Refractive and ocular biometric characteristics of non-myopic and pseudomyopic eyes in mild hyperopic Chinese children aged 3-12 years.

Purpose: To investigate the refractive and ocular biometric characteristics of children with mild hyperopia and distinguish between non-myopic and pseudomyopic eyes before cycloplegia.

Methods: The eligible children underwent refractive error measurements using a NIDEK autorefractor before and after the administration of 0.5 % tropicamide. Ocular biometric parameters, including axial length (AL), anterior chamber depth (ACD), and lens thickness (LT), were measured using the IOLMaster 700 before cycloplegia. We performed comparative analyses between the non-myopic and pseudomyopic groups, categorized based on whether the spherical equivalent (SE) before cycloplegia exceeded -0.50 diopters (D). Univariable and multivariable regression analyses were performed to control for confounding factors.

Results: The final analysis included 968 eyes. The participants with pseudomyopia were more likely to be boys ( = 0.029), younger ( = 0.004), less hyperopic ( < 0.001) after cycloplegia, and exhibit a higher delta SE ( < 0.001) compared to the non-myopic participants. Pseudomyopic eyes were associated with a shallower ACD ( = 0.004) and thicker LT ( < 0.001) than non-myopic eyes. After adjusting for sex, age, and SE, pseudomyopic eyes showed increased AL ( = 0.001) and LT ( < 0.001) and decreased ACD ( = 0.005) compared with non-myopic eyes before cycloplegia.

Conclusions: Among the children with mild hyperopia, pseudomyopia was more common in younger boys with a lower cycloplegic SE and higher delta SE. A thicker LT, shallower ACD, and increased AL may indicate the presence of pseudomyopia, which may provide insights into the rapid progression of myopia in children with pseudomyopia.