AIM: To investigate the clinical significance of changes of refractive and lenticular accommodation parameters in children with myopia of retinopathy of prematurity(ROP).

METHODS: A retrospective study was conducted in 98(192 eyes)1-6 year-old children with ROP who recovered spontaneously without treatment during outpatient follow-up between October 2018 and September 2019. According to the refractive screening results, the subjects were divided into myopia group(41 cases with 80 affected eyes)and non-myopia group(57 cases with 112 affected eyes). Meanwhile, 40 emmetropic premature infants(80 eyes)of the same age and without ROP were selected as the control group. Refractive parameters \〖spherical equivalent(SE), corneal curvature(CR), axial length(AL), anterior chamber depth(ACD), vitreous depth(VITR), lens thickness(LT)\〗 and lenticular accommodation parameters(SE and LT before and after mydriasis and their change values)in different groups were compared. Refractive parameters in myopic children with ROP in different age groups were analyzed, and the relationship among SE, refractive parameters and lens adjustment parameters in preschool myopic children with ROP was discussed.

RESULTS: SE and LT of myopia group(-3.95±1.31D, 4.21±0.34mm)were higher/larger than those of non-myopia group(1.32±0.36D, 4.08±0.21mm)and control group(1.39±0.42D, 3.71±0.41mm), while ACD(2.42±0.39mm)was lower than that of non-myopia group(2.61±0.24mm)or control group(3.11±0.32mm). Besides, LT of non-myopia group was larger than control group, and ACD was lower than control group(all P<0.001). SE of myopia group before and after mydriasis(-3.95±1.31, -3.02±0.97D)were higher than those of non-myopia group(1.32±0.36, 2.67±0.81D)or control group(1.39±0.42, 2.61±0.76D). and the difference value of SE(0.93±0.30D)was lower than that of non-myopia group(1.31±0.31D)or control group(1.25±0.19D)(P<0.001). LT before and after mydriasis(4.21±0.34, 3.95±0.22mm)were larger than those of non-myopia group(4.08±0.21, 3.71±0.37mm)or control group(3.71±0.41, 3.35±0.16mm), and the difference value of LT(0.26±0.08mm)was lower than non-myopia group(0.37±0.12mm)or control group(0.36±0.11mm). Moreover, LT of non-myopia group before and after mydriasis were larger than those of control group(all P<0.001). For subjects under 3 years old, SE, CR and LT of myopia group were higher and ACD was lower than those of non-myopia group. For subjects between 3 and 6 years old, SE and LT of myopia group were higher than those of non-myopia group(all P<0.05). SE was positively correlated with CR and LT in myopic children with ROP under 3 years old, but it was negatively correlated with the difference value of LT before and after mydriasis(P<0.05); SE was positively correlated with LT in myopic children with ROP between 3 and 6 years old, but was negatively correlated with the difference value of LT before and after mydriasis(P<0.05).

CONCLUSION: Refractive changes of preschool myopic children with ROP are characterized by lens thickening and shallow anterior chamber. Patients under 3 years old are accompanied by steep CR, and lens thickening appears after the age of three. CR is related to the occurrence of myopia of ROP in children under 3 years old. LT and lenticular accommodation are leading factors for myopia of ROP in children between 1 and 6 years old.