Association between mode of delivery and astigmatism in preschool children

Association between Gestational Age, Birth Weight, Parental Age at Childbirth, Mode of Delivery, and Infantile Esotropia

SIGNIFICANCE

This study investigated the potential perinatal risk factors associated with infantile esotropia in a Chinese population, including advanced parental age at childbirth and mode of delivery. The findings may be significant in developing better intervention strategies for infantile esotropia.

PURPOSE

This study aimed to investigate the associations between gestational age, birth weight, parental age at childbirth, mode of delivery, family history of strabismus, and infantile esotropia in the Chinese population.

METHODS

Ninety-nine patients with infantile esotropia and 117 control subjects were enrolled between March 2018 and March 2021. Detailed questionnaires were administered to parents to collect relevant information. Univariate and multivariate logistic regression models were used to identify possible risk factors of infantile esotropia. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated.

RESULTS

Infantile esotropia was associated with low birth weight (<2500 g; OR, 4.235; 95% CI, 1.460 to 12.287; P = .008) and emergency cesarean delivery (OR, 2.230; 95% CI, 1.127 to 4.413; P = .02).

CONCLUSIONS

The findings suggest that low birth weight and emergency cesarean deliveries are risk factors for infantile esotropia, highlighting a need for collaborative care between obstetricians, pediatricians, and vision care providers.

Prevalence of and factors associated with astigmatism in preschool children in Wuxi City, China

PURPOSE

To investigate the status of astigmatism in preschool children in Wuxi City, and explore the risk factors related to astigmatism. The risk factors related to astigmatism development as predictors can help us identify preschool children who need vision screening at an early stage to ensure good visual quality.

METHODS

The cross-sectional study was conducted in 10 kindergartens randomly selected in five districts of Wuxi City in November 2018. All preschool children were measured by objective refractometry under non-cycloplegic refraction. The basic information of preschool children was collected. The relevant factors of astigmatism in the questionnaire were completed by parents. Spss 26. 0 software was used for univariate and multivariate correlation analysis.

RESULTS

A total of 889 preschool children participated in the study, 864 were finally included in the study. The prevalence of astigmatism was 36.0%. The risk of astigmatism in premature children was higher than that in non-premature children (adjusted odds ratio = 1.841). The prevalence of astigmatism with parents' astigmatism history was higher, compared with preschool children without parents' astigmatism history (adjusted odds ratio = 2.037). When maternal age at childbirth was older (≥ 35 years old), the risk of astigmatism increased in preschool children (adjusted odds ratio = 2.181). Compared with bottle feeding, the risk of astigmatism for mixed feeding and breastfeeding reduced in preschool children. Compared with preschool children exposed to electronic screen for less than 2 h every day, preschool children exposed to electronic screen for more than 2 h had an increased risk of astigmatism (P = 0.004).

CONCLUSION

The prevalence of astigmatism among preschool children in Wuxi City was high. Some risk factors such as premature birth, parents' astigmatism history, maternal age at childbirth, feeding pattern, and electronic screen exposure time were closely related to the occurrence of astigmatism among preschool children. For preschool children with significant risk factors, their eyesight should be checked regularly to ensure their visual quality.

The biometric parameters of aniso-astigmatism and its risk factor in Chinese preschool children: the Nanjing eye study

Backgrounds

Aniso-astigmatism may hinder normal visual development in preschool children. Knowing its prevalence, biometric parameters and risk factors is fundamental to children eye care. The purpose of this study was to determine the biometric components of aniso-astigmatism and associated maternal risk factors in Chinese preschool children.

Methods

In the population-based, prospective cohort Nanjing Eye Study, children were measured for noncycloplegic refractive error using an autorefractor and for biometric parameters using an optical low-coherent reflectometry. The difference of total astigmatism (TA) between both eyes was calculated using cylinder power (non-vectorial aniso-TA was defined as ≥1.00 Dioptre Cylinder [DC] between both eyes) and by vector analysis (vectorial aniso-TA was defined as a difference of ≥0.5 in J₀ or J₄₅ between both eyes which is equivalent to 1.00 DC). The prevalence of aniso-TA was presented. Interocular biometric parameters were compared between with vs. without aniso-astigmatism group. In addition, risk factors were determined using multivariate logistic regression model.

