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Longitudinal change in components of astigmatism and its association with axial length-corneal radius ratio in Chinese young children: the Nanjing Eye Study

  • Pediatrics
  • Published:
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Abstract

Purpose

To assess the longitudinal change in components of astigmatism from age 4 to 7 years and its association with axial length-corneal radius ratio (AL/CR).

Methods

Children born between September 2011 and August 2012 in Yuhuatai District of Nanjing were invited to participate in the Nanjing Eye Study for a comprehensive eye examination annually since 2015. The data presented in this paper were obtained in 2016, 2017, and 2019. At each study encounter, noncycloplegic autorefraction and ocular biometric parameters were measured. Changes of total astigmatism (TA), corneal astigmatism (CA), anterior corneal astigmatism (ACA), residual astigmatism (RA), and internal astigmatism (IA) were analyzed in clinical notation (Cyl) and vector notation (J0, J45).

Results

Nine hundred fifty-four children (mean ± standard deviation of baseline age: 4.63 ± 0.29 years, 53.7% boys) had complete data and were included in this study. Mean slopes of longitudinal changes in Cyl notation were significantly negative for TA, CA, and ACA, but positive for IA. TA, CA, ACA, and RA of J0 notation had a shift toward increasing with-the-rule (WTR) astigmatism and/or decreasing against-the-rule (ATR) astigmatism. TA of J45 notation showed an increase in astigmatism at axis 135° and/or a decrease in astigmatism at axis 45°, while CA and ACA of J45 notation showed an opposite change. Longitudinal changes in ACA and IA were negatively correlated in J0 notation, but not in J45 notation. Based on compensation factor (CF, defined as the minus ratio of IA and ACA), the compensation proportions for J0 in varying degrees (CF: 0.1–2) in 2016, 2017, and 2019 were 91.3%, 93.5%, and 90.0%, respectively, while these for J45 were 74.9%, 76.5%, and 34.6%, respectively. Higher AL/CR increase was associated with less decrease or more increase in CA and ACA of Cyl notation, and a shift toward increasing WTR and/or decreasing ATR in these of J0 notation.

Conclusions

The compensatory role of IA was persistent and prominent from 4 to 7 years old for J0 notation in Chinese young children. The progression of AL/CR was correlated with astigmatism originated from the cornea.

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Acknowledgements

We thank the children, their parents or legal guardians, and all the members of the Maternal and Child Healthcare Hospital of Yuhuatai District, Nanjing, China, for their helpful advice and support.

Funding

This work was supported by the National Natural Science Foundation of China (Grant No. 81673198; No. 81803258; No. 82003475); Jiangsu Province’s Science and Technology Project (Grant No. BE2020722); and Postgraduate Research & Practice Innovation Program of Jiangsu Province (Grant No. JX10213644 and No. JX10213651).

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Authors and Affiliations

  1. Department of Ophthalmology, The First Affiliated Hospital With Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China

    Xiaoxiao Li, Rui Li, Shiya Shen, Zijin Wang, Yue Wang, Wen Yan, Yun Wang, Andi Zhao, Danni Chen, Wei Guo, Hu Liu & Hui Zhu

  2. The Second Affiliated Hospital, Zhejiang University School of Medicine, Eye Center, Hangzhou, China

    Haohai Tong

  3. Department of Child Healthcare, The First Affiliated Hospital With Nanjing Medical University, Nanjing, China

    Dan Huang

  4. Department of Ophthalmology, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou, China

    Xiaoyan Zhao

  5. Department of Ophthalmology, Wuxi Children’s Hospital, Wuxi, China

    Xiaohan Zhang

  6. The Fourth School of Clinical Medicine of Nanjing Medical University, Nanjing, China

    Tao Zhang & Xiaodong Shao

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  1. Xiaoxiao Li
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Contributions

Liu H and Zhu H designed the study. Li X and Zhu H wrote the main manuscript text. Li X, Li R, and Shen S prepared tables. Li X, Li R, Wang Z, Tong H, Huang D, Wang Y, and Zhao X performed data interpretation and analysis. Li X, Li R, Shen S, Tong H, Zhang X, Wen Y, Wang Y, Zhao A, Chen D, Guo W, Zhang T, and Shao X performed the ocular examination.

Corresponding authors

Correspondence to Hu Liu or Hui Zhu.

Ethics declarations

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards by the local Ethics Committee of the First Affiliated Hospital with Nanjing Medical University and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Competing interests

The authors declare no competing interests.

Informed consent

Written informed consent was obtained from the parents or guardians of all participants. Oral assent was obtained from all children before the examination.

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Shiya Shen contributed equally to the study and they should be regarded as joint first authors.

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Li, X., Li, R., Shen, S. et al. Longitudinal change in components of astigmatism and its association with axial length-corneal radius ratio in Chinese young children: the Nanjing Eye Study. Graefes Arch Clin Exp Ophthalmol 260, 335–343 (2022). https://doi.org/10.1007/s00417-021-05386-8

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  • DOI: https://doi.org/10.1007/s00417-021-05386-8

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