Abstract
Purpose :
To assess peripheral refraction profiles in infants enrolled in The Emmetropization Via Accommodation (EVA) Study (NCT03669146). The objective of the study was to determine if wearing moderate spectable under-correction (3.0 D) and performing visual exercises that promote accommodation for a 15-month period will enhance emmetropization by promoting more prolate ocular grown in highly hyperopic (≥+5.0 D) 3-month-old infants.
Methods :
Thirty-five infants (57% female) enrolled in the clinical trial. Thirty infants were randomized to observation (control) or treatment and 5 infants with hyperopia >+7.00 D were enrolled in a case series where all participants received treatment. Participants were followed for a 15-month period. Spherical equivalent (SEQ) cycloplegic (1% cyclopentolate) central and peripheral (nasal and temporal) refractive error were measured with the Welch Allyn SureSight. Measurements were taken at 3 months, 9 months, and 18 months of age. Relative peripheral SEQ was calculated by subtracting central from peripheral SEQ.
Results :
The mean 3-month relative peripheral refractive error was myopic on average at baseline, both nasally and temporally for treated infants (-1.3 ± 0.9D, -2.6 ± 1.2D) and for control infants (-1.7 ± 1.2D, -1.8 ± 1.4D). Central refractive error underwent emmetropization in both the treatment and observation group, changing from +5.2 ± 1.1D at baseline to +2.2 ± 0.6D at 18 months in treated infants and +5.0 ± 1.1D to + 2.0 ± 1.2 D in observation infants. Relative peripheral refraction remained myopic, on average, at 18 months of age, both nasally and temporally for treated (-0.3 ± 0.9D, -1.3 ± 1.2D) and control infants (-0.2 ± 0.6D, -0.8 ± 0.8D) There were no statistically significant treatment group differences between the relative peripheral SEQ values at any of the ages (all P>0.13).
Conclusions :
Relative peripheral myopia is thought to be a stop signal for foveal eye growth, but emmetropization occurred even in the presence of relative peripheral myopia. Both central hyperopia and relative peripheral myopia decreased during emmetropization.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.