Year-to-year myopia progression poor predictive model for long-term
While annual myopia progression in children was linked to subsequent progression the next year, the correlation as a single factor was not significant enough to fully predict subsequent or long-term myopia progression.
“What we need to be worried about going into the future is that children who might become myopic early on in life run a high risk for developing diseases later on. This is really the background as to why people want to slow myopia progression,” Noel A. Brennan, PhD, clinical research fellow of myopia control at Johnson & Johnson Vision, told Primary Care Optometry News about the study he presented at the virtual ARVO meeting.
The study comprised 674 children with myopia, 7 to 10 years old, who were enrolled in the Singapore Cohort Study of the Risk Factors for Myopia (SCORM). Brennan and colleagues evaluated cycloplegic autorefraction and axial length measurements at baseline and at least two follow-up visits.
“The major way that clinicians decide whether to instigate myopia control treatment is by looking at progression over time,” Brennan said. “Future progression does correlate with past progression, but the correlation is not particularly strong. As a result, some kids might not receive needed treatment simply because of a refraction measurement.”
Results showed that for every 1 D increase in annual myopia progression in year 1, year 2 progression increased by 0.35 D (P < .001), and year 1 myopia progression had the highest prediction rate for fast year 2 progression (AUC = 0.76; 95% CI, 0.73-0.8), compared with baseline or age of myopia onset (AUC = 0.7). The prediction rate decreased at year 3 (AUC = 0.69; 95% CI, 0.65-0.73) and year 4 (AUC = 0.63; 95% CI, 0.57-0.68).
“One approach that should be considered if you have a young myopic patient: treatment should begin right away rather than sitting and waiting and watching over a year, because we know the risks for becoming highly myopic especially when it begins early,” Brennan said. “Any child under the age of 12 [years] with myopia should be considered for treatment pretty much straight away.”
Brennan concluded that future studies will look at whether axial length measurements may be a way to “get a better handle on predicting progression rate.”
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