Graduation Year
2024
Document Type
Thesis
Degree
M.S.P.H.
Degree Name
MS in Public Health (M.S.P.H.)
Degree Granting Department
Epidemiology and Biostatistics
Major Professor
Jean Paul Tanner, Ph.D.
Committee Member
Jason L. Salemi, Ph.D.
Committee Member
Raymond T. Kraker, M.S.P.H.
Keywords
baseline association, directed acyclic graph, pediatrics, regression, strabismus
Abstract
Intermittent exotropia (IXT) is a condition resulting in an eye deviation away from normal alignment, potentially treatable with overminus lenses. These induce accommodation of the eye, combatting the eye drifting outward. Overminus lenses may help treat IXT but also potentially worsen refractive error. Analyses aimed to find associations of baseline factors as they relate to IXT control outcomes, as well as the risk of worsening spherical equivalent refractive error (SER). One hundred ninety-six participants aged 3 to <11 treated with overminus lenses for 12 months were analyzed to explore associations between age, sex, race, ethnicity, strabismus severity, accommodative convergence/accommodation ratio (AC/A), and baseline SER with outcomes of change in SER and change in control. Analyses included outcomes for both SER and control as continuous and binary outcomes, and a secondary combined outcome. More myopic baseline refractive error and older age were associated with a worsening in SER after 12 months, -0.08 diopters (D) worsening SER per 1 year age increase (95% CI -0.13 to -0.03), and -0.30 D worsening SER per additional 1 D of myopic refractive error (95% CI -0.39 to -0.21). A larger AC/A ratio was associated with better distance control (0.11 points improvement per D of AC/A, 95% CI 0.03 to 0.19). The combined SER and control outcome showed the same factors (age, baseline refractive error, and AC/A ratio) were significantly associated with improving outcomes. Overminus lens therapy may be beneficial for some patients, but further study is needed to explore the results of these exploratory analyses.
Scholar Commons Citation
Robinson, Julianne L., "Baseline Factors and their Association with Refractive Error and Control in a Pediatric Randomized Clinical Trial of Overminus Therapy for Intermittent Exotropia" (2024). USF Tampa Graduate Theses and Dissertations.
https://digitalcommons.usf.edu/etd/11199
