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

Tomoko Terai,1,2 Shohei Eda,1,2 Jun Sugasawa,2 Masahiro Tonari,2 Junko Matsuo,2 Hidehiro Oku,2 Tsunehiko Ikeda2 1Department of Ophthalmology, Shiga Medical Center for Children, Moriyama-City, Shiga, Japan; 2Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka, Japan Purpose: To investigate the age-related development of refractive errors and changes of visual acuity (VA), and the systemic and ocular anomalies in Japanese children and young adults with Down syndrome (DS).Design: Retrospective cohort study.Subjects and methods: This study involved 222 Japanese children and young adults with DS (age range: 3 months to 19 years) seen at the Department of Ophthalmology, Shiga Medical Center for Children, Shiga, Japan. The subjects were divided into the following six age groups: 1) infant (age 0 to <4 years), 2) preschool (age 4 to <7 years), 3) lower primary-school grades (age 7 to <10 years), 4) upper primary-school grades (age 10 to <13 years), 5) junior high school (age 13 to <16 years), and 6) late teen/young adults (age 16 to <20 years). Through examination of the subjects’ medical charts, we investigated the development and changes of refractive errors and VA, best-corrected VA (BCVA), and systemic and ocular anomalies.Results: For vision testing, Teller Acuity Cards™ (Bernell Corporation) were used for the infants, and the Landolt ring was used for the school-age children. VA was found to develop with age. Mean BCVA was 0.19±0.17 logarithm of the minimum angle of resolution (mean age: 11.3±3.2 years). Mean of refractive errors was hyperopia in the infant (2.2±2.4 diopters [D] OD, 2.4±2.5D OS), yet became myopia to the junior high school (-0.3±4.4D OD, -0.2±4.4D OS).Conclusion: Our findings revealed that in children and in late-teen and young-adult subjects with DS, VA slowly develops and that refractive errors requiring correction exist and are difficult to examine. Keywords: astigmatism, Down syndrome, hyperopia, refraction, visual acuit