IMI—Management and Investigation of High Myopia in Infants and Young Children

作者：Ian Flitcroft, John Ainsworth, Audrey Chia, Susan A. Cotter, Elise Harb, Zi‐Bing Jin, Caroline C. W. Klaver, Anthony T. Moore, Ken K. Nischal, Kyoko Ohno‐Matsui, Evelyn A. Paysse, Michael X. Repka, Irina Yurievna Smirnova, Martin P. Snead, Virginie J. M. Verhoeven, Pavan K. Verkicharla · 发表于：Investigative Ophthalmology & Visual Science · 年份：2023 · DOI：10.1167/iovs.64.6.3 · 被引用次数：51 · 研究领域：Ophthalmology and Visual Impairment Studies、Corneal surgery and disorders、Retinopathy of Prematurity Studies

Purpose: The purpose of this study was to evaluate the epidemiology, etiology, clinical assessment, investigation, management, and visual consequences of high myopia (≤-6 diopters [D]) in infants and young children. Findings: High myopia is rare in pre-school children with a prevalence less than 1%. The etiology of myopia in such children is different than in older children, with a high rate of secondary myopia associated with prematurity or genetic causes. The priority following the diagnosis of high myopia in childhood is to determine whether there is an associated medical diagnosis that may be of greater overall importance to the health of the child through a clinical evaluation that targets the commonest features associated with syndromic forms of myopia. Biometric evaluation (including axial length and corneal curvature) is important to distinguishing axial myopia from refractive myopia associated with abnormal development of the anterior segment. Additional investigation includes ocular imaging, electrophysiological tests, genetic testing, and involvement of pediatricians and clinical geneticists is often warranted. Following investigation, optical correction is essential, but this may be more challenging and complex than in older children. Application of myopia control interventions in this group of children requires a case-by-case approach due to the lack of evidence of efficacy and clinical heterogeneity of high myopia in young children. Conclusions: High myopia in i...