Abstract
Purpose: :
We sought to analyze longitudinal refractive changes in patients with albinism in their first decade of life.
Methods: :
The IRB at the University of Minnesota approved this retrospective review of patients with albinism who had cycloplegic refractions done at three different ages that were determined a priori (visit A: 0-18 mos., visit B: 4-6 yrs., visit C: 8-10 yrs.). We evaluated group data and then evaluated right eyes (REs) with ANOVA to determine if changes in refraction over time were significant.
Results: :
Of 481 charts evaluated, 44 patients met inclusion criteria. All but one wore glasses. The mean BCVA was 20/77 (range 20/30-20/200). The mean spherical equivalent for all eyes was 3.06D at visit A, 2.84D at visit B, and 2.53D at visit C. ANOVA analysis of the REs showed no significant difference from visits A to C (p=0.333). The mean cylinder for all eyes was 1.69 D (± 0.113) at visit A, 2.66 D (±0.126) at visit B, and 3.09 D (±0.150) at visit C. ANOVA for REs showed a significant difference from visits A to C (p<0.0001). Subgroup analysis of REs for oculocutaneous albinism (OCA) 1A (10 eyes), OCA1B (14 eyes), and OCA2 (14 eyes) also showed a significant increase in astigmatism from visit A to C (p=0.023, p=0.001, and p<0.0001, respectively). Higher mean astigmatism (3.83D ±0.273) and poorer mean acuity (20/105) were found for OCA1A, compared with OCA1B (2.45D ±0.295; 20/58) and OCA2 (3.28D ±0.204; 20/82) (p=0.001 and p=0.019 respectively).
Conclusions: :
This longitudinal study of 44 patients with albinism shows that, contrary to patients with normal eyes, astigmatism increases in the first few years of life. Our results support the work by Wang et al. that showed an increase of astigmatism in 27 patients with albinism. However, our data suggest that greater astigmatism in OCA1A may be due to diminished emmetropization related to poorer BCVA when compared with other types of albinism. All children with albinism require periodic follow up visits with cycloplegic refraction to provide accurate refraction that has been shown to improve BCVA.
Keywords: refractive error development • astigmatism