This study aims to investigate the relationship between the type and severity of refractive error and anisometropia development in preschool children. Retrospective cohort study. Data from Maccabi Healthcare Services, Israel's second-largest Health Maintenance Organization (HMO), were analyzed. The study included all isometropic children aged 1 to 6 years, re-examined for refraction at least 2 years following their initial examination between 2012 and 2022. Anisometropia was defined as a ≥1 diopter interocular difference in spherical equivalent. Relationships were assessed using logistic regression models adjusted for key sociodemographic factors. Among 33,496 isometropic children (51.2% male, mean age 3.2 ± 1.5 years), the prevalences of emmetropia, myopia, and hyperopia were 26.7% (n = 8944), 4.2% (n = 1397), and 69.1% (n = 23,155), respectively. Over a mean follow-up period of 5.1 ± 2.4 years, 2593 children (7.7%) were diagnosed with anisometropia. Adjusted odds ratios (ORs) for anisometropia gradually increased with baseline refractive error severity, reaching 13.90 (5.32-36.34) in severe myopia and 4.19 (3.42-5.15) in severe hyperopia. This pattern was also evident in cylindrical anisometropia, where ORs increased with greater baseline astigmatism, peaking at 12.10 (9.19-15.92) in children with high astigmatism (≥3 D). Associations remained consistent in sensitivity and subgroup analyses including across both sexes and when using a stricter anisometropia criterion. Children aged 1 to 6 years, initially without anisometropia but showing increasing severity of myopia, hyperopia, or astigmatism, are more likely to develop anisometropia. This underscores the importance of follow-up refractive measurements within this population to promptly diagnose and treat anisometropia and prevent potential visual complications.

中文翻译：

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儿童早期屈光不正与屈光参差发展的相关性

本研究旨在探讨学龄前儿童屈光不正的类型和严重程度与屈光参差发展之间的关系。回顾性队列研究。对以色列第二大健康维护组织 (HMO) Maccabi Healthcare Services 的数据进行了分析。该研究纳入了所有 1 至 6 岁的等参儿童，他们在 2012 年至 2022 年间初次检查后至少 2 年内重新检查了屈光度。屈光参差的定义为当量球镜屈光度差≥1。使用针对关键社会人口因素进行调整的逻辑回归模型来评估关系。在 33,496 名等参儿童（51.2% 为男性，平均年龄 3.2 ± 1.5 岁）中，正视眼、近视和远视的患病率分别为 26.7% (n = 8944)、4.2% (n = 1397) 和 69.1% (n = 23,155) ）， 分别。在平均 5.1 ± 2.4 年的随访期内，2593 名儿童 (7.7%) 被诊断患有屈光参差。屈光参差的调整比值比 (OR) 随着基线屈光不正严重程度的增加而逐渐增加，重度近视时达到 13.90 (5.32-36.34)，重度远视时达到 4.19 (3​​.42-5.15)。这种模式在柱镜屈光参差中也很明显，其中 OR 随基线散光的增加而增加，在高度散光 (≥3 D) 的儿童中达到峰值 12.10 (9.19-15.92)。在敏感性和亚组分析中，包括两性以及使用更严格的屈光参差标准时，关联性保持一致。 1至6岁的儿童，最初没有屈光参差，但近视、远视或散光的严重程度不断增加，更容易出现屈光参差。这强调了对该人群进行后续屈光测量对于及时诊断和治疗屈光参差并预防潜在的视力并发症的重要性。