Variant myopia: A new presentation?
Jameel Rizwana Hussaindeen1, Mithra Anand2, Viswanathan Sivaraman3, Krishna Kumar Ramani2, Peter M Allen4
1 Srimathi Sundari Subramanian, Department of Visual Psychophysics, Elite School of Optometry; Binocular Vision Clinic, Sankara Nethralaya, Units of Medical Research Foundation, Chennai, Tamil Nadu, India
2 Srimathi Sundari Subramanian, Department of Visual Psychophysics, Elite School of Optometry, Chennai, Tamil Nadu, India
3 Binocular Vision Clinic, Sankara Nethralaya, Units of Medical Research Foundation, Chennai, Tamil Nadu, India
4 Department of Vision and Hearing Sciences, Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK
Dr. Krishna Kumar Ramani
Elite School of Optometry, No. 8, GST Road, St. Thomas Mount, Chennai - 600 016, Tamil Nadu
Source of Support: None, Conflict of Interest: None
Purpose: Variant myopia (VM) presents as a discrepancy of >1 diopter (D) between subjective and objective refraction, without the presence of any accommodative dysfunction. The purpose of this study is to create a clinical profile of VM. Methods: Fourteen eyes of 12 VM patients who had a discrepancy of >1D between retinoscopy and subjective acceptance under both cycloplegic and noncycloplegic conditions were included in the study. Fourteen eyes of 14 age- and refractive error-matched participants served as controls. Potential participants underwent a comprehensive orthoptic examination followed by retinoscopy (Ret), closed-field autorefractor (CA), subjective acceptance (SA), choroidal and retinal thickness, ocular biometry, and higher order spherical aberrations measurements. Results: In the VM eyes, a statistically and clinically significant difference was noted between the Ret and CA and Ret and SA under both cycloplegic and noncycloplegic conditions (multivariate repeated measures analysis of variance, P < 0.0001). A statistically significant difference was observed between the VM eyes, non-VM eyes, and controls for choroidal thickness in all the quadrants (Univariate ANOVA P < 0.05). The VM eyes had thinner choroids (197.21 ± 13.04 μ) compared to the non-VM eyes (249.25 ± 53.70 μ) and refractive error-matched controls (264.62 ± 12.53 μ). No statistically significant differences between groups in root mean square of total higher order aberrations and spherical aberration were observed. Conclusion: Accommodative etiology does not play a role in the refractive discrepancy seen in individuals with the variant myopic presentation. These individuals have thinner choroids in the eye with variant myopic presentation compared to the fellow eyes and controls. Hypotheses and clinical implications of variant myopia are discussed.