Work

Risk Factors for Astigmatism in the Vision in Preschoolers (VIP) Study

Year: 2014

Type: article

Abstract: PURPOSE: To determine demographic and refractive risk factors for astigmatism in the Vision in Preschoolers (VIP) Study. METHODS: Three- to 5-year old Head Start preschoolers (N=4,040) from 5 clinical centers underwent comprehensive eye examinations by study-certified optometrists and ophthalmologists, including monocular visual acuity (VA) testing, cover testing, and cycloplegic retinoscopy. Astigmatism was defined as the presence of ≥ +1.5 diopters (D) cylinder in either eye, measured with cycloplegic refraction. The associations of risk factors with astigmatism were evaluated using the odds ratio (OR) and its 95% confidence intervals (95% CI) from logistic regression models. RESULTS: Among 4,040 VIP Study participants over-representing children with vision disorders, 687 (17%) had astigmatism, and majority of astigmatism was with-the-rule (83.8%). In multivariate analyses, African-American (OR=1.65, 95% CI: 1.22–2.24), Hispanic (OR=2.25, 95% CI: 1.62–3.12) and Asian children (OR=1.76, 95% CI: 1.06–2.93) were more likely to have astigmatism compared with non-Hispanic white children, while American Indian children were less likely to have astigmatism than Hispanic, African American and Asian children (P<0.0001). Refractive error was associated with astigmatism in a non-linear manner, with an OR of 4.50 (95% CI: 3.00 – 6.76) for myopia (≤ −1.0D in spherical equivalent), and 1.55 (95% CI: 1.29 –1.86) for hyperopia (≥ +2.0D) when compared to children without refractive error (> −1.0D, < +2.0D). There was a trend of an increasing percentage of astigmatism among older children (linear trend p=0.06). The analysis for risk factors of with-the-rule astigmatism provided similar results. CONCLUSIONS: Among Head Start preschoolers, Hispanic ethnicity, African-American and Asian race, myopic and hyperopic refractive error were associated with an increased risk of astigmatism, consistent with findings from the population-based Multi-ethnic Pediatric Eye Disease and Baltimore Pediatric Eye Disease studies. American Indian children had lower risk of astigmatism.

Source: PubMed Central

DOI: 10.1097/opx.0000000000000242