April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Early Life Risk Factors Associated with Childhood Strabismus: The Multi-ethnic Pediatric Eye Disease Study and the Baltimore Pediatric Eye Disease Study
Author Affiliations & Notes
  • Jolyn Wei
    Department of Ophthalmology, University of Southern California, Los Angeles, California
  • Susan Cotter
    Department of Ophthalmology, University of Southern California, Los Angeles, California
  • Rohit Varma
    Department of Ophthalmology, University of Southern California, Los Angeles, California
  • Kristina Tarczy-Hornoch
    Department of Ophthalmology, University of Southern California, Los Angeles, California
  • Roberta McKean-Cowdin
    Preventive Medicine, Univ of Southern California, Los Angeles, California
  • James Tielsch
    Bloomberg School of Public Health, Johns Hopkins, Baltimore, Maryland
  • David Friedman
    Bloomberg School of Public Health, Johns Hopkins, Baltimore, Maryland
  • Michael Repka
    Ophthalmology, Johns Hopkins Wilmer Eye Inst, Baltimore, Maryland
  • Joanne Katz
    Bloomberg School of Public Health, Johns Hopkins, Baltimore, Maryland
  • Multi-ethnic Pediatric Eye Disease Study & Baltimore Pediatric Eye Disease Study Groups
    Department of Ophthalmology, University of Southern California, Los Angeles, California
  • Footnotes
    Commercial Relationships  Jolyn Wei, None; Susan Cotter, None; Rohit Varma, None; Kristina Tarczy-Hornoch, None; Roberta McKean-Cowdin, None; James Tielsch, None; David Friedman, None; Michael Repka, None; Joanne Katz, None
  • Footnotes
    Support  NIH Grants EY014472 & EY014483
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 6321. doi:
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      Jolyn Wei, Susan Cotter, Rohit Varma, Kristina Tarczy-Hornoch, Roberta McKean-Cowdin, James Tielsch, David Friedman, Michael Repka, Joanne Katz, Multi-ethnic Pediatric Eye Disease Study & Baltimore Pediatric Eye Disease Study Groups; Early Life Risk Factors Associated with Childhood Strabismus: The Multi-ethnic Pediatric Eye Disease Study and the Baltimore Pediatric Eye Disease Study. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6321.

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Abstract

Purpose: : To investigate early life risk factors associated with esotropia or exotropia in infants and young children.

Methods: : 9970 children 6 to 72 months of age enrolled in two population-based cross-sectional studies in California and Maryland received comprehensive eye examinations and a parent underwent a detailed interview. Odds ratios (ORs) for various potential early life risk factors associated with esotropia or exotropia were determined using multivariate logistic regression analysis.

Results: : Esotropia was independently associated with older age, prematurity, maternal smoking during pregnancy, anisometropia, and hyperopia. There was a severity-dependent association of hyperopia with the prevalence of esotropia, with ORs increasing from 6.4 for 2.00 to <3.00 Diopters (D) of hyperopia to an OR of 122.0 for ≥5.00 D of hyperopia. Exotropia was associated with prematurity, maternal smoking during pregnancy, astigmatism (OR=2.5 for 1.50 to <2.50 D, and OR =5.9 for ≥2.5 D of astigmatism), and aniso-astigmatism in the J0 component (OR ≥2 for J0 aniso-astigmatism ≥0.25 D).

Conclusions: : Prematurity and maternal smoking during pregnancy are associated with a higher risk of having both esotropia and exotropia. Refractive error is associated in a severity-dependent manner to the prevalence of esotropia and exotropia. Given that that refractive error is correctable, these risk associations should be considered when developing guidelines for the screening and management of refractive error in preschool children.

Keywords: clinical (human) or epidemiologic studies: risk factor assessment • esotropia and exotropia • hyperopia 
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