Longitudinal Observation Of Ocular Refractive Development In Hyperopia Children

[Purpose] To study the rules of refractive development and the changes of refractive components in children with hyperopia.[Methods] Pediatric hyperopia children attending the clinic of the Ophthalmology Department of Provincial Hospital affiliated to Shandong University during June 2007 to December 2013 were included in the study. All selected children were followed 4 years and underwent a comprehensive ophthalmic examination that included orthoptic examination, anterior segment assessment, fundus examination. The degree of refraction was measured by refractionist performing retinoscopy after instillation of 1 drop of 1% atropine in each eye thrice every day for 3 days, then axial length (AL), refraction power of cornea (K1、K2) and anterior chamber depth (ACD) were measured by optic coherence biometry (Zeiss IOL Master).The data was collected for statistical analyzed.[Results]1. Out of all selected children,26.92% were mild hyperopia,33.85% were moderate hyperopia and 39.23% were severe hyperopia when they were first coming to the clinic. After four years follow-up, the ratio becomes:mild hyperopia was 27.69%, moderate hyperopia was 27.69%, severe hyperopia was 6.92%, emmetropia was 19.23%, myopia was 18.46%.2. During the follow-up, the spherical equivalent refraction reduced-1.09±1.00D annually; CDVA raised 0.10±0.13 annually; axial length increased 0.60±0.46mm annually; Keratometry value and anterior chamber depth was stabled, with a slight average annual variation; the ratio of AL/CR raised 0.07±0.07 annually.3. The annual average change of spherical equivalent refraction (t=-3.36P=0.02), AL (t=3.22P=0.00) and AL/CR (t=2.24P=0.03) were higher in children with astigmatism than children with hyperopia.4. The annual average change of spherical equivalent refraction (t=-5.96P=0.00) AL (t=-4.45P=0.00) and AL/CR (t=2.23P=0.03) were lower in children with esotropia than children with hyperopia.5. One year before the onset of myopia, the velocity of change in spherical equivalent refraction, AL and AL/CR were faster than any other time (P<0.05).6. The degree of hyperopia was negatively related to AL (r=-0.81 P=0.00), Keratometry value (Kl r=-0.15 P=0.00; K2 r=-0.28 P=0.00),ACD(r=-0.18 P=0.00) and AL/CR (r=-0.76 P=0.00).[Conclusion]In the four-year follow-up, the refractive status of selected children had an obvious myopic shift. The degree of hyperopia reduced, CDVA raised, axial length increased, the ratio of AL/CR raised, annually. The change of spherical equivalent refraction, axial length and AL/CR were faster in children with astigmatism than children with hyperopia. The change of spherical equivalent refraction, axial length and AL/CR were slower in children with esotropia than children with hyperopia. One year before the onset of myopia, the velocity of change in spherical equivalent refraction, axial length and AL/CR were increased. There is inverse correlation between the degree of refraction and axial length in hyperopia children.