Risk factors for astigmatism in the Vision in Preschoolers Study
Jiayan Huang, Maureen G Maguire, Elise Ciner, Marjean Taylor Kulp, Lynn A Cyert, Graham E Quinn, Deborah Orel-Bixler, Bruce Moore, Gui-Shuang Ying, Vision in Preschoolers (VIP) Study Group, Paulette Schmidt, Agnieshka Baumritter, Elise Ciner, Lynn Cyert, Velma Dobson, Beth Haas, Marjean Taylor Kulp, Maureen Maguire, Bruce Moore, Deborah Orel-Bixler, Ellen Peskin, Graham Quinn, Maryann Redford, Janet Schultz, Gui-Shuang Ying, Deborah Orel-Bixler, Pamela Qualley, Dru Howard, Lempi Miller Suzuki, Sarah Fisher, Sara Frane, Cindy Hsiao-Threlkeld, Selim Koseoglu, A Mika Moy, Sharyn Shapiro, Lisa Verdon, Tonya Watson, Sean McDonnell, Erika Paez, Darlene Sloan, Evelyn Smith, Leticia Soto, Robert Prinz, Joan Edelstein, Beatrice Moe, Bruce Moore, Joanne Bolden, Sandra Umaña, Amy Silbert, Nicole Quinn, Heather Bordeau, Nancy Carlson, Amy Croteau, Micki Flynn, Barry Kran, Jean Ramsey, Melissa Suckow, Erik Weissberg, Marthedala Chery, Maria Diaz, Leticia Gonzalez, Edward Braverman, Rosalyn Johnson, Charlene Henderson, Maria Bonila, Cathy Doherty, Cynthia Peace-Pierre, Ann Saxbe, Vadra Tabb, Paulette Schmidt, Marjean Taylor Kulp, Molly Biddle, Jason Hudson, Melanie Ackerman, Sandra Anderson, Michael Earley, Kristyne Edwards, Richard Hertle, Nancy Evans, Heather Gebhart, Jay Henry, Jeffrey Hutchinson, LeVelle Jenkins, Andrew Toole, Keith Johnson, Richard Shoemaker, Rita Atkinson, Fran Hochstedler, Tonya James, Tasha Jones, June Kellum, Denise Martin, Christina Dunagan, Joy Cline, Sue Rund, Elise Ciner, Angela Duson, Lydia Parke, Mark Boas, Shannon Burgess, Penelope Copenhaven, Ellie Francis, Michael Gallaway, Sheryl Menacker, Graham Quinn, Janet Schwartz, Brandy Scombordi-Raghu, Janet Swiatocha, Edward Zikoski, Leslie Kennedy, Rosemary Little, Geneva Moss, Latricia Rorie, Shirley Stokes, Jose Figueroa, Eric Nesmith, Gwen Gold, Ashanti Carter, David Harvey, Sandra Hall, Lisa Hildebrand, Margaret Lapsley, Cecilia Quenzer, Lynn Rosenbach, Lynn Cyert, Linda Cheatham, Anna Chambless, Colby Beats, Jerry Carter, Debbie Coy, Jeffrey Long, Shelly Rice, Shelly Dreadfulwater, Cindy McCully, Rod Wyers, Ramona Blake, Jamey Boswell, Anna Brown, Jeff Fisher, Jody Larrison, Paulette Schmidt, Beth Haas, Maureen Maguire, Agnieshka Baumritter, Mary Brightwell-Arnold, Christine Holmes, Andrew James, Aleksandr Khvatov, Lori O'Brien, Ellen Peskin, Claressa Whearry, Gui-Shuang Ying, Maryann Redford, Jiayan Huang, Maureen G Maguire, Elise Ciner, Marjean Taylor Kulp, Lynn A Cyert, Graham E Quinn, Deborah Orel-Bixler, Bruce Moore, Gui-Shuang Ying, Vision in Preschoolers (VIP) Study Group, Paulette Schmidt, Agnieshka Baumritter, Elise Ciner, Lynn Cyert, Velma Dobson, Beth Haas, Marjean Taylor Kulp, Maureen Maguire, Bruce Moore, Deborah Orel-Bixler, Ellen Peskin, Graham Quinn, Maryann Redford, Janet Schultz, Gui-Shuang Ying, Deborah Orel-Bixler, Pamela Qualley, Dru Howard, Lempi Miller Suzuki, Sarah Fisher, Sara Frane, Cindy Hsiao-Threlkeld, Selim Koseoglu, A Mika Moy, Sharyn Shapiro, Lisa Verdon, Tonya Watson, Sean McDonnell, Erika Paez, Darlene Sloan, Evelyn Smith, Leticia Soto, Robert Prinz, Joan Edelstein, Beatrice Moe, Bruce Moore, Joanne Bolden, Sandra Umaña, Amy