April 2009
Volume 50, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2009
Risk Factors for Persistence of Infantile Anisometropia
Author Affiliations & Notes
  • J. Wang
    Retina Foundation of the Southwest, Dallas, Texas
  • C. S. Cheng
    Retina Foundation of the Southwest, Dallas, Texas
  • D. Weakley
    Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas
  • E. E. Birch
    Retina Foundation of the Southwest, Dallas, Texas
    Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas
  • Footnotes
    Commercial Relationships  J. Wang, None; C.S. Cheng, None; D. Weakley, None; E.E. Birch, None.
  • Footnotes
    Support  NIH grant EY005236 and Gerber Foundation grant
Investigative Ophthalmology & Visual Science April 2009, Vol.50, 2432. doi:
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      J. Wang, C. S. Cheng, D. Weakley, E. E. Birch; Risk Factors for Persistence of Infantile Anisometropia. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2432.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : In the only longitudinal study of infantile anisometropia, Abrahamsson & Sjostrand (1996) studied astigmatic children with infantile hyperopic anisometropia and found that marked anisometropia (defined as anisometropia ≥3D) at 1 year of age is related to amblyopia. Here we investigated a broader range of infantile anisometropia longitudinally.

Methods: : Twenty eight anisometropic (≥1 D) children (6 mixed, 3 myopic and 19 hyperopic anisometropia) were included; all were initially diagnosed by 2 years of age and followed until at least 5 years of age (5-13 years old). Eight had marked anisometropia (≥3D). Risk factors evaluated were: initial amount of anisometropia; presence/absence of bilateral high refractive error (≥3D myopia or hyperopia) at the first visit; age at and type of treatment. Outcome evaluated was persistence of anisometropia through the last visit. Mantel-Haenszel odds ratios (OR) were calculated. Amblyopia (≥2 lines) was also evaluated at the last visit.

Results: : Eighteen of 28 (64%) had persistent anisometropia. Marked infantile anisometropia at the first visit was a significant risk factor for marked anisometropia that persisted through at least 5 years of age (OR=133; p<0.001). Neither bilateral high refractive error at the first visit nor treatment was a significant risk factor for persistence of anisometropia. Children with non-hyperopic anisometropia had 5.97±4.77D anisometropia at the first visit, which is significantly higher than hyperopic type anisometropia (1.90±1.08D). Overall, 10/28 (36%) children with infantile anisometropia developed amblyopia, including 5 children who had marked anisometropia at the initial visit. In non-amblyopic children, 72% (13/18) had decreased anisometropia during follow-up (mean decrease = -0.78±1.17D); 8 out of 18 (61%) resolved (<0.5D). Amblyopic children, on the average, increased 0.31±1.05D. More children with non-hyperopic anisometropia developed amblyopia (6/9; 67%) compared with hyperopic anisometropia (4/19; 21%; p=0.01).

Conclusions: : Marked infantile anisometropia before 2 years of age is likely to persist and presents a high risk for amblyopia. Non-hyperopic anisometropia is significantly higher and is more often associated with amblyopia than hyperopic anisometropia.

Keywords: refractive error development • amblyopia • hyperopia 
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