Abstract

Volume.123 Number.9

Original article : Clinical science

Visual Acuity Development and Prognosis in Children with Congenital High Myopia
Takuya Asakawa, Osamu Hieda, Miho Sasaki, Yuko Cho, Sayaka Kamata, Yoshinori Nakai, Yo Nakamura, Chie Sotozono
Department of Ophthalmology, Kyoto Prefectural University of Medicine

Purpose: Ametropia due to myopia is unlikely to cause amblyopia; however, there are reportedly rare cases of congenital high myopia, i.e., high myopia that is present from infancy. In this study, we investigated the visual acuity (VA) development and prognosis in cases of congenital high myopia.
Subjects and methods: This study involved 20 eyes of 10 children who underwent the initial examination at the Department of Ophthalmology, Kyoto Prefecture University of Medicine, Kyoto, Japan between January 2008 to January 2016, met the criteria for congenital high myopia at 6 years of age[myopic refractive error (RE), ≥6.0 diopters (D); corrected VA, <20/20], were at least 6 years of age at the final observation, and completed followed-up examinations for at least 2 years. Amblyopia treatment was based on wearing corrective eyeglasses by using cycloplegic refraction. In cases of anisometropia in which VA development is insufficient, the patient was instructed to wear an eye patch on the healthy eye for approximately 2 to 3 hours per day.
Results: Better development of VA was associated with lower age at the treatment initiation. Moreover, VA at the final observation was lower as the myopic RE measured at the treatment initiation was larger. Among 11 eyes of 7 children with a myopic RE of ≥10.0 D at the treatment initiation, retinal detachment occurred in 4 eyes of 3 children during the clinical course, and one eye had diffuse chorioretinal atrophy.
Conclusions: Our findings indicate that patient age at the treatment initiation and refractive power are factors that influence the prognosis of VA in children with congenital high myopia. Treatment initiated earlier is more beneficial in children with myopic RE ≥6.0 D at or below 6 years of age; it is also necessary to check organic changes of the fundus regularly, especially in cases of myopic RE ≥10.0 D.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 123: 919-923, 2019.

Key words
Congenital high myopia, Pediatrics, Retinal detachment
Reprint requests to
Osamu Hieda, M.D., Ph.D. Department of Ophthalmology Kyoto Prefectural University of Medicine. 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan