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Longitudinal changes of refractive error in preschool children with congenital ectopia lentis

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Abstract

Background

Congenital ectopia lentis (CEL) is a hereditary eye disease which severely impacts preschool children’s visual function and development. This study aimed to evaluate the longitudinal changes in spherical equivalent (SE) refractive error in preschool children with CEL.

Methods

A retrospective cohort study was conducted at Zhongshan Ophthalmic Center, Guangzhou, China. Medical records of CEL patients under 6-year-old who were diagnosed with Marfan syndrome at the initial visit from January 2014 to March 2022 were collected and were divided into surgery and non-surgery groups. Mean change rate of SE in the two groups was evaluated, and the potential associated factors of SE change rate were investigated by mixed-effect regression model.

Results

A total of 94 preschool patients from 14 provinces of China were included. Among the 42 children of the surgery group, the mean age with standard deviation (SD) was 5.02 ± 0.81 years and patients experienced a myopic shift of –0.05 ± 0.09 D/month in average. The mean age with SD of the 52 children of the non-surgery group was 4.34 ± 1.02 years, and the mean myopic shift was –0.09 ± 0.14 D/month. The mixed-effect regression model identified that higher degree of myopia at baseline was associated with slower myopic shift both in surgery (β = 0.901, 95% CI: 0.822 ~ 0.980, P < 0.001) and in non-surgery group (β = 1.006, 95% CI: 0.977 ~ 1.034, P < 0.001) in CEL patients. Surgical treatment (β = 2.635, 95% CI: 1.376 ~ 3.894, P < 0.001) was associated with slower myopic shift in all participants CEL patients.

Conclusions

Myopic progression was slower in the surgery group than in the non-surgery group of CEL. Preschool CEL patients who met the surgical indication are suggested being performed with timely surgery to slow down the myopic progression.

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Acknowledgements

This work was supported by the staff in the Clinical Research Center of Zhongshan Ophthalmic Center.

Funding

This work was supported by National Natural Science Foundation of China (81873673, 81900841), Guangdong Basic and Applied Basic Research Foundation (2021A1515011673, 2022A1515011181).

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Author notes

  1. Zhangkai Lian, Yin Hu and Zhenzhen Liu have contributed equally.

Authors and Affiliations

  1. State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, #54 Xianlie South Road, Yuexiu District, Guangzhou, 510060, China

    Zhangkai Lian, Yin Hu, Zhenzhen Liu, Siyuan Liu, Danying Zheng & Guangming Jin

  2. Albany Medical College, Albany, New York, USA

    Charlotte Aimee Young

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  1. Zhangkai Lian
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Contributions

DZ and GJ conceived the study and design and acting as corresponding authors. ZkL, HY and QC contributed to the study design. ZkL, SL, ZzL, XZ conducted the study and collected the data. ZzL, HY and GJ analyzed the data. YH plotted the graphs. ZkL wrote the initial manuscript draft. CAY, QC, DZ and GJ revised and edited the manuscript. All authors reviewed and agreed with the results and conclusions of this manuscript.

Corresponding authors

Correspondence to Danying Zheng or Guangming Jin.

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Competing interests

The authors declare no competing interests.

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The authors have no conflicts of interest to declare.

Ethical approval

The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013). The study was approved by Ethical Committee of the Zhongshan Ophthalmic Center, Sun Yat-sen University (ID: 2020KYPJ146) and individual consent for this retrospective analysis was waived.

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Lian, Z., Hu, Y., Liu, Z. et al. Longitudinal changes of refractive error in preschool children with congenital ectopia lentis. Int Ophthalmol 44, 85 (2024). https://doi.org/10.1007/s10792-024-02953-w

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