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Jyh Haur Woo, Seang-Mei Saw, Chen Wei Pan, J. Chan, Lay Leng Seah; Refractive Errors in Chinese Children with Congenital Ptosis. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4489.
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Congenital ptosis is associated with visual deprivation and anisometropic amblyopia. However, the prevalence of refractive errors, amblyopia and functional visual outcome after ptosis correction in Chinese children has rarely been reported. We aim to describe the prevalence and types of refractive errors in Chinese children with congenital ptosis compared to normal controls. Secondly, we also report the prevalence of amblyopia and visual acuity outcome after ptosis surgery.
This was a retrospective review of case records of Chinese children with congenital ptosis, who were treated at KK Women’s and Children’s Hospital and Singapore National Eye Centre, from June 2004 to June 2013. Normal controls were obtained from a population-based survey in southwest Singapore, via door-to-door recruitment of participants and disproportionate random sampling in 6-month increments. We performed a subgroup analysis of subjects compared with controls from 3 to 5 years with regards to the presence of refractive error and amblyopia. The other outcome measure includes the best-corrected visual acuity (BCVA) before and after surgical correction.
We included 139 children with 170 eyes with congenital ptosis. The age at presentation of the subjects ranged from 1 month to 12 years. There were 74 males and 65 females. Children with congenital ptosis had higher prevalence of myopia (4 years, 20.4% vs 8.6%, p<0.001; 5 years, 20.9% vs 7.6%, p<0.001), astigmatism (4 years, 70.2% vs 54.3%, p<0.001; 5 years, 77.6% vs 56.8%, p<0.001) and lower prevalence of hyperopia (4 years, 3.2% vs 12.8%, p<0.001; 5 years, 6.1% vs 19.8%, p<0.001) at 4 and 5 years compared to normal controls. The prevalence of amblyopia was 54.7%, 25.9% and 22.4% at 3, 4 and 5 years respectively. 53 (38.1%) subjects underwent ptosis surgery during the study period. The BCVA (decimal notation) of these patients improved from 0.27 to 0.38 after surgical correction (p <0.05) after at least 1 year of follow-up, although there was no significant change in the spherical equivalent (1.03 vs 1.24, p=0.15).
There is a higher prevalence of myopia and astigmatism and lower prevalence of hyperopia in Chinese children with congenital ptosis compared to normal controls. Surgical correction marginally improved the visual acuity.
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