| Objective:To investigate the spherical equivalent(SE) refractive errors changes and stereopsis development in children with refractive accommodative esotropia(RAE). Methods:A retrospective cohort study. We retrospectively reviewed the complete refractive records of patients with RAE and performed Titmus test of these patients at the last follow-up visit. Patients were divided into groups according to the age at initiation of spectacles use(≤3years, 3-5years, and≥5years groups), initial power of anisometropia( mild≤1.0D; moderate anisometropia 1.0D~2.5D; high anisometropia SE≥2.5D), and initial visual acuity(Binocular vision balance and amblyopia). Independent samples T test, mixed linear model analysis and chi-square test was used to statistical analysis. Results:(1) A total of 106 patients(212 eyes) were included. Fifty-eight patients(54.7%) were boys and 48 patients(45.3%) were girls. The initial retinoscopy records display: 16( 15.1%) patients were 3 or less than 3 years of age, 54(50.9%) patients were more than 3years of age but less than 5 years of age, 36(34.0%) patients were5 or more than 5 years of age; 67(63.2%) patients have low degree of anisometropia, 23(21.7%) patients have moderate degree of anisometropia, 16(15.1%) patients have high degree of anisometropia. The last retinoscopy records display: 87(82.1%) patients have low degree of anisometropia, 14(13.2%) patients have moderate degree of anisometropia, 5(4.7%) patients have high degree of anisometropia.(2) The mean initial SE refractive error was +5.61±1.85 D for both eyes, +5.14±1.93 D for right eyes and +6.08±1.66 D for left eyes. The mean initial SE refractive error was greatest in patients who were treated when they were 3 or less than 3 years of age(+6.83±1.93 D) and the least in the patients who were treated when 5 or more than 5 years of age(+5.18±1.74 D).The difference of SE in mild, moderate and high group is(+0.30 + 0.26 D),(+1.72 + 0.38 D), and(3.22 + 0.32 D), respectively.(3) The mean age that spectacles were prescribed was 4.29±1.28 years(mean±standard deviation, range, 0.5-6.5 years), and the mean follow-up period was 6.76±2.78 years(range, 3-11 years).Twenty-seven patients(25.5%)were followed up for more than 10 years;At the last visit, eight patients(7.5%) no longer need to use spectaclesat 11.88±3.91 age(range, 6-16 age).(4) An overall decline tendency in SE was observed in three age groups(F=109.57, P<0.01).(5) After wearing glasses, a decrease trend in spherical equivalent was observed in three anisometropia groups(F=142.913, P<0.01).(6) The effect of the initial binocular visual acuity on the have statistically different(t=9.787, P<0.05).(7) The influence of the initial degree of anisometropia on stereopsis recovery have difference significant(χ2=18.785, P<0.001). Conclusions:(1) The children with refractive accommodative esotropia always suffering from hyperopia, and can also associated with anisometropia.(2) With the time of wearing glasses increased, an overall decline tendency in SE was observed and initial states of the anisometropia tend to refraction balanced.(3) With the time of wearing glasses increased, patients can maintain orthotropia and restore a part of stereopsis.(4) The higher the initial degree of anisometropia is, the lower the initial vision acuity has and the poorer the subsequent stereopsis obtain.(5) If the initial states of the anisometropia is high but the laststates is balanced, the RAE patients can obtain good stereopsis.(6) Compared with the immediate visual benefit, maybe it is not the most important that hyperopia correction whether or not inhibits emmetropization. |
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