Results

Of 1131 children (66.90 ± 3.38 months, 53.31% male), the prevalence of non-vectorial aniso-TA was 1.95% (95% Confidence Interval (CI) = 1.14–2.75%), while the prevalence of vectorial aniso-TA was twice as common as non-vectorial aniso-TA, neither varying with sex or age. With aniso-TA eyes were more asymmetric in axial length and corneal curvature radius than without aniso-TA eyes. In multivariate logistic regression model, 5-min Apgar score less than 7 was significantly associated with higher risk of aniso-TA (vectorial aniso-TA: Odds Ratio (OR) = 6.42, 95%CI = 2.63–15.69, P < 0.001; non-vectorial aniso-TA: OR = 4.99, 95%CI = 1.41–17.68, P = 0.01). Being twin or triple was significantly associated with higher risk of vectorial aniso-CA (OR = 2.43, 95%CI = 1.05–5.60, P = 0.04). Pre-term delivery (OR = 2.60, 95%CI = 1.09–6.15, P = 0.03) and post-term delivery (OR = 3.61, 95%CI = 1.31–9.96, P = 0.01) were significantly associated with higher risk of vectorial aniso-CA.

Conclusions

Both corneal curvature radius and axial length asymmetry were correlated with aniso-TA. Children with 5-min Apgar score < 7 were more likely to have aniso-TA, while twin or triple, pre-term or post-term delivery were more likely to have vectorial aniso-CA.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12886-021-01808-7.

Risk factors for astigmatic components and internal compensation: the Nanjing Eye Study

Purpose

To determine the risk factors for total astigmatism (TA), anterior corneal astigmatism (ACA), and internal compensation in Chinese preschool children.

Methods

In the population-based Nanjing Eye Study, children were measured for noncycloplegic refractive error and for biometric parameters. Data from questionnaires and measures from right eyes were analyzed for determining risk factors for TA, ACA, and internal compensation from multivariate logistic regression models.

Results

Of 1327 children (66.8 ± 3.4 months, 53.2% male), older age of the child (OR = 0.95 for per month increase; P = 0.03), older paternal age at child birth (OR = 1.04 for per year increase; P = 0.03), paternal astigmatism (OR = 1.89; P = 0.003), maternal astigmatism (OR = 1.73, P = 0.008), and second-hand smoke exposure during pregnancy (OR = 1.64; P = 0.03) were associated with higher risk of TA, while partial breastfeeding (OR = 0.49, P = 0.006) or formula feeding (OR = 0.46, P = 0.003) were associated with lower risk of TA. Larger ratio of axial length to corneal radius (OR = 16.16 for per unit increase; P = 0.001), maternal working during pregnancy (OR = 1.27; P = 0.04), and cesarean delivery (OR = 1.68, P = 0.04) were associated with higher risk of ACA, while formula feeding was associated with lower risk of ACA (OR = 0.57, P = 0.01). Paternal astigmatism (OR = 0.50, P = 0.01) and assisted reproduction (OR = 0.56, P = 0.03) were associated with lower risk of horizontal or vertical internal compensation. More outdoor activity time (OR = 1.15 for per hour increase, P = 0.01) was associated with higher risk of oblique internal compensation while more nighttime sleep on weekends (OR = 0.83 for per hour increase, P = 0.01) was associated with lower risk of oblique internal compensation.

Conclusions

Our study confirmed some previously reported risk factors and identified some novel risk factors for astigmatism including formula feeding for lower risk of both ACA and TA, and older paternal age at child birth for higher risk of TA.

Decentration following femtosecond laser small incision lenticule extraction (SMILE) in eyes with high astigmatism and its impact on visual quality

Background

To measure the decentration following SMILE in eyes with high myopic astigmatism and investigate its impact on visual quality.

Methods

The prospective study was conducted to analyze patients who underwent SMILE for correction of myopia and myopic astigmatism ≥2.5D (high astigmatism group, HA) at the ophthalmology department, Eye and ENT hospital, Shanghai, China.. Patients with myopic astigmatism < 1.5D served as controls (low astigmatism group, LA). Decentration was measured using a Scheimpflug camera with a difference map of the tangential curvature at 12 months postoperatively. Also the associations between decentration from the coaxial sighted corneal light reflex (CSCLR) and the visual outcomes, correction efficacy of astigmatism, wavefront aberrations and objective scatter index (OSI) were analyzed.

Results

No significant differences were observed in the decentered distance between HA and LA in either eyes (OD: HA: 0.18 ± 0.10 mm, LA: 0.20 ± 0.14 mm, P = 0.659; OS: HA: 0.22 ± 0.11 mm, LA: 0.20 ± 0.11 mm, P = 0.637). The analysis across the three levels of decentration (< 0.1 mm, 0.1–0.2 mm, and > 0.2 mm) showed no significant association between decentration and visual outcomes of predictability, efficiency, safety, MTF cutoff, OSI, SR and OVs in both groups. Also no significant association was observed between decentration and postoperative astigmatism in either group. A significant relationship between the magnitude of decentration and induced coma and spherical aberration was observed in HA.

Conclusions

The amount of decentration between HA and LA groups showed no differences. Decentration > 0.20 mm from CSCLR resulted in greater induction of coma and SA after SMILE in eyes with HA.