Refractive Error Change and Overminus Lens Therapy for Childhood Intermittent Exotropia
-
Published:2024-05-01
Issue:5
Volume:142
Page:417
-
ISSN:2168-6165
-
Container-title:JAMA Ophthalmology
-
language:en
-
Short-container-title:JAMA Ophthalmol
Author:
, , Alexander Monsey L1, Allen Megan1, Alluri Sreevardhan1, Amster Deborah M1, Anderson Heather A1, Argoubi Afifa1, Astle William F1, Austin Darrell S1, Bailey Maragaret K1, Baker John D1, Beaulieu Wesley T1, Beck Roy W1, Berns Fabiana1, Bhatt Amit R1, Birch Eileen E1, Bitner Derek P1, Bland Tracy A1, Bodack Marie I1, Boente Charline S1, Bohra Lisa1, Bond Lezlie L1, Bothun Erick D1, Boyle Nicole M1, Brafford Randy C1, Castle Kelly M1, Chamberlain Carolyn1, Cheung Nathan L1, Christiansen Stephen P1, Christoff Alex1, Chung Ida1, Cioffi Katherine R1, Clausius Deborah A1, Cobb Patricia1, Collins Mary Louise Z1, Colon Beth J1, Conley Julie A1, Conner Courtney L1, Connolly Katie S1, Cooper Karen1, Crossnoe Connie J1, Crouch Eric R1, Cupit Shawn L1, Curtis Linda T1, Cutrer Beth M1, Davis Barry1, de Alba Campomanes Alejandra G1, De Leon Erika A1, Dean Trevano W1, Diener-West Marie I1, Dillon Angela C1, Dinani Zainab1, Donahue Quayleen1, Donahue Sean P1, Droste Patrick J1, Ecerova Zuzana1, Eltzroth Jillian M1, Esposito Christina A1, Evans Patricia L1, Everett Donald F1, Fang Caroline C1, Feis Alicia E1, Fergus Lisa M1, Fimbel Brooke P1, Fishman Deborah R1, Flanagan Maureen A1, Forde Roberta A1, Fouzdar Jain Samisksha1, Franklin John Mark1, Frazier Marcela1, Gafford Jennifer B1, Geddie Brooke E1, Gertsch Kevin R1, Gianfermi Elena1, Gray Michael E1, Grigorian Adriana P1, Gunton Kammi B1, Hahn Alexis C1, Hahn-Parrott Laurie1, Haider Kathryn M1, Haley Wendy Jean1, Hatch Stanley W1, Hatt Sarah R1, Henderson Robert J1, Heyman Catherine L1, Higgins Rosemary D1, Hilbrands Jan1, Hoepner James E1, Holleschau Ann M1, Holtorf Hannah L1, Hoover Darren L1, Hopkins Kristine B1, Huang Kristine1, Hutchinson Amy K1, James Yvonne R1, Jastrzemsbki Benjamin G1, Jenewein Erin C1, Jensen Allison A1, Jhajj Jasleen K1, Jones Sarah K1, Jordan Catherine O1, Kaplon Joseph D1, Khan Shabana1, Klaehn Lindsay D1, Kong Lingkun1, Koontz Emily R1, Koutnik Cassandra A1, Kramer Andrea M1, Kraus Courtney L1, Krueger Samantha L1, Kulp Marjean T1, Kurup Sudhi P1, LaMattina Kara C1, Lambert Jennifer E1, Lambert Scott R1, Law Cristina L1, Lazar Elizabeth L1, Leach Shelby1, Lee Katherine A1, Leske David A1, Li Zhuokai1, Lim Maria E1, Liu Xiaonong1, Lorenzana Ingryd1, Loud Rachel N1, Lyon Don W1, Lyons Alex F1, Manuchian Sonia1, Marozas Lauren1, Marsh Justin D1, Martinson Stacy R1, May Laura M1, McCoy Vrablec Laura1, McMurtrey J. Ryan1, Meil Gail C1, Melia B. Michele1, Merrill Kim S1, Mets-Halgrimson Rebecca B1, Meyers Sara R1, Miller Aaron M1, Miller Caiytlin C1, Mohney Brian G1, Montejo Jenifer1, Morgan Linda1, Morrison Kelsie B1, Morrison Ann M1, Morrison David G.1, Myung Jenny1, Nash David L1, Nylin Elyse1, Oechslin Tamara S1, Olvera Maria N1, Ortiz Gillaine1, Oseguera Teresa1, Pang Yi1, Parker Sue M1, Patel Reena A1, Paysse Evelyn A1, Peragallo Jason H1, Perzyk Susan N1, Peters Robert J1, Phillips Paul H1, Plaumann Maureen D1, Plum Larry W1, Poff Stephen W1, Pollack Karen E1, Qayum Jennifer N1, Quebbemann Micaela N1, Raghuram Aparna1, Rahmani Bahram1, Ralay Ranaivo Hantamalala1, Repka Michael X1, Retnasothie Dashaini V1, Roberts Tawna L1, Robinson Julianne L1, Roe Matthew K1, Romany Gihan1, Rutner Daniella1, Sala Allyson1, Sanders Emi N1, Saunders Richard A1, Sayani Amar1, Scheiman Mitchell M1, Schulman-Ellis Erica L1, Shah Birva K1, Shah Veeral S1, Shelton Erica R1, Siatkowski R. Michael1, Slinger Kristin E1, Smith Rachel M1, Solis Casandra S1, Stec Magdalena1, Stevens Nancy E1, Stevens Julia L1, Stewart Miqua L1, Strul Sasha1, Stutz Kathleen M1, Suh Donny W1, Summers Allison I1, Superstein Roseanne1, Sutherland Desirae R1, Tamkins Susanna M1, Taub Marc B1, Thibeault Maryse1, Titelbaum Jenna R1, Tolbert Tiffany T1, Toole Andrew J1, Toro David O1, Tung Irene T1, Twardowski Christina M1, Tychsen Lawrence1, Tzanetakos