{Reference Type}: Journal Article
{Title}: Refractive Error Change and Overminus Lens Therapy for Childhood Intermittent Exotropia.
{Author}:  ; ;Chen AM;Erzurum SA;Chandler DL;Hercinovic A;Wu R;Vricella M;Waters AL;Ticho BH;Erickson JW;Han S;McDowell PS;Li Z;Kraker RT;Holmes JM;Cotter SA;
{Journal}: JAMA Ophthalmol
{Volume}: 142
{Issue}: 5
{Year}: 2024 May 1
{Factor}: 8.253
{DOI}: 10.1001/jamaophthalmol.2024.0276
{Abstract}: <B>UNASSIGNED: </B>Increased myopic shift was found to be associated with 1 year of overminus spectacle treatment for children with intermittent exotropia (IXT). Persistence of myopic shift after discontinuing overminus spectacles is unknown.<BR><B>UNASSIGNED: </B>To compare refractive error change over 3 years in children with IXT originally treated with overminus vs nonoverminus spectacles.<BR><B>UNASSIGNED: </B>This study was an 18-month extension of the Trial of Overminus Spectacle Therapy for Intermittent Exotropia cohort, which previously randomized children aged 3 to 10 years with IXT and baseline spherical equivalent refractive error (SER) between -6.00 diopters (D) and 1.00 D to overminus spectacles (-2.50 D for 12 months, -1.25 D for 3 months, and nonoverminus for 3 months) or nonoverminus spectacles. Children were recruited from 56 sites from July 2010 to February 2022. Data were analyzed from February 2022 to January 2024.<BR><B>UNASSIGNED: </B>After trial completion at 18 months, participants were followed up at 24 and 36 months. Treatment was at investigator discretion from 18 to 36 months.<BR><B>UNASSIGNED: </B>Change in SER (cycloplegic retinoscopy) from baseline to 36 months.<BR><B>UNASSIGNED: </B>Of 386 children in the Trial of Overminus Spectacle Therapy for Intermittent Exotropia, 223 (57.8%) consented to 18 months of additional follow-up, including 124 of 196 (63.3%) in the overminus treatment group and 99 of 190 (52.1%) in the nonoverminus treatment group. Of 205 children who completed 36-month follow-up, 116 (56.6%) were female, and the mean (SD) age at randomization was 6.2 (2.1) years. Mean (SD) SER change from baseline to 36 months was greater in the overminus group (-0.74 [1.00] D) compared with the nonoverminus group (-0.44 [0.85] D; adjusted difference, -0.36 D; 95% CI, -0.59 to -0.12; P = .003), with 30 of 112 (26.8%) in the overminus group having more than 1 D of myopic shift compared with 14 of 91 (15%) in the nonoverminus group (risk ratio, 1.8; 95% CI, 1.0-3.0). From 12 to 36 months, mean (SD) myopic shift was -0.34 (0.67) D and -0.36 (0.66) D in the overminus and nonoverminus groups, respectively (adjusted difference, -0.001 D; 95% CI, -0.18 to 0.18; P = .99).<BR><B>UNASSIGNED: </B>The greater myopic shift observed after 1 year of -2.50-D overminus lens treatment remained at 3 years. Both groups had similar myopic shift during the 2-year period after treatment weaning and cessation. The risk of myopic shift should be discussed with parents when considering overminus lens treatment.<BR><B>UNASSIGNED: </B>ClinicalTrials.gov Identifier: NCT02807350.