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Li Deng, Jane E. Gwiazda; Anisometropia in Children from Infancy to 15 Years. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2500.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate anisometropia in children from 6 months to 15 years.
Children with refractions at 6 months (n=1124), 5 years (n=395), and 12-15 (n=316) years were included in this analysis. 212 of these children had both 5-year and 12-15 year refractions and 190 had both 6-month and 12-15 year refractions. The infants were refracted in the laboratory by non-cycloplegic near retinoscopy and the older children by non-cycloplegic distance retinoscopy. Myopes were defined as having a spherical equivalent refraction (SER) < -0.50 D in at least one eye and emmetropes had SERs from -0.50 to +1.0 D. The chi-square test was applied to assess the association between ametropia and anisometropia when both were treated as categorical variables. Correlation analysis was used when both were treated as continuous variables.
The mean difference in refraction between the two eyes was similar at 6 months (0.11D) and 5 years (0.15D), increasing to 0.28D at 12-15 years. Using a cutoff of 1.00D for anisometropia, the prevalence of anisometropia was 1.96%, 1.27%, and 5.77% at 6 months, 5 years, and 12-15 years, respectively. Using 0.50D as the cutoff, the prevalence of anisometropia was 9% at both 6 months and 5 years, increasing to 20% at 12-15 years. At 12-15 years the prevalence of anisometropia in the myopes was 37.50% versus 9.68% in the emmetropes (p = 0.0001). The difference in SER between the eyes was 0.17D in the emmetropes and 0.48D in the myopes. At 12-15 years, the correlation between the level of ametropia in the worse eye and the amount of anisometropia was statistically significant (r = -0.37, p<0.0001). Longitudinally, anisometropia at 5 years (but not at 6 months) was related to anisometropia at 12-15 years (p = 0.039). Anisometropia at the younger ages was not related to an increased risk of myopia by 15 years.
The prevalence of anisometropia by either cutoff (1.00D or 0.50D) increases between 5 and 15 years, when some children’s eyes grow longer and become myopic. Our data suggest that anisometropia before school age is not a risk factor for later myopia development and that anisometropia accompanies myopia progression.
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