Silbert, Nicole Quinn, Heather Bordeau, Nancy Carlson, Amy Croteau, Micki Flynn, Barry Kran, Jean Ramsey, Melissa Suckow, Erik Weissberg, Marthedala Chery, Maria Diaz, Leticia Gonzalez, Edward Braverman, Rosalyn Johnson, Charlene Henderson, Maria Bonila, Cathy Doherty, Cynthia Peace-Pierre, Ann Saxbe, Vadra Tabb, Paulette Schmidt, Marjean Taylor Kulp, Molly Biddle, Jason Hudson, Melanie Ackerman, Sandra Anderson, Michael Earley, Kristyne Edwards, Richard Hertle, Nancy Evans, Heather Gebhart, Jay Henry, Jeffrey Hutchinson, LeVelle Jenkins, Andrew Toole, Keith Johnson, Richard Shoemaker, Rita Atkinson, Fran Hochstedler, Tonya James, Tasha Jones, June Kellum, Denise Martin, Christina Dunagan, Joy Cline, Sue Rund, Elise Ciner, Angela Duson, Lydia Parke, Mark Boas, Shannon Burgess, Penelope Copenhaven, Ellie Francis, Michael Gallaway, Sheryl Menacker, Graham Quinn, Janet Schwartz, Brandy Scombordi-Raghu, Janet Swiatocha, Edward Zikoski, Leslie Kennedy, Rosemary Little, Geneva Moss, Latricia Rorie, Shirley Stokes, Jose Figueroa, Eric Nesmith, Gwen Gold, Ashanti Carter, David Harvey, Sandra Hall, Lisa Hildebrand, Margaret Lapsley, Cecilia Quenzer, Lynn Rosenbach, Lynn Cyert, Linda Cheatham, Anna Chambless, Colby Beats, Jerry Carter, Debbie Coy, Jeffrey Long, Shelly Rice, Shelly Dreadfulwater, Cindy McCully, Rod Wyers, Ramona Blake, Jamey Boswell, Anna Brown, Jeff Fisher, Jody Larrison, Paulette Schmidt, Beth Haas, Maureen Maguire, Agnieshka Baumritter, Mary Brightwell-Arnold, Christine Holmes, Andrew James, Aleksandr Khvatov, Lori O'Brien, Ellen Peskin, Claressa Whearry, Gui-Shuang Ying, Maryann Redford
Abstract
Purpose: To determine demographic and refractive risk factors for astigmatism in the Vision in Preschoolers Study.
Methods: Three- to 5-year-old Head Start preschoolers (N = 4040) from five clinical centers underwent comprehensive eye examinations by study-certified optometrists and ophthalmologists, including monocular visual acuity testing, cover testing, and cycloplegic retinoscopy. Astigmatism was defined as the presence of greater than or equal to +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 interval (CI) from logistic regression models.
Results: Among 4040 Vision in Preschoolers Study participants overrepresenting children with vision disorders, 687 (17%) had astigmatism, and most (83.8%) had with-the-rule astigmatism. In multivariate analyses, African American (OR, 1.65; 95% CI, 1.22 to 2.24), Hispanic (OR, 2.25; 95% CI, 1.62 to 3.12), and Asian (OR, 1.76; 95% CI, 1.06 to 2.93) children were more likely to have astigmatism than non-Hispanic white children, whereas 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 nonlinear manner, with an OR of 4.50 (95% CI, 3.00 to 6.76) for myopia (≤-1.0 D in spherical equivalent) and 1.55 (95% CI, 1.29 to 1.86) for hyperopia (≥+2.0 D) when compared with children without refractive error (>-1.0 D, <+2.0 D). 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, African American, and Asian race as well as 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 Study and the Baltimore Pediatric Eye Disease Study. American Indian children had lower risk of astigmatism.
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Source: PubMed