Refraction dynamics in schoolchildren with congenital partial atrophy of the optic nerve over a ten-year observation period

Abstract

Introduction. Optic nerve atrophy is a degenerative condition and a prevalent cause of visual impairment, including in children. Data on refractogenesis in schoolchildren with partial atrophy of the optic nerve (PAON) are scarce, with existing literature focusing primarily on the correction of low vision associated with this disorder. Purpose: to assess the refraction dynamics in schoolchildren with congenital PAON over a ten-year observation period.Materials and methods. We conducted a retrospective analysis of refraction changes over a decade among three groups: 1) 47 schoolchildren with PAON, 2) 49 schoolchildren with ametropia without PAON, and 3) 49 schoolchildren without any ophthalmopathology.Results. All groups exhibited a trend towards myopization (р < 0.001). In groups with myopic and emmetropic refractions (without ophthalmopathology at the start), either the emergence or an increase in myopic refraction was noted. In hypermetropic children, a gradual decrease towards emmetropic refraction or a shift to myopic refraction was observed. For myopic schoolchildren using contact lenses and perifocal glasses from the ages of 11–13, myopia progression stabilized, particularly with perifocal optical correction (р < 0.01). Despite refractive changes during the school years, regular courses of functional treatment and accommodation training led to a slight improvement in visual acuity in PAON patients (by an average of 0.05 ± 0.01 (p = 0.001) in myopes and 0.06 ± 0.01 (р < 0.001) in hypermetropes) and a significant increase in visual acuity in children with normal fundus ametropia (by an average of 0.14 ± 0.02 (р < 0.001) in myopes and 0.18 ± 0.02 (р < 0.001) in hypermetropes).Conclusion. The ten-year observation demonstrates a myopization trend in all groups of schoolchildren, which holds particular relevance for those with PAON due to their inherently lower visual acuity. An optimal optical correction strategy, employing modern myopia control measures in tandem with regular functional treatment and accommodation training, is essential for a health-preserving educational approach in schoolchildren with PAON.