Longitudinal development of ocular biometric components and refractive error in hyperopic children with infantile versus late-onset accommodative esotropia.

Purpose: To examine the developmental patterns of refractive error and optical components in hyperopic children with infantile (onset ≤12 months of age) accommodative or late-onset (18-48 months of age) accommodative esotropia.

Methods: This prospective longitudinal study included children with infantile (n = 34) or late-onset (n = 63) accommodative esotropia. Axial length (AL), anterior chamber depth (ACD), lens thickness (LT) and keratometry (K1, K2) were obtained with a Lenstar LS 900. Lenstar measures were recorded <6 months after cycloplegic spherical equivalent refraction (SER) was derived. An initial examination was conducted at 5.8 ± 1.5 years of age, with a follow-up duration of 4.8 ± 0.8 years. A linear mixed-effects model was used to estimate the rate of individual development for each ocular component and SER, and to compare the two groups.

Results: All biometric components changed with age. The rates of change with age for SER and AL were significantly different between the infantile and late-onset groups (SER: -0.18 vs. -0.12D/year, p < 0.001; AL: 0.16 vs. 0.14 mm/year, p < 0.01). The rate of change with age of the AL/CR ratio was significantly different between the infantile and late-onset groups (0.019 vs. 0.016, p < 0.001). No significant differences in the rates of change in ACD, LT, K1 or K2 were identified.

Conclusions: Major ocular biometric components in children continue to mature in both infantile and late-onset accommodative esotropia. Annual change in axial length is smaller in late-onset accommodative esotropia than for infantile accommodative esotropia, consistent with less change in the SER with age.