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

Year 2022, Volume: 5 Issue: 1, 287 - 290, 17.01.2022

Sücattin İlker Kocamış , İbrahim Özdemir

https://doi.org/10.32322/jhsm.1017563

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.

Keywords

accommodation, cycloplegic refraction, myopia progression

References

• Vitale S, Sperduto RD, Ferris FL, 3rd Increased prevalence of myopia in the United States between 1971-1972 and 1999-2004. Arch Ophthalmol 2009; 127: 1632-9.
• Saw SM, Gazzard G, Shih-Yen EC, Chua WH. Myopia and associated pathological complications. Ophthalmic Physiol Opt 2005; 25: 381-91.
• Hammond CJ, Snieder H, Gilbert CE, Spector TD. Genes and environment in refractive error: the twin eye study. Invest Ophthalmol Vis Sci 2001; 42: 1232-6.
• Fan DSP, Lam DSC, Lam RF, et al. Prevalence, incidence, and progression of myopia of school children in Hong Kong. Invest Ophthalmol Vis Sci 2004; 45: 1071-5.
• Zadnik K, Sinnott LT, Cotter SA, et al. Prediction of juvenile-onset myopia. JAMA Ophthalmol 2015; 133: 683-9.
• Polling JR, Verhoeven VJ, Tideman JW, Klaver CC. Duke-Elder’s views on prognosis, prophylaxis, and treatment of myopia: way ahead of his time. Strabismus 2016; 24: 40-3.
• Fotouhi A, Morgan IG, Iribarren R, Khabazkhoob M, Hashemi H. Validity of noncycloplegic refraction in the assessment of refractive errors: the Tehran Eye Study. Acta Ophthalmol 2012; 90: 380-6.
• Chinese Medical Association of Ophthalmology DoR. Definition and classic criterion for distinguishing between true myopia and pseudo-myopia. Chinese J Ophthalmol 1986; 22: 184-5.
• Morgan IG, Iribarren R, Fotouhi A, Grzybowski A. Cycloplegic refraction is the gold standard for epidemiological studies. Acta Ophthalmol 2015; 93: 581-5.
• Lin Z, Vasudevan B, Ciuffreda KJ, et al. The difference between cycloplegic and noncycloplegic autorefraction and its association with progression of refractive error in Beijing urban children. Ophthalmic Physiol Opt 2017; 37: 489-97.
• Howlett MH, McFadden SA. Form-deprivation myopia in the guinea pig (Cavia porcellus). Vision Res 2006; 46: 267-83.
• Tkatchenko TV, Shen Y, Tkatchenko AV. Mouse experimental myopia has features of primate myopia. Invest Ophthalmol Vis Sci 2010; 51: 1297-303.
• Seidemann A, Schaeffel F. An evaluation of the lag of accommodation using photorefraction. Vision Res 2003; 43: 419-30.
• Gwiazda JE, Hyman L, Norton TT, et al. Accommodation and related risk factors associated with myopia progression and their interaction with treatment in COMET children. Invest Ophthalmol Vis Sci 2004; 45: 2143-51.
• Koomson NY, Amedo AO, Opoku-Baah C, Ampeh PB, Ankamah E, Bonsu K. Relationship between reduced accommodative lag and myopia progression. Optom Vis Sci 2016; 93: 683-91.
• Chung K, Mohidin N, O’Leary DJ. Undercorrection of myopia enhances rather than inhibits myopia progression. Vision Res 2002; 42: 2555-9.
• Adler D, Millodot M. The possible effect of undercorrection on myopic progression in children. Clin Exp Optom 2006; 89: 315-21.
• Jin CC, Pei RX, Du B, et al. Lag of accommodation predicts clinically significant change of spherical equivalents after cycloplegia. Int J Ophthalmol 2021; 14: 1052-8.
• Hussaindeen JR, Anand M, Sivaraman V, Ramani KK, Allen PM. Variant myopia: A new presentation? Indian J Ophthalmol 2018; 66: 799-805.
• Ip JM, Saw SM, Rose KA, et al. Role of near work in myopia: findings in a sample of Australian school children. Invest Ophthalmol Vis Sci 2008; 49: 2903-10.
• Lin Z, Vasudevan B, Jhanji V, et al. Near work, outdoor activity, and their association with refractive error. Optom Vis Sci 2014; 91: 376-82.
• Walline JJ. Myopia Control: A Review. Eye Contact Lens 2016; 42: 3-8.
• Anstice NS, Phillips JR. Effect of dual-focus soft contact lens wear on axial myopia progression in children. Ophthalmology 2011; 118: 1152-61.
• French AN, Morgan IG, Mitchell P, Rose KA. Patterns of myopigenic activities with age, gender and ethnicity in Sydney schoolchildren. Ophthal. Physiol Opt 2013; 33: 318-28.
• Mutti DO, Mitchell GL, Hayes JR, et al. Accommodative lag before and after the onset of myopia. Invest Ophthalmol Vis Sci 2006; 47: 837-46.
• Troilo D, Gottlieb MD, Wallman J. Visual deprivation causes myopia in chicks with optic nerve section. Curr Eye Res 1987; 6: 993-9.
• Tong L, Huang XL, Koh AL, Zhang X, Tan DT, Chua WH. Atropine for the treatment of childhood myopia: effect on myopia progression after cessation of atropine. Ophthalmology 2009; 116: 572-9.
• Lanca C, Foo LL, Ang M, Tan CS, et al. Rapid Myopic Progression in Childhood Is Associated With Teenage High Myopia. Invest Ophthalmol Vis Sci 2021; 62: 17.
• Guirao A, Williams DR. A method to predict refractive errors from wave aberration data. Optom Vis Sci 2003; 80:36‑42.