{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T13:08:03Z","timestamp":1765112883154,"version":"3.37.3"},"reference-count":40,"publisher":"Wiley","license":[{"start":{"date-parts":[[2019,6,23]],"date-time":"2019-06-23T00:00:00Z","timestamp":1561248000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81170869","Y20160615"],"award-info":[{"award-number":["81170869","Y20160615"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Zhejiang Top Disciplines (B) Nursing Science and Technology Project of Wenzhou City","award":["81170869","Y20160615"],"award-info":[{"award-number":["81170869","Y20160615"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Ophthalmology"],"published-print":{"date-parts":[[2019,6,23]]},"abstract":"<jats:p><jats:italic>Purpose<\/jats:italic>. To assess the changing profile of astigmatism in Chinese schoolchildren and the association between astigmatism changes and ocular biometry. <jats:italic>Methods<\/jats:italic>. We examined and followed up 1,463 children aged 6\u20139\u2009years from Wenzhou, China. We measured noncycloplegic refraction twice each year and tested axial length (AL) and corneal radius of curvature (CRC) annually for two years. We defined clinically significant astigmatism (CSA) as \u2264\u22120.75 diopter (D) and non-CSA astigmatism as \u22640 to &gt;\u22120.75\u2009D. <jats:italic>Results<\/jats:italic>. Prevalence of CSA at baseline was 22.4% (<jats:italic>n<\/jats:italic>\u2009=\u2009327) and decreased to 20.3% (<jats:italic>n<\/jats:italic>\u2009=\u2009297) at the two-year follow-up (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mrow><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.046<\/mml:mn><\/mml:mrow><\/mml:math>). Ninety-two (8.1%) non-CSA children developed CSA. In multiple regression, after adjusting for age, gender, baseline cylinder refraction, and axis, children who had longer baseline ALs (&gt;23.58\u2009mm; odds ratio (OR)\u2009=\u20095.19, 95% confidence interval (CI): 2.72\u20139.90) and longer baseline AL\/CRC ratio (&gt;2.99, OR\u2009=\u20094.99, 95% CI: 2.37\u201310.51) were more likely to develop CSA after two years. Four-hundred and two (27.5%) children had increased astigmatism, 783 (53.5%) had decreased, and 278 (19.0%) had no change during the two-year follow-up. Children with increased astigmatism had longer baseline ALs (23.33\u2009mm, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mrow><mml:mi>P<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:mrow><\/mml:math>), higher AL\/CRC ratios (2.99\u2009mm, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\"><mml:mrow><mml:mi>P<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:mrow><\/mml:math>), and more negative spherical equivalent refraction (SER) (\u22120.63\u2009D, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\"><mml:mrow><mml:mi>P<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:mrow><\/mml:math>) compared with the decreased and no astigmatism change subgroups. Also, children in the increased astigmatism subgroup had more AL growth (0.68\u2009mm, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\"><mml:mrow><mml:mi>P<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:mrow><\/mml:math>), higher increases in AL\/CRC ratio (0.08, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\"><mml:mrow><mml:mi>P<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:mrow><\/mml:math>), and more negative SER change (\u22120.86\u2009D, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\"><mml:mrow><mml:mi>P<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:mrow><\/mml:math>) compared with the decreased and no astigmatism change subgroups. <jats:italic>Conclusions<\/jats:italic>. The prevalence of astigmatism decreased slightly over the two-year study period. Longer ALs and higher AL\/CRC ratios were independent risk factors for developing CSA. Increased astigmatism was associated with AL growth, AL\/CRC ratio increases, and the development of myopia. This trial is registered with <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/chictr.org\/showproj.aspx?proj=15305\">ChiCTR1800019915<\/jats:ext-link>.<\/jats:p>","DOI":"10.1155\/2019\/5613986","type":"journal-article","created":{"date-parts":[[2019,6,23]],"date-time":"2019-06-23T19:32:16Z","timestamp":1561318336000},"page":"1-8","source":"Crossref","is-referenced-by-count":4,"title":["Simultaneous Changes in Astigmatism with Noncycloplegia Refraction and Ocular Biometry in Chinese Primary Schoolchildren"],"prefix":"10.1155","volume":"2019","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2291-2353","authenticated-orcid":true,"given":"Yaoyao","family":"Lin","sequence":"first","affiliation":[{"name":"School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6477-9963","authenticated-orcid":true,"given":"Dandan","family":"Jiang","sequence":"additional","affiliation":[{"name":"The Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7474-7639","authenticated-orcid":true,"given":"Chunchun","family":"Li","sequence":"additional","affiliation":[{"name":"The Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6423-1084","authenticated-orcid":true,"given":"Xiao","family":"Chang","sequence":"additional","affiliation":[{"name":"School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Balamurali","family":"Vasudevan","sequence":"additional","affiliation":[{"name":"College of Optometry, Mid Western University, Glendale, AZ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8556-6641","authenticated-orcid":true,"given":"Xiaoqiong","family":"Huang","sequence":"additional","affiliation":[{"name":"The Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6204-6587","authenticated-orcid":true,"given":"Wenzhe","family":"Zhou","sequence":"additional","affiliation":[{"name":"The Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 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