The clinical features and concomitant diseases in preschool high myopia

Abstract

The aim of this study was to summarize the clinical and demographic findings of preschool children presenting to the ophthalmology clinic with high myopia and to compare them with controls. A retrospective chart review was performed in patients with myopia of -6D or higher before the age of 4 years. The control group of similar age and sex was created from the patients presenting to the ophthalmology department for routine eye examination without any apparent complaint. Child and parent characteristics, concomitant ocular and systemic pathologies were recorded and analyzed. Seventy patients (35 cases with high myopia and 35 controls) were included in the study. Compared to controls, the cases in the study group had significantly higher rate of birth in spring (37.1% vs 8.6%), higher rate of strabismus (57.1% vs 14.3%) and paternal smoking (54.3% vs 37.1%), higher parental consanguinity (34.3% vs 11.4%) and higher rate of concomitant diseases (51.4% vs 17.1%). Birth season, paternal smoking and consanguinity were found to correlate with high myopia in children under the age of 4. High rates of ocular and systemic comorbidities should be considered in patients with high myopia at preschool age.

Keywords

• high myopia
• preschool myopia
• strabismus
• consanguinity
• birth season

References

1. 1. Holden BA, Fricke TR, Wilson DA et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology 2016;123:1036–42. doi.org/10.1016/j.ophtha.2016.01.006
2. 2. Morgan IG, Ohno-Matsui K, Saw SM. Myopia. Lancet (London, England) 2012;379:1739–48. doi.org/10.1016/S0140-6736(12)60272-4
3. 3. Deng L, Gwiazda J. Birth season, photoperiod, and infancy refraction. Optom Vis Sci 2011;88:383-7. doi:10.1097/OPX.0b013e31820b0517
4. 4. Shih YF, Ho TC, Hsiao CK, Lin LL. Long-term visual prognosis of infantile-onset high myopia. Eye (Lond) 2006;20: 888-92. doi:10.1038/sj.eye.6702035
5. 5. Low W, Dirani M, Gazzard G et al. Family history, near work, outdoor activity, and myopia in Singapore Chinese preschool children. Br J Ophthalmol 2010;94:1012-6. doi:10.1136/bjo.2009.173187
6. 6. Hu Y, Ding X, Long W, He M, Yang X. Longitudinal changes in spherical equivalent refractive error among children with preschool myopia. Invest Ophthalmol Vis Sci 2019;60:154-60. doi: 10.1167/iovs.18-24862
7. 7. Morgan IG, French AN, Ashby RS et al. The epidemics of myopia: Aetiology and prevention. Progress in Retinal and Eye Research 2018;62:134–49. doi.org/10.1016/j.preteyeres.2017.09.004
8. 8. Jones LA, Sinnott LT, Mutti DO, Mitchell GL, Moeschberger ML, Zadnik K. Parental history of myopia, sports and outdoor activities, and future myopia. Invest Ophthalmol Vis Sci 2007;48(8):3524-32. doi: 10.1167/iovs.06-1118.

9. 9. Mutti DO, Mitchell GL, Moeschberger ML, Jones LA, Zadnik K. Parental myopia, near work, school achievement, and children's refractive error. Invest Ophthalmol Vis Sci 2002;43(12):3633-40.
10. 10. Pärssinen O, Kauppinen M. Associations of near work time, watching TV, outdoors time, and parents' myopia with myopia among school children based on 38-year-old historical data. Acta Ophthalmol. 2021. doi: 10.1111/aos.14980.
11. 11. Mandel Y, Grotto I, El-Yaniv R et al. Season of birth, natural light, and myopia. Ophthalmology 2008;115:686-92.
12. 12. Ramamurthy D, Lin Chua SY, Saw SM. A review of environmental risk factors for myopia during early life, childhood and adolescence. Clinical & Experimental Optometry 2015;98:497–506 . doi.org/10.1111/cxo.12346
13. 13. Iyer JV, Low WC, Dirani M, Saw SM. Parental smoking and childhood refractive error: the STARS study. Eye (London, England) 2012;26:1324–8. doi.org/10.1038/eye.2012.160
14. 14. Saw SM, Chia KS, Lindstrom JM, Tan DT, Stone RA. Childhood myopia and parental smoking. Br J Ophthalmol 2004;88(7):934-7. doi: 10.1136/bjo.2003.033175.
15. 15. Rahi JS, Cumberland PM, Peckham CS. Myopia over the lifecourse: prevalence and early life influences in the 1958 British birth cohort. Ophthalmology 2011;118(5):797-804. doi: 10.1016/j.ophtha.2010.09.025. 16. Hsiang HW, Ohno-Matsui K, Shimada N et al. Clinical characteristics of posterior staphyloma in eyes with pathologic myopia. Am J Ophthalmol 2008;146:102-10. doi: 10.1016/j.ajo.2008.03.010
16. 17. Zhang XJ, Lau YH, Wang YM et al. Prevalence of strabismus and its risk factors among school aged children: The Hong Kong Children Eye Study. Sci Rep 2021;11(1):13820. doi: 10.1038/s41598-021-93131-w.
17. 18. Tang SM, Chan RY, Bin Lin S et al. Refractive Errors and Concomitant Strabismus: A Systematic Review and Meta-analysis. Sci Rep 2016;6:35177. doi: 10.1038/srep35177.
18. 19. Scott DA, Sherr EH. RERE-Related Disorders. In: Adam MP, Ardinger HH, Pagon RA, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 2019:1993-2020.