Ocular findings in Japanese children with Down syndrome: the course of visual acuity and refraction, and systemic and ocular anomalies

Figures & data

Table 1 Ocular anomalies (without refractive error)

Type of ocular anomaly	No of subjects	%
Strabismus	87	39.7
Esodeviation	57	25.7
Overelevation in adduction	39	17.6
Exodeviation	22	9.9
Dissociated vertical deviation	1	0.5
Nystagmus	46	20.7
Latent nystagmus	26	11.7
Jerk type	20	9.0
Pendular type + jerk type	9	4.1
Pendular type	9	4.1
Head-position anomalies	32	14.4
Head tilt	25	11.3
Face turn	13	5.9
Chin up	8	3.6
Blepharoconjunctivitis	29	13.1
Lens opacities	25	11.3
Nasolacrimal duct obstruction	12	5.4
Tigroid fundus (diffuse type and partial type)	80	36.9
Peripapillary vascular abnormalities	13	5.9
Myelinated nerve fiber	1	0.5

Table 2 Systemic anomalies

Disease	No of subjects	%
Heart disease	117	52.7
Atrial septal defect	39	17.6
Ventricular septal defect	26	11.9
Patent ductus arteriosus	25	11.7
Atrioventricular septal defect	22	9.9
Endocardial cushion defect	9	4.1
Tetralogy of Fallot	7	3.2
Others	20	9.0
Hypothyroidism	38	17.1
Gastrointestinal disease	9	4.1
Duodenal atresia	6	2.7
Imperforate anus	2	0.9
Others	3	1.4
Otolaryngology disease	38	17.1
Middle otitis	25	11.7
Hearing loss	9	4.1
Others	7	3.2
Orthopedic disease	32	14.4
AAS	6	2.7
AAS (suspect)	14	6.3
Flat foot	7	3.2
Others	6	2.7
Cryptorchidism	5	2.3
Epilepsy	4	1.8
Others
Cryptorchidism, leukemia, anemia, atopic dermatitis, and so on	16	7.2

Abbreviation: AAS, atlanto-axial subluxation.

Table 3 The number of subjects in each age group and all subject data tested by VA cards and refraction

Age group	Range (yrs)	All (n)	VA (n)	Mean±SD (yrs)	Refraction (n)	Mean±SD (yrs)
I	0 to <4	204	200	1.7±1.0	157	2.5±1.0
P	4 to <7	177	177	5.3±0.9	145	5.2±0.8
LPSG	7 to <10	112	112	8.1±0.8	92	8.0±0.7
UPSG	10 to <13	70	70	11.2±1.0	49	11.2±1.0
JHS	13 to <16	46	46	14.4±1.2	33	14.4±1.0
LTYA	16 to <20	24	24	17.8±1.1	17	18.7±1.0

Abbreviations: VA, visual acuity; yrs, years; n, number of subjects; I, infant; P, preschool; LPSG, lower primary school grades; UPSG, upper primary school grades; JHS, junior high school; LTYA, late-teen/young-adult.

Table 4 Age group responses to VA card tests

Age group	Range (yrs)	Median age (yrs)	N	TAC		Morizane		Symbol		Landolt
				n	%	n	%	n	%	n	%
I	0 to <4	3.0	200	191	95.5	3	1.5	6	3.0	0	0
P	4 to <7	4.9	177	75	42.4	10	5.6	30	16.9	62	35.0
LPSG	7 to <10	7.7	112	8	7.1	3	2.7	16	14.3	85	75.9
UPSG	10 to <13	11.3	70	1	1.4	0	0	4	5.7	65	92.9
JHS	13 to <16	14.3	46	1	2.2	0	0	1	2.2	44	95.7
LTYA	16 to <20	18.3	24	0	0	0	0	1	4.2	23	95.8

Abbreviations: VA, visual acuity; TAC, Teller acuity cards, Teller Acuity Cards^® II; Morizane, dot card for near point, Morizane; Symbol, single symbol optotypes; Landolt, single Landolt ring test cards; yrs, years; n, number of subjects; I, infant; P, preschool; LPSG, lower primary school grades; UPSG, upper primary school grades; JHS, junior high school; LTYA, late-teen/young-adult.

