Axial Length Elongation Profiles from 3 to 6 years old in an Asian Paediatric Population: the Growing Up in Singapore Towards health Outcomes birth cohort study (GUSTO)

Abstract

Purpose : To describe and determine associated factors of axial length (AL) elongation from 3 to 6 years old in an Asian paediatric population.

Methods : Eligible subjects were recruited from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort study. AL measurement was performed using IOLMaster (Carl Zeiss Meditec, Jena, Germany) at 3 and 6 years of age. Anthropometric measurements at birth, cycloplegic refraction at 3 and 6 years old, questionnaires on the children’s behavioural habits at 2 years old, and parental spherical equivalent refraction were performed. Multivariable linear regression model with generalised estimating equation was performed to determine factors associated with AL elongation.

Results : Overall, 273 eyes of 194 children were included. The mean AL increased from 21.72 ± 0.59 mm at 3 years old to 22.52 ± 0.66mm at 6 years old (P < 0.001). Myopic eyes at 6 years old had greater mean AL elongation (1.02 ± 0.34 mm) compared to emmetropic eyes (0.85 ± 0.25 mm, P=0.008) and hyperopic eyes (0.74 ± 0.16 mm, P < 0.001). Greater birth weight (per 100g, β = 0.010, P = 0.02) was associated with greater AL elongation from 3 to 6 years old, while parental and other behavioural factors assessed at 2 years old were not (all P ≥ 0.08).

Conclusions : In this pre-school population, AL elongates at an average length of 0.80 mm from 3 to 6 years old, with myopes demonstrating the greatest elongation. Higher birth weight was a significant risk factor. Further longitudinal observations would be useful to characterise the elongation profile up to teenage years.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.