discussionmentioning

confidence: 99%

“…The deviation is the result of an abnormal activation of the accommodation reflex required to overcome blurring caused by uncorrected hyperopia [4,5]; therefore, prescribing spectacles for correction of hyperopia has been a main treatment option for patients with RAE [1,5,6,7,8]. During the follow-up, most of the RAE patients experience a refractive shift toward decreasing hyperopia, even myopia [4,9,10,11].…”

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confidence: 99%

Accommodative Esotropia Who Needs Spectacles for Good Ocular Alignment after Refractive Shift below +2.00 Diopters

Kim

2014

Korean J Ophthalmol

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PurposeThe aim of this study is to investigate the clinical characteristics of patients diagnosed with refractive accommodative esotropia (RAE) whose refractive errors were gradually reduced to below +2.00 diopters (D) during follow-up but use of spectacles was still required for maintenance of good ocular alignment.MethodsWe conducted a retrospective review of the medical records of patients diagnosed with RAE from 1995 to 2011. Patients were divided into 2 groups according to their ocular alignment at the last visit. Inclusion criteria were hyperopia ≥+2.00 D detected with cycloplegic refraction at the initial visit, which then became mild hyperopia (<+2.00 D) or myopia during follow-up, with more than 5 years of follow-up.ResultsA total of 92 patients met the inclusion criteria. Twenty-six patients showed persistent esotropia (≥10 prism diopters [PD]) without spectacles (group A) and 66 patients showed good ocular alignment (<10 PD) without spectacles (group B) at the last visit. No statistically significant differences in the spherical equivalent of the refractive errors at the initial and last visit were observed between the two groups. A significantly lower number of positive responses on the Lang I stereotest was observed in group A (n = 1, 3.8%) compared to group B (n = 22, 33.3%) (p = 0.003). There were increasing trends toward group A with worsening stereoacuity measured by the Stereo Fly Stereotest between the two groups (p = 0.016, linear by linear association). The results of the Lang I test, Stereo Fly Stereotest, and duration between the onset of esotropia and prescribing spectacles showed a significant association with the discontinuation of spectacles in the univariate logistic analysis.ConclusionsStereoacuity showed more significant associations than refractive errors in RAE with refractive error <+2.00 D but still required spectacles for maintenance of good ocular alignment. The prompt treatment of accommodative esotropia at the onset of esotropia is important for the discontinuation of spectacles.

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The effect of optical correction on refractive development in children with accommodative esotropia

Cited by 13 publications

References 24 publications

Long-term development of refractive error in refractive, nonrefractive and partially accommodative esotropia

Long-term development of refractive error in refractive, nonrefractive and partially accommodative esotropia

Relationship between lenticular power and refractive error in children with hyperopia

Accommodative Esotropia Who Needs Spectacles for Good Ocular Alignment after Refractive Shift below +2.00 Diopters

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