Characteristics of full compensation and its association with total astigmatism: A cross-sectional study

Ziyun Wu; Yuanyuan Hu; Zihang Xu; Wei Sun; Yirong Wang; Zhen Shao; Yi Liu; Mingkun Yu; Peiran Si; HuanHuan Huo; Xingrong Wang; Hongsheng Bi

doi:10.3389/fpubh.2023.1119654

Characteristics of full compensation and its association with total astigmatism: A cross-sectional study

Front Public Health. 2023 Feb 6:11:1119654. doi: 10.3389/fpubh.2023.1119654. eCollection 2023.

Authors

Ziyun Wu^{1

2}, Yuanyuan Hu^{2

3}, Zihang Xu^{1

2}, Wei Sun^{1

2

3}, Yirong Wang³, Zhen Shao³, Yi Liu³, Mingkun Yu^{1

2}, Peiran Si³, HuanHuan Huo^{1

2}, Xingrong Wang^{1

2

3}, Hongsheng Bi^{1

2

3}

Affiliations

¹ Shandong University of Traditional Chinese Medicine, Jinan, China.
² Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China.
³ Shandong Academy of Eye Disease Prevention and Therapy, Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, China.

Abstract

Objective: To evaluate the characteristics of full compensation and its association with the prevalence of total astigmatism (TA), and to analyze the effects of TA on uncorrected distance visual acuity (UDVA).

Methods: With random cluster sampling based on a school-based cross-sectional design, children aged 4 to 18 years were recruited in September 2020, Shandong Province, China. TA, anterior corneal astigmatism (ACA), and ocular residual astigmatism (ORA) were converted to vectorial components (J0, J45), followed by an assessment of the compensatory effect of ACA by ORA. Astigmatism was defined as a cylinder that was better than or equal to 0.75 diopters (D). Logistic regression analysis was used to assess the related factors for children with full compensation, and the generalized linear model was used to assess the influence of TA on UDVA.

Results: Out of 4,494 eligible children, data of 4,145 children (92.3%, 9.23 ± 3.15 years, 50.4% boys) were included in the statistical analysis. The prevalence of TA (27.9%) increased significantly with age (P_trend < 0.001). The distribution of full compensation in J0 and J45 components were similar (22.1% and 25.6%, respectively), which decreased with age (P_trend < 0.001). The closer the refractive status was to emmetropization, the higher the proportion of full compensation and the lower the prevalence of TA were. Shorter axial length (J0: Odds Ratio (OR) = 0.76, 95% confidence interval (CI): 0.61 to 0.94, P = 0.010), better UDVA (J0: OR = 0.37, 95% CI: 0.21 to 0.65, P < 0.001; J45: OR = 0.34, 95% CI: 0.20 to 0.59, P < 0.001), and longer average corneal curvature radius (J0: OR = 3.72, 95% CI: 2.18 to 6.34, P < 0.001; J45: OR = 2.82, 95% CI: 1.67 to 4.76, P < 0.001) were associated with full compensation. Higher TA was associated with a worse UDVA (β = 0.03, 95% CI: 0.02 to 0.04, P < 0.001).

Conclusions: The prevalence of TA gradually increased with age, and showed a U-shaped distribution with increased refraction. Full compensation was associated with smaller TA and better UDVA. This indicated that considering the compensatory effect of ORA is vital for astigmatism correction in clinical work, which may improve the visual quality.

Keywords: cross-sectional study; full compensation; related factors; total astigmatism; uncorrected distance visual acuity.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Astigmatism* / epidemiology
Child
Cornea
Cross-Sectional Studies
Female
Humans
Male
Refraction, Ocular
Visual Acuity

Grants and funding

This research was supported by the National Key Research and Development Program (2019YFC1710202 and 2019YFC1710203), and the Key Research and Development Program of Shandong Province (2019GSF108252).