Vivian1, Varney Kelly D1, Ventura Gaylord G1, Verderber Lisa C1, Walker Kimberly R1, Wall Palak B1, Wallace David K1, Wang Jingyun1, Weise Katherine K1, Wernimont Suzanne M1, Willen Christi M1, Wolinski Elisabeth T1, Woodard Victoria C1, Wright Martha M1, Yamada Tomohiko1, Yen Kimberly G1, Yonkers Amanda M1, Freedman Sharon F1, Christian Melanie L1, Crouch Earl R1, Enyedi Laura B1, Good William V1, Jackson Jorie L1, London Richard1, Manh Vivian M1, Manny Ruth E1, Morrell Beth A1, Petersen David B1, Pineles Stacy L1, Rogers David L1, Ruark Scott T1, Schweinler Bonita R1, Silver Jayne L1, Chen Angela M.2, Erzurum S. Ayse3, Chandler Danielle L.4, Hercinovic Amra4, Wu Rui4, Vricella Marilyn5, Waters Amy L.6, Ticho Benjamin H.7, Erickson John W.8, Han Silvia2, McDowell Paula S.9, Li Zhuokai4, Kraker Raymond T.4, Holmes Jonathan M.10, Cotter Susan A.2
Affiliation:
1. for the Pediatric Eye Disease Investigator Group 2. Southern California College of Optometry at Marshall B. Ketchum University, Fullerton 3. Eye Care Associates, Poland, Ohio 4. Jaeb Center for Health Research, Tampa, Florida 5. State University of New York, College of Optometry, New York 6. Children’s Mercy Hospitals and Clinics, Kansas City, Missouri 7. Ticho Eye Associates, Chicago Ridge, Illinois 8. Nemours Children’s Clinic, Jacksonville, Florida 9. Michigan College of Optometry at Ferris State University, Big Rapids 10. University of Arizona, Tucson
Abstract
ImportanceIncreased myopic shift was found to be associated with 1 year of overminus spectacle treatment for children with intermittent exotropia (IXT). Persistence of myopic shift after discontinuing overminus spectacles is unknown.ObjectiveTo compare refractive error change over 3 years in children with IXT originally treated with overminus vs nonoverminus spectacles.Design, Setting, and ParticipantsThis study was an 18-month extension of the Trial of Overminus Spectacle Therapy for Intermittent Exotropia cohort, which previously randomized children aged 3 to 10 years with IXT and baseline spherical equivalent refractive error (SER) between −6.00 diopters (D) and 1.00 D to overminus spectacles (−2.50 D for 12 months, −1.25 D for 3 months, and nonoverminus for 3 months) or nonoverminus spectacles. Children were recruited from 56 sites from July 2010 to February 2022. Data were analyzed from February 2022 to January 2024.InterventionsAfter trial completion at 18 months, participants were followed up at 24 and 36 months. Treatment was at investigator discretion from 18 to 36 months.Main Outcomes and MeasuresChange in SER (cycloplegic retinoscopy) from baseline to 36 months.ResultsOf 386 children in the Trial of Overminus Spectacle Therapy for Intermittent Exotropia, 223 (57.8%) consented to 18 months of additional follow-up, including 124 of 196 (63.3%) in the overminus treatment group and 99 of 190 (52.1%) in the nonoverminus treatment group. Of 205 children who completed 36-month follow-up, 116 (56.6%) were female, and the mean (SD) age at randomization was 6.2 (2.1) years. Mean (SD) SER change from baseline to 36 months was greater in the overminus group (−0.74 [1.00] D) compared with the nonoverminus group (−0.44 [0.85] D; adjusted difference, −0.36 D; 95% CI, −0.59 to −0.12; P = .003), with 30 of 112 (26.8%) in the overminus group having more than 1 D of myopic shift compared with 14 of 91 (15%) in the nonoverminus group (risk ratio, 1.8; 95% CI, 1.0-3.0). From 12 to 36 months, mean (SD) myopic shift was −0.34 (0.67) D and −0.36 (0.66) D in the overminus and nonoverminus groups, respectively (adjusted difference, −0.001 D; 95% CI, −0.18 to 0.18; P = .99).Conclusions and RelevanceThe greater myopic shift observed after 1 year of −2.50-D overminus lens treatment remained at 3 years. Both groups had similar myopic shift during the 2-year period after treatment weaning and cessation. The risk of myopic shift should be discussed with parents when considering overminus lens treatment.Trial RegistrationClinicalTrials.gov Identifier: NCT02807350
Publisher
American Medical Association (AMA)
|
|