Regularities of the refractive genesis of school myopia and criteria for its prediction

摘要

The paper provides the data of a 2-year monitoring of ocular refraction in 327 consecutive 10-14-year-old schoolchildren (654 eyes) unrandomized under natural conditions and cycloplegia. The authors studied whether there was an association of refraction and its changes with absolute and relative accommodation, habitual accommodation tonicity, the length of the anteroposterior optic axis, and the presence of pseudomyopathy and astigmatism. Over 2 years, myopia occurred in 15.4% of the eyes, its degree increased from -0.88 (-1.37/-0.50) to -1.25 (-2.31/-0.62) diopters. Criteria for myopia prediction were identified. These included a relative accommodation reserve of less than 2.5 diopters, an anteroposterior optic axis length of more than 24.33 mm, a habitual accommodation tonicity of less than + 0.41 diopters, the presence of pseudomyopia (77.8% of cases), reversed astigmatism and underlying emmetropia. A mathematical model was constructed for prediction of myopia, the proportion of its correct prediction being 90.4%, which makes it possible to recommend for clinical application.