Longitudinal changes in astigmatism characteristics among preschool children: a vector-based analysis from Beijing
Year: 2026
Type: article
Study design: Observational Study
Abstract: To address the limitations of conventional magnitude-axis approaches, this longitudinal study applied Thibos vector analysis to characterize the progression of astigmatism among preschool children aged 3–6 years in Haidian, Beijing. By decomposing total astigmatism (TA) and corneal astigmatism (CA) into power-vector components (J0 and J45 for TA; cJ0 and cJ45 for CA), we evaluated changes in individual astigmatic components over 1 year. Children with astigmatism were recruited from the ophthalmology clinic of Haidian District Maternal and Child Health Care Hospital. Cycloplegic autorefraction was used to measure refractive error, and power vector analysis was performed to quantify longitudinal changes in TA and CA. Moderate astigmatism was most prevalent among 3-year-old children (46.43%), whereas mild astigmatism predominated among those aged 4–6 years (46.77-50.00%). With-the-rule (WTR) astigmatism accounted for 95.25% of cases, and compound astigmatism was the most common subtype (74.78%). Over 1 year, vector analysis showed significant shifts toward WTR astigmatism for both TA and CA (ΔJ0 > 0 and ΔcJ0 > 0), with TA exhibiting greater variability than CA ( p < 0.001). Strong correlations were observed between ΔJ0 and ΔcJ0 ( r = 0.3601, p < 0.0001) and between ΔJ45 and ΔcJ45 ( r = 0.2412, p < 0.0001). Changes in axial length (AL) correlated with the magnitude of TA ( r = 0.4971, p < 0.0001) but not with that of CA ( p > 0.05). Children who received spectacle correction showed greater astigmatism progression than those who did not ( p < 0.001). However, they exhibited a smaller myopic shift in spherical equivalent (M) ( p < 0.001), whereas AL elongation did not differ significantly between the groups ( p > 0.05). WTR and compound astigmatism predominated among preschool children. Moderate astigmatism was most prevalent at 3 years of age, and astigmatism shifted further toward WTR over the following year. Longitudinal changes in TA were greater than those in CA and were associated with AL elongation. In this observational study, spectacle correction was associated with greater astigmatism progression but a smaller myopic shift in M, highlighting its role in refractive management. These findings indicate a need for prospective study of the impact of spectacle progression on myopia and astigmatism progression. Not applicable.
Source: BMC Ophthalmology
Authors: Lu Chen, Wei Chen, Huan Tong, Jingjing Feng, Shanshan Xing, Jianing Pu, Xinli Liu, Lihua Wang
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,990
OpenAlex ID: W7212265391
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