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Elise B Ciner, Marjean T Kulp, Maureen G Maguire, Maxwell Pistilli, T. Rowan Candy, Gui-Shuang Ying, Graham E Quinn, Bruce D Moore, Lynn Cyert; Vision In Preschoolers-Hyperopia In Preschoolers (VIP-HIP) Study: Associations between visual function and magnitude of refractive error for emmetropic to moderately hyperopic children. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1535. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate previously unknown associations between visual function and uncorrected spherical equivalent (SE) refractive error in emmetropic and hyperopic children without strabismus or amblyopia and <1D of anisometropia or astigmatism.
Children aged 4 or 5 years in preschool were enrolled. Visual functions assessed included monocular distance visual acuity (VA), binocular near VA (crowded HOTV), accommodative lag (Monocular Estimation Method [MEM] and Grand Seiko [GS]), and near stereoacuity by Preschool Assessment of Stereopsis with a Smile (PASS). Cycloplegic autorefraction with Retinomax confirmed eligibility (<1.0D in the most myopic meridian to ≤6.0D in the most hyperopic meridian with anisometropia and astigmatism <1D). Distance and near cover test and distance VA ruled out strabismus or amblyopia. Children were classified as Group 1 (<+1D); Group 2 (>+1 to <+3D); or Group 3 (+3 to +6D) SE refraction. Visual functions were analyzed by group and as continuous variables as a function of SE.
554 children were included in the analysis (mean age 58 months). Mean SE(±SD)(N) for the groups were +.52D(±.49)(270); +2.18D(±.57)(113) and +3.95D(±.78)(113). For each visual function analyzed either as groups or as continuous variables, there was a consistent trend of poorer performance with increasing SE (p<0.001). More children in Groups 1 (52%,26%) and 2 (47%,15%) compared to Group 3(25%,9%) were able to achieve (distance, near) VA of 20/20 or better. While mean (±SD) logMAR VA was different for Groups 1-3 for distance (.05(±.10); .06(±.10);.12(±.11)) and near (.13(±.11); .15(±.10); .19(±.11)) (p<.001), all were within normal age ranges. Accommodative responses were less accurate with increasing hyperopia (ρ=0.33 GS, 0.50 MEM [p<0.001 for both]). Lags were greater with MEM than GS (p<0.001). Median near stereoacuities were 40, 60 and 120 sec arc for Groups 1 to 3 with more children in Group 1(23%) than 2(13%) or 3(7%) achieving 30 sec arc. The percentage of children with no reduced near visual functions for VA, PASS or GS for Groups 1 to 3 was 81%; 64%; and 39%. (Table)
Decreased function (VA, accommodative lag and stereoacuity) was associated with increasing hyperopia in these children. It is not known how these visual functions change with time or optical correction.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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