Long-term changes in refractive error in patients with accommodative esotropia

Abstract

Purpose: To evaluate changes in the spherical equivalent (SE) refractive error and astigmatism in Korean patients with accommodative esotropia.

Design: Retrospective cases series.

Participants: A total of 111 patients with accommodative esotropia who received at least 2 years of follow-up after receiving prescription spectacles.

Methods: Patients were divided into groups according to the age at which spectacles were prescribed (youngest, middle, and oldest age groups), initial degree of SE refractive error (lowest, moderate, and highest SE group), initial degree of astigmatism (least, moderate, and most astigmatic group), and presence of amblyopia (amblyopic or nonamblyopic). Changes in SE refractive error and astigmatism were compared between groups. Factors that significantly influenced changes in refractive error were analyzed using mixed linear models.

Main outcome measures: Changes in SE refractive error and changes in astigmatism according to the duration of time after the initiation of wearing spectacles.

Results: Patients were followed up for a mean of 7.55 ± 3.59 years. Although an initial increase in SE was noted in the youngest-age group, an overall decreasing tendency in SE refractive error during the follow-up period was noted in the youngest (P < 0.01, mixed linear model), the middle (P < 0.01), and the oldest (P < 0.01) age groups. Amblyopic eyes showed greater decreases in SE compared with nonamblyopic eyes (P=0.01). The most hyperopic group showed the greatest decrease in hyperopia over time (P=0.01). The initial degree of hyperopia (P < 0.01) and amblyopia (P < 0.01) showed significant associations with changes in SE refractive error. The initial degree of astigmatism (P < 0.01) showed a significant association with changes in astigmatism.

Conclusions: Patients with accommodative esotropia showed a continuous decrease in SE refractive error over time. Changes in refractive error in patients with accommodative esotropia may be influenced by both spectacle wearing and amblyopia.

Financial disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.