Development of Refractive Parameters in 3- to 6-Year-Old Children and Its Application in Myopia Prediction and Intervention Guidance

Objective. To investigate refractive development and prevalence of myopia in children aged 3-6 years in Hebei Province, China, and to explore the developmental law of refraction, so as to clinically guide the prediction and intervention of myopia. Methods. In May 2019, a total of 6120 people were inspected in 68 kindergartens in 11 cities in Hebei Province. Child refractive refraction was checked under noncycloplegia using a handheld binocular vision screener (SW-800, SUOER, Tianjin, China). Axial length (AL) and corneal radius of curvature (CR) were measured using an ocular biometry (IOLMaster 500, Carl Zeiss, Germany). Myopia was defined as spherical equivalent SE ≤ − 0.75 D . Results. A total of 5506 children aged 3-6 years met the criteria and were included in the statistical analysis. The prevalence of myopia was 3.49% (1.93% at age 3, 2.90% at age 4, 3.78% at age 5, and 3.88% at age 6). Overall, the mean SE was + 0.67 ± 1.05 D ( + 0.81 ± 1.00 D at age 3, + 0.79 ± 1.05 D at age 4, + 0.67 ± 1.08 D at age 5, and + 0.13 ± 1.01 D at age 6); the mean CR was 7.76 ± 0.26 mm ( 7.78 ± 0.26 mm at age3, 7.75 ± 0.25 mm at age 4, 7.77 ± 0.26 mm at age 5, and 7.76 ± 0.25 mm at age 6); the mean AL was 22.31 ± 0.73 mm ( 21.98 ± 0.63 mm at age 3, 22.12 ± 0.69 mm at age 4, 22.34 ± 0.73 mm at age 5, and 22.49 ± 0.73 mm at age 6). Conclusions. Prevalence of myopia increases with age in children aged 3-6 years in Hebei, China. With the increase of age, CR is basically stable, and AL increases gradually. AL/CR, which is closely related to SE, can be used as an indicator to predict myopia and guide clinical work.

Birth weight and refractive state measured by Spot Vision Screener in children aged 40 months

ObjectivesChildren with retinopathy of prematurity (ROP) often have myopia. Even without ROP, birth weight and refractive state are related immediately after birth, but this relationship is reduced with increasing age. Here, we examined whether refractive state and birth weight were associated in 40-month-old children.Methods and analysisOf 541 children aged 40 months in Tsubame City, Japan, who underwent a medical examination between April 2018 and March 2019, this cross-sectional study enrolled 411 whose birth weights were available (76% of all).We measured the non-cycloplegic refraction using a Spot Vision Screener and correlated this with birth weight. Children were divided into three groups according to normal (2500–3500 g), high (>3500 g) or low (<2500 g) birth weights, and mean differences in spherical equivalent (SE) between the groups were analysed.ResultsThe average SE for the right eye was 0.34 D (95% CI 0.28 to 0.40). Average birth weight was 3032.1 g (95% CI 2990.2 to 3073.9). Birth weight did not correlate with SE for the right eye (Pearson’s correlation, r=−0.015, p=0.765) or with the degree of anisometropia (Pearson’s correlation, r=−0.05, p=0.355). Furthermore, the mean SE showed no significant difference across the three groups of children with different birth weights (one-way analysis of variance, p=0.939).ConclusionData on refractive states and birth weight for 411 children of similar age in one Japanese city were analysed, showing that birth weight did not influence SE, J0, J45 and the absolute degree of anisometropia at about 40 months of age.

Amblyopia risk factors among pediatric patients in a hospital-based setting using photoscreening

Purpose The aim of our study was to determine the prevalence of amblyopia risk factors in children visiting the American University of Beirut Medical Center (AUBMC) using automated vision screening. Methods This was a hospital-based screening of 1102 children aged between 2 and 6 years. Vision screening was performed using PlusoptiX S12 over 2 years (2018–2020). The need for referral to a pediatric ophthalmologist was based on the amblyopia risk factors set forth by the American Association for Pediatric Ophthalmology and Strabismus. Referred patients underwent a comprehensive eye examination. Results A total of 1102 children were screened, 63 were referred for amblyopia risk factors (5.7%); 37/63 (59%) underwent comprehensive eye examination and 73% were prescribed glasses. Of the non-referred group of children, 6.35% had astigmatism, 6.25% were hyperopic and 3.27% were myopic. The refractive errors observed among the examined patients were distributed as follows: 41% astigmatism, 51% hyperopia, and 8% myopia; amblyopia was not detected. Refractive amblyopia risk factors were associated with the presence of systemic disorders. Bland-Altman plots showed most of the differences to be within limits of agreement. Conclusion Using an automated vision screener in a hospital-based cohort of children aged 2 to 6 years, the rate of refractive amblyopia risk factors was 5.7%. Hyperopia was the most commonly encountered refractive error and children with systemic disorders were at higher risk.

