Visual Function of Moderately Hyperopic 4- and 5-Year-Old Children in the Vision in Preschoolers - Hyperopia in Preschoolers Study

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• 作者：Elise B. Ciner^a ; ^{Eciner@salus.edu" class="auth_mail" title="E-mail the corresponding author} ; Marjean Taylor Kulp^b ; Maureen G. Maguire^c ; Maxwell Pistilli^c ; T. Rowan Candy^d ; Bruce Moore^e ; Gui-shuang Ying^c ; Graham Quinn^f ; Gale Orlansky^a ; Lynn Cyert^g ; on behalf of the Vision In Preschoolers - Hyperopia In Preschoolers (VIP-HIP) Study Group Writing CommitteeElise Ciner ; OD ; Whitley Harbison ; Zack Margolies ; MSW ; Sarah McHugh-Grant ; Erin Engle ; Richard Schulang ; MEd ; Gale Orlansky ; OD ; MEd ; Leah Sack ; Jasmine Campbell ; Marjean Taylor Kulp ; OD ; MS ; Julie Preston ; OD ; PhD ; MEd ; Andrew Toole ; OD ; PhD ; Tamara Oechslin ; OD ; MS ; Nancy Stevens ; MS ; RD ; LD ; Pam Wessel ; Bruce Moore ; OD ; Marcia Feist-Moore ; MEd ; Catherine Johnson ; OD ; Stacy Lyons ; OD ; Nicole Quinn ; OD ; Renee Mills ; BS ; Maureen Maguire ; PhD ; Maria Blanco ; Mary Brightwell-Arnold ; James Dattilo ; Sandra Harkins ; Christopher Helker ; MSPH ; Ellen Peskin ; MA ; Maxwell Pistilli ; MS ; Gui-Shuang Ying ; PhD ; Marjean Taylor Kulp ; OD ; MS (Study Chair) ; Elise Ciner ; OD ; Maureen Maguire ; PhD ; Bruce Moore ; OD ; Lynn Cyert ; OD ; PhD ; Graham Quinn ; MD ; MSCE ; T. Rowan Candy ; PhD ; Jill Pentimonti ; PhD ; Gui-Shuang Ying ; PhD ; Robert H. Bradley ; PhD ; Laura Justice ; PhD ; CCC-SLP ; Jill Pentimonti ; PhD ; Velma Dobson ; PhD ; Maryann Redford ; DDS ; MPH
• 刊名：American Journal of Ophthalmology
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：170
• 期：Complete
• 页码：143-152
• 全文大小：193 K

文摘

To compare visual performance between emmetropic and uncorrected moderately hyperopic preschool-age children without strabismus or amblyopia.

Design

Cross-sectional study.

Methods

setting: Multicenter, institutional. patient or study population: Children aged 4 or 5 years. intervention or observation procedures: Visual functions were classified as normal or reduced for each child based on the 95% confidence interval for emmetropic individuals. Hyperopic (≥3.0 diopters [D] to ≤6.0 D in the most hyperopic meridian; astigmatism ≤1.50 D; anisometropia ≤1.0 D) and emmetropic status were determined by cycloplegic autorefraction. main outcome measures: Uncorrected monocular distance and binocular near visual acuity (VA); accommodative response; and near random dot stereoacuity.

Results

Mean (± standard deviation) logMAR distance visual acuity (VA) among 248 emmetropic children was better than among 244 hyperopic children for the better (0.05 ± 0.10 vs 0.14 ± 0.11, P < .001) and worse eyes (0.10 ± 0.11 vs 0.19 ± 0.10, P < .001). Mean binocular logMAR near VA was better in emmetropic than in hyperopic children (0.13 ± 0.11 vs 0.21 ± 0.11, P < .001). Mean accommodative response for emmetropic children was lower than for hyperopic subjects for both Monocular Estimation Method (1.03 ± 0.51 D vs 2.03 ± 1.03 D, P < .001) and Grand Seiko (0.46 ± 0.45 D vs 0.99 ± 1.0 D, P < .001). Median near stereoacuity was better in emmetropic than in than hyperopic children (40 sec arc vs 120 sec arc, P < .001). The average number of reduced visual functions was lower in emmetropic than in hyperopic children (0.19 vs 1.0, P < .001).

Conclusions

VA, accommodative response, and stereoacuity were significantly reduced in moderate uncorrected hyperopic preschool children compared to emmetropic subjects. Those with higher hyperopia (≥4 D to ≤6 D) were at greatest risk, although more than half of children with lower magnitudes (≥3 D to <4 D) demonstrated 1 or more reductions in function.