Journal List > J Korean Ophthalmol Soc > v.59(4) > 1010888

Chae and Kim: Long-term Changes in the Spherical Equivalent and Axial Length in Bilateral High-hyperopia Children

Abstract

Purpose

To explore changes in the spherical equivalent refractive error and axial length of both eyes of children with high hyperopia over time.

Methods

Children with bilateral hyperopia ≥ 4.0 diopters (D) underwent visual acuity testing and comprehensive ophthalmic examinations. The mean age at the first visit was 6.5 years and spherical equivalent refractive error and axial length were measured at least three times over the following year. Axial length was measured using an intraocular lens Master instrument (Carl Zeiss Meditec, Jena, Germany).

Results

The mean annual increase in axial length was +0.21 mm and the mean annual reduction in spherical equivalent refractive error was −0.39 D. Between the ages of 3 and 5 years, the mean annual increase in axial length was +0.36 ± 0.26 mm. In patients aged ≥ 9 years old, the mean annual increase was 0.12 ± 0.09 mm (p = 0.00). The mean annual reduction in spherical equivalent refractive error was −0.53 ± 1.00 D between the ages of 3 and 5 years, but became −0.32 ± 0.54 D at age ≥ 9 years old. This difference was not significant (p = 0.11).

Conclusions

In children with bilateral hyperopia, the spherical equivalent refractive error decreased and the axial length increased with age. The rate of axial length growth was higher in younger children.

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Figure 1.
Number of axial length measurements participated longer than 2 years. Range from 3 to 9, there were 2 eyes measured 9 times of axial length.
jkos-59-369f1.tif
Table 1.
The mean SE and AL changes during the period under observation
1st visit Last visit Annual change p-value*
SE (D) +6.69 ± 2.5 +5.09 ± 3.0 −0.39 ± 0.28 <0.05
AL (mm) +20.75 ± 1.36 +21.65 ± 1.74 +0.21 ± 0.15 <0.05
Age (years) 6.56 ± 1.55 10.97 ± 2.45

Values are presented as mean ± SD unless otherwise indicated.

SE = spherical equivalent; AL = axial length.

* Student t-test. p-value < 0.05 was set as statistical significance.

Table 2.
Changes in keratometric values
1st visit Last visit Annual change (D/year) p-value*
K (D) +42.83 ± 2.24 +42.79 ± 1.98 −0.04 ± 0.75 0.7

K = keratometry.

* Student t-test.

Table 3.
The annual hyperopic change rates during follow up period after initial refraction according to the severity of hyperopia
Number of eyes Initial degree of hyperopia (D) Annual change (D/year)
Group 1 (+4 ≤ and < +6D) 16 +5.60 ± 0.14 −0.43 ± 0.34
Group 2 (+6 ≤ and < +8D) 28 +7.11 ± 0.76 −0.31 ± 0.32
Group 3 (+8D ≤) 16 + 11.04 ± 2.43 −0.43 ± 0.48
p-value* 0.00 0.279

Values are presented as mean ± SD unless otherwise indicated.

* One way analysis of variance (ANOVA).

Table 4.
The annual axial length change rates during follow up period after initial measurement according to the severity of hyperopia
Number of eyes Initial measurement of axial length (mm) Annual change (mm/year)
Group 1 (+4 < and < +6D) 17 +21.34 ± 0.65 +0.26 ± 0.12
Group 2 (+6 < and <+8D) 31 +21.18 ± 0.76 +0.18 ± 0.07
Group 3 (+8D <) 16 +19.48 ± 1.9 +0.24 ± 0.25
p-value* 0.00 0.11

Values are presented as mean ± SD unless otherwise indicated.

* One way analysis of variance (ANOVA).

Table 5.
Comparison of SE and AL changes in different age interval
Age (years) 3~5 (n = 4) 5~7 (n = 24) 7~9 (n = 30) 9~ (n = 34) p-value*
SE (D/year) annual change −0.53 ± 1.00 −0.41 ± 0.57 −0.44 ± 0.47 −0.32 ± 0.54 0.11
AL (mm/year) annual change +0.36 ± 0.26 +0.27± 0.17 +0.23 ± 0.18 +0.12 ± 0.09 0.00

Values are presented as mean ± SD unless otherwise indicated.

SE = spherical equivalent; AL = axial length.

* Jonckheere-Terpstra test.

Table 6.
Comparison of SE in amblyopic eye and non-amblyopic eye
Number of eyes Initial degree of hyperopia (D) Annual change (D/year)
Amblyopic eye 27 +7.71 ± 2.31 −0.08 ± 0.06
Non-Amblyopic eye 33 +5.85 ± 2.37 −0.35 ± 0.18
p-value 0.00 0.572

Values are presented as mean ± SD unless otherwise indicated.

SE = spherical equivalent.

* Student t-test.

Table 7.
Comparison of AL in amblyopic eye and non-amblyopic eye
Number of eyes Initial degree of axial length (mm) Annual change (mm/year)
Amblyopic eye 27 +20.54 ± 1.32 +0.22 ± 0.20
Non-Amblyopic eye 33 +20.93 ± 1.39 +0.19 ± 0.10
p-value* 0.000 0.801

Values are presented as mean ± SD unless otherwise indicated.

AL = axial length.

* Student t-test.

Table 8.
Comparison of SE in eyes with undercorrection and full correction
Number of eyes Initial degree of hyperopia (D) Estimates of annual change (D/year)
Undercorrection 28 +6.82 ± 2.13 −0.31 ± 0.27
Full correction 32 +6.58 ± 2.91 −0.40 ± 0.35
p-value* 0.224 0.744

Values are presented as mean ± SD unless otherwise indicated.

SE = spherical equivalent.

* Student t-test.

Table 9.
Comparison of AL in eyes with undercorrection and full correction
Number of eyes Initial degree of Axial length (mm) Estimates of annual change (mm/year)
Undercorrection 28 +20.49 ± 1.33 +0.17 ± 0.09
Full correction 32 +20.97 ± 1.41 +0.19 ± 0.49
p-value* 0.003 0.134

Values are presented as mean ± SD unless otherwise indicated.

AL = axial length.

* Student t-test.

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