Comparison of photoscreeners and hand-held autorefractometer with cycloplegic autorefraction as a vision screening tool for children with newly diagnosed attention deficit hyperactivity disorder

Purpose: To compare non-cycloplegic refraction measurements of two photoscreeners and the hand-held autorefractometer with cycloplegic measurements of the autorefractometer in patients with attention deficit hyperactivity disorder (ADHD).Methods: This cross-sectional, comparative study consisted of 53 children who were newly diagnosed with ADHD. We compared spherical, cylindrical, cylindrical axis and spherical equivalent (SE) measurements in Plusoptix A12, Spot Vision Screener, and Retinomax K-plus Screen with Tonoref II. Reliability was analyzed by using the interclass correlation coefficient (ICC) and Bland-Altman plot was used to evaluate the agreement between devices.Results: The mean age of children was 9.45 ± 1.68. All of the devices measured spherical power and SE significantly more myopic than the Tonoref II. While The Spot Vision Screener, PlusoptiX A12, and Tonoref II provided similar cylindrical power, Retinomax K-plus Screen measured significantly lower than the Tonoref II. The excellent reliability was detected in spherical power, cylindrical power, SE and J0 between Tonoref II and PlusoptiX A12 (ICC:0.930, 0.921, 0.927 and 0.920, respectively. All of the hand-held devices showed excellent reliability in terms of cylindrical power and J0 (ICC>0.90, for all) and good reliability for J45 (ICC:0.75-0.90 for all).Conclusion: Despite all devices having advantages or disadvantages, Plusoptix A12 showed excellent reliability for detecting refractive errors in children with ADHD.

Comparison of photoscreeners and hand-held autorefractometer with cycloplegic autorefraction as a vision screening tool for children with newly diagnosed attention deficit hyperactivity disorder

Purpose: To compare non-cycloplegic refraction measurements of two photoscreeners and the hand-held autorefractometer with cycloplegic measurements of the autorefractometer in patients with attention deficit hyperactivity disorder (ADHD).Methods: This cross-sectional, comparative study consisted of 53 children who were newly diagnosed with ADHD. We compared spherical, cylindrical, cylindrical axis and spherical equivalent (SE) measurements in Plusoptix A12, Spot Vision Screener, and Retinomax K-plus Screen with Tonoref II. Reliability was analyzed by using the interclass correlation coefficient (ICC) and Bland-Altman plot was used to evaluate the agreement between devices.Results: The mean age of children was 9.45 ± 1.68. All of the devices measured spherical power and SE significantly more myopic than the Tonoref II. While The Spot Vision Screener, PlusoptiX A12, and Tonoref II provided similar cylindrical power, Retinomax K-plus Screen measured significantly lower than the Tonoref II. The excellent reliability was detected in spherical power, cylindrical power, SE and J0 between Tonoref II and PlusoptiX A12 (ICC:0.930, 0.921, 0.927 and 0.920, respectively. All of the hand-held devices showed excellent reliability in terms of cylindrical power and J0 (ICC>0.90, for all) and good reliability for J45 (ICC:0.75-0.90 for all).Conclusion: Despite all devices having advantages or disadvantages, Plusoptix A12 showed excellent reliability for detecting refractive errors in children with ADHD.

The Effect of Biometric Parameters on Spot Vision Screener Results

objective: Our aim in this study is to investigate the relationship between biometric parameters and spot vision screener [SVS]Materyal-Metods: 250 eyes of 125 children between the age of 6,77±1,59 included the study. The results of cyloplegic [CSVS] and noncycloplegic [NSVS] spot vision screener [Plusoptix p12,Germany] measurements and autorefractometer with cycloplegia [CA] were compared. The spherical equivalent [SE] differences of between CA and NSVS measurements with CA and CSVS measurements were compared with AL, ACD, CR, Mean K and AL / CR values. The relationship between them was examined.Results: According to the amblyopia risk factors [ARFs] based on the criteria from AAPOS 2013 guidelines , 33 eyes [13%] in the NSVS results and 34 eyes [13.6%] in the CSVS results were detected as amblyopic. According to CA results, NSVS had 67.3% sensitivity, 94.5% specificity, CSVS 69.4% sensitivity and 89.1% specificity in detecting amblyopia. When the SE differences of between CA and NSVS values were comparaed with biometric parameters a negative correlation was observed with ACD , AL and especially AL/CR ratio .Conclussion: Both NSVS and CSVS showed moderate sensitivity and high specificity in detecting AFRs based on the criteria from AAPOS 2013 guidelines. CSVS has no additional clinical advantage. Biometric parameters effect the NSVS results.