Table 5 The course of VA (age groups and VA: logMAR)

Age group	Range (yrs)		TAC		Morizane		Symbol		Landolt
			Right mean±SD	Left mean±SD	Right range	Left range	Right range	Left range	Right mean±SD	Left mean±SD
I	0 to <4	1.21±0.22		1.21±0.24	1.00~0.70	1.00~0.70	1.00~0.52	1.00~0.40	NA	NA
P	4 to <7	0.98±0.24		0.98±0.24	1.00~0.22	1.00~0.22	1.00~0.22	1.00~0.22	0.41±0.24	0.43±0.21
LPSG	7 to <10	1.09±0.26		1.09±0.26	1.30~0.22	1.30~0.40	1.00~0.13	1.00~0.13	0.31±0.21	0.33±0.21
UPSG	10 to <13	1.22		1.22	NA	NA	0.70~0.22	0.70~0.22	0.29±0.21	0.30±0.23
JHS	13 to <16	NA		NA	NA	NA	0.70	0.70	0.27±0.22	0.29±0.28
LTYA	16 to <20	NA		NA	NA	NA	0.70	1.00	0.35±0.29	0.38±0.30

Abbreviations: VA, visual acuity; logMAR, logarithm of the minimum angle of resolution; TAC, Teller acuity cards, Teller Acuity Cards^® II; Morizane, dot card for near point, Morizane; Symbol, single symbol optotypes; Landolt, single Landolt ring test cards; yrs, years; I, infant; P, preschool; LPSG, lower primary school grades; UPSG, upper primary school grades; JHS, junior high school; LTYA, late-teen/young-adult.

Table 6 Best VA and glasses

	Whole	Group 1: good glasses wearing	Group 2: difficulty with glasses wearing (uncorrected refractive errors)	Group 3: no refractive errors
Years (mean±SD)	11.3±3.3	11.3±3.3	11.5±3.1	10.5±3.2
No of subjects	98	74	8	16
LogMAR (mean±SD)	0.19±0.17	0.19±0.17	0.34±0.13	0.08±0.10
Range of logMAR	0.0–0.699	−0.079–0.699	0.097–0.523	0.0–0.398

Abbreviations: VA, visual acuity; logMAR, logarithm of the minimum angle of resolution.

Table 7 The course of refractive errors

Age group	n	Hyperopia (≥+1.0D)				Emmetropia (>−1.0, <+1.0D)				Myopia (≤−1.0D)				Astigmatism (≥1.0D) (≥2.0D)
		Right		Left		Right		Left		Right		Left		Right		Left		Right		Left
		n	%	n	%	n	%	n	%	n	%	n	%	n	%	n	%	n	%	n	%
I	157	120	76.4	128	81.2	27	17.2	16	10.2	10	6.4	13	8.3	120	76.4	119	75.3	52	33.1	60	38.2
P	145	111	76.6	108	74.5	17	11.7	20	13.8	17	11.7	17	11.7	118	81.4	103	71.0	55	37.9	61	42.1
LPSG	92	62	67.4	59	64.1	14	15.2	16	17.4	16	17.4	17	18.5	78	84.8	74	80.4	41	44.6	45	48.9
UPSG	49	29	59.2	31	63.3	9	18.4	6	12.2	11	22.4	12	24.5	41	83.7	42	85.7	27	55.1	42	61.2
JHS	33	14	42.4	15	45.4	7	21.2	6	18.2	12	36.4	12	36.4	30	90.9	30	90.9	20	60.6	21	63.6
LTYA	17	8	47.1	7	41.2	3	17.6	3	17.6	6	35.3	7	41.2	16	94.1	16	94.1	9	52.9	10	58.8

Abbreviations: D, diopters; n, number of subjects; I, infant; P, preschool; LPSG, lower primary school grades; UPSG, upper primary school grades; JHS, junior high school; LTYA, late-teen/young-adult.

Table 8 The course of refractive errors

Age group	Range (yrs)	Mean±SD (yrs)	Spherical refraction (D)		Cylindrical refraction (D)
			Right mean±SD	Left mean±SD	Right mean±SD	Left mean±SD
I	0 to <4	2.5±1.0	2.2±2.4	2.4±2.5	1.5±1.0	1.6±1.1
P	4 to <7	5.2±0.8	2.0±2.7	2.1±2.7	1.62±1.0	1.5±1.1
LPSG	7 to <10	8.0±0.7	1.2±3.3	1.5±3.4	1.8±1.0	1.8±1.1
UPSG	10 to <13	11.2±1.1	0.8±3.8	1.0±3.6	2.1±1.2	2.1±1.1
JHS	13 to <16	14.4±1.0	−0.3±4.4	−0.2±4.4	2.2±1.0	2.2±1.2
LTYA	16 to <20	18.7±1.0	−0.7±4.8	−0.5±4.8	2.0±0.8	2.1±0.8

Abbreviations: D, diopters; yrs, years; I, infant; P, preschool; LPSG, lower primary school grades; UPSG, upper primary school grades; JHS, junior high school; LTYA, late-teen/young-adult.