Changes in Refractive Errors in Albinism: a Longitudinal Study over the First Decade of Life.

PURPOSE To analyze longitudinal changes in refraction in patients with albinism. METHODS The medical records of 481 patients were reviewed retrospectively to identify patients who had cycloplegic refractions at three ages: visit A, 0-18 months old; visit B, 4-6 years old; visit C, 8-10 years old. We recorded refraction, type of albinism, glasses wear, and best-corrected visual acuity at visit C. Only right eyes were analyzed. RESULTS A total of 75 patients were included. Of these, 73 wore glasses. Mean best-corrected visual acuity at visit C was 20/72 (range, 20/25-20/200). Mean spherical equivalent was 2.81 +/- 2.4 D at visit A, 2.53 +/- 3.4 D at visit B, and 2.15 +/- 4.0 D at visit C. These values did not differ significantly from visits A to C (P = 0.0578). Mean astigmatism for the three time points was 1.60 +/- 1.00 D, 2.50 +/- 1.14 D, and 2.87 +/- 1.45 D; these values did differ significantly from A to C (P < 0.0001). Subgroup analysis for OCA1A (16 eyes), OCA1B (20 eyes), and OCA2 (30 eyes) showed an increase in astigmatism from A to C, with a significant difference in means (P < 0.0001, P < 0.0001, and P = 0.0001, resp.). Worse best-corrected visual acuity and higher mean astigmatism at visit C were found for OCA1A (20/104 and +4.08 +/- 1.34) compared to OCA1B (20/59 and +2.30 +/- 1.36; P < 0.0001) and OCA2 (20/66 and +2.53 +/- 1.21; P < 0.0001). CONCLUSIONS Children with albinism require periodic cycloplegic refraction, because astigmatism often increases within the first 10 years of life.