Intermittent Exotropia May Not Affect Pediatric Myopia Progression

Intermittent exotropia may not influence myopia progression in children, according to a study published in Optometry and Vision Science. A reduction in myopia progression trended towards significance in children who underwent strabismus correction surgery, according to the report. 

Researchers retrospectively analyzed 1239 pediatric patients with myopia (average age at initial presentation, 8.74 years) who underwent evaluation at a single center between 2012 and 2020. The primary outcome measures were the trends in refractive error over time in those with and without intermittent exotropia and trends in those who did and did not undergo strabismus surgery.

The report shows that 275 (22%) patients had intermittent exotropia, and 12 (4.4%) patients in this group underwent surgical correction during the study period. 

The researchers found no statistically significant difference in myopia progression between children with intermittent exotropia and children without strabismus (−0.41 vs −0.41 diopters (D)/ year; P =.95). The team also determined there was no difference in mean annual spherical equivalent change between patients with intermittent exotropia who did not undergo surgery compared with those who did, although this value trended toward statistical significance (−0.42 vs −0.25 D/year; P =.059).

“Improved understanding of how myopia behaves in strabismic versus non-strabismic patients will positively impact patient care by guiding treatment decisions and ultimately reducing cost, limiting potential exposure to adverse effects, and improving outcomes,” according to the researchers.

Study limitations include its retrospective nature, single center design, a relatively short mean follow-up time, and limited sample size.