Ann M Morrison, Matthew L Robich, Lisa A Jordan, Loraine T Sinnott, Donald O Mutti
{"title":"高度远视婴儿的正视化：部分屈光矫正的随机临床试验。","authors":"Ann M Morrison, Matthew L Robich, Lisa A Jordan, Loraine T Sinnott, Donald O Mutti","doi":"10.1097/OPX.0000000000002254","DOIUrl":null,"url":null,"abstract":"<p><strong>Significance: </strong>Highly hyperopic infants are at greater risk for not undergoing emmetropization and later developing conditions such as strabismus, amblyopia, and early literacy and reading problems. An early intervention consisting of partial hyperopic correction and encouragement of accommodation may influence the rate of emmetropization in these high-risk infants.</p><p><strong>Purpose: </strong>This study aimed to determine if moderate spectacle partial correction (3.00 D cut from cycloplegic) and visual exercises to promote accommodation enhance emmetropization (reaching ≤+3.00 D) in highly hyperopic (≥+5.00 D to ≤+7.00 D) 3-month-old infants compared with no treatment (observation).</p><p><strong>Methods: </strong>Thirty-five highly hyperopic 3-month-old infants (57% female) were randomized to observation or treatment ( clinicaltrials.gov ; NCT03669146). Primary analysis compared the mean hyperopia at 18 months of age in treated versus untreated participants. Data were also modeled using proportional hazards survival analysis (time to reach ≤+3.00 D).</p><p><strong>Results: </strong>There was no significant difference in refractive error at 18 months of age between infants in the treated (+1.6 ± 0.6 D) and observation groups (+1.2 ± 0.7 D; p = 0.23) but treatment affected the rate of emmetropization depending on baseline hyperopia (p = 0.01). At 12 months of age, treated infants had similar refractive errors regardless of baseline hyperopia but untreated infants at 12 months underwent faster emmetropization if their baseline hyperopia was <+5.50 D and slower emmetropization if it was >+5.50 D.</p><p><strong>Conclusions: </strong>Partial hyperopic refractive correction with accommodative exercises in highly hyperopic infants did not affect average refractive error at 18 months. However, treatment affected the rate of emmetropization and how long it took to reach ≤+3.00 D. Treatment slowed the rate of emmetropization at lower levels of initial hyperopia but may enhance emmetropization at higher levels.</p>","PeriodicalId":19649,"journal":{"name":"Optometry and Vision Science","volume":" ","pages":"310-319"},"PeriodicalIF":1.6000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Emmetropization in highly hyperopic infants: A randomized clinical trial of partial refractive correction.\",\"authors\":\"Ann M Morrison, Matthew L Robich, Lisa A Jordan, Loraine T Sinnott, Donald O Mutti\",\"doi\":\"10.1097/OPX.0000000000002254\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Significance: </strong>Highly hyperopic infants are at greater risk for not undergoing emmetropization and later developing conditions such as strabismus, amblyopia, and early literacy and reading problems. An early intervention consisting of partial hyperopic correction and encouragement of accommodation may influence the rate of emmetropization in these high-risk infants.</p><p><strong>Purpose: </strong>This study aimed to determine if moderate spectacle partial correction (3.00 D cut from cycloplegic) and visual exercises to promote accommodation enhance emmetropization (reaching ≤+3.00 D) in highly hyperopic (≥+5.00 D to ≤+7.00 D) 3-month-old infants compared with no treatment (observation).</p><p><strong>Methods: </strong>Thirty-five highly hyperopic 3-month-old infants (57% female) were randomized to observation or treatment ( clinicaltrials.gov ; NCT03669146). Primary analysis compared the mean hyperopia at 18 months of age in treated versus untreated participants. Data were also modeled using proportional hazards survival analysis (time to reach ≤+3.00 D).</p><p><strong>Results: </strong>There was no significant difference in refractive error at 18 months of age between infants in the treated (+1.6 ± 0.6 D) and observation groups (+1.2 ± 0.7 D; p = 0.23) but treatment affected the rate of emmetropization depending on baseline hyperopia (p = 0.01). At 12 months of age, treated infants had similar refractive errors regardless of baseline hyperopia but untreated infants at 12 months underwent faster emmetropization if their baseline hyperopia was <+5.50 D and slower emmetropization if it was >+5.50 D.</p><p><strong>Conclusions: </strong>Partial hyperopic refractive correction with accommodative exercises in highly hyperopic infants did not affect average refractive error at 18 months. However, treatment affected the rate of emmetropization and how long it took to reach ≤+3.00 D. Treatment slowed the rate of emmetropization at lower levels of initial hyperopia but may enhance emmetropization at higher levels.</p>\",\"PeriodicalId\":19649,\"journal\":{\"name\":\"Optometry and Vision Science\",\"volume\":\" \",\"pages\":\"310-319\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Optometry and Vision Science\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/OPX.0000000000002254\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/10 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Optometry and Vision Science","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/OPX.0000000000002254","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/10 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
Emmetropization in highly hyperopic infants: A randomized clinical trial of partial refractive correction.
Significance: Highly hyperopic infants are at greater risk for not undergoing emmetropization and later developing conditions such as strabismus, amblyopia, and early literacy and reading problems. An early intervention consisting of partial hyperopic correction and encouragement of accommodation may influence the rate of emmetropization in these high-risk infants.
Purpose: This study aimed to determine if moderate spectacle partial correction (3.00 D cut from cycloplegic) and visual exercises to promote accommodation enhance emmetropization (reaching ≤+3.00 D) in highly hyperopic (≥+5.00 D to ≤+7.00 D) 3-month-old infants compared with no treatment (observation).
Methods: Thirty-five highly hyperopic 3-month-old infants (57% female) were randomized to observation or treatment ( clinicaltrials.gov ; NCT03669146). Primary analysis compared the mean hyperopia at 18 months of age in treated versus untreated participants. Data were also modeled using proportional hazards survival analysis (time to reach ≤+3.00 D).
Results: There was no significant difference in refractive error at 18 months of age between infants in the treated (+1.6 ± 0.6 D) and observation groups (+1.2 ± 0.7 D; p = 0.23) but treatment affected the rate of emmetropization depending on baseline hyperopia (p = 0.01). At 12 months of age, treated infants had similar refractive errors regardless of baseline hyperopia but untreated infants at 12 months underwent faster emmetropization if their baseline hyperopia was <+5.50 D and slower emmetropization if it was >+5.50 D.
Conclusions: Partial hyperopic refractive correction with accommodative exercises in highly hyperopic infants did not affect average refractive error at 18 months. However, treatment affected the rate of emmetropization and how long it took to reach ≤+3.00 D. Treatment slowed the rate of emmetropization at lower levels of initial hyperopia but may enhance emmetropization at higher levels.
期刊介绍：
Optometry and Vision Science is the monthly peer-reviewed scientific publication of the American Academy of Optometry, publishing original research since 1924. Optometry and Vision Science is an internationally recognized source for education and information on current discoveries in optometry, physiological optics, vision science, and related fields. The journal considers original contributions that advance clinical practice, vision science, and public health. Authors should remember that the journal reaches readers worldwide and their submissions should be relevant and of interest to a broad audience. Topical priorities include, but are not limited to: clinical and laboratory research, evidence-based reviews, contact lenses, ocular growth and refractive error development, eye movements, visual function and perception, biology of the eye and ocular disease, epidemiology and public health, biomedical optics and instrumentation, novel and important clinical observations and treatments, and optometric education.
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