Abstract
Purpose:
Children with Down syndrome are more susceptible to cataracts, both congenital and acquired, particularly cerulean blue dot cataracts composed of amyloid-β deposits1. The purpose of this retrospective study is to understand if lens and anterior segment amyloid-β alters the refractive power of the eye.
Methods:
Records of all children with Down syndrome seen by a single provider at one institution over a 3-year period were retrospectively reviewed. Tests of association were used to assess the relationship between the presence/absence of cataracts, refractive error, and accommodation.
Results:
The median age of the study population was 1.93 years (range: 0.03-18.9 years). Fifteen (14.3%) of the 105 patients had cataracts, 10 (67%) were cerulean blue dot cataracts. An age greater than 2 years and myopia were independently associated with cataracts (OR=7.85, p=0.004 and OR=6.5, p=0.004, respectively) and remained significant after adjusting for both variables (OR= 6.51, p=0.008, OR= 5.2, p=0.012 respectively). There was no association between cataracts and astigmatism or incomplete accommodation.
Conclusions:
Myopia is independently associated with cataract in Down syndrome children which may be the result of amyloid-β accumulation in the lens. Myopia and age are associated with cataract in Down syndrome children, predominantly the amyloid-β cataract. We will review the greater than 800 children with Down syndrome seen in our eye clinics among various providers to further explore this. We are also prospectively quantifying the collection of amyloid-β in the lenses of patients with Down syndrome with a quasi-elastic light scattering instrument.
Keywords: 445 cataract •
677 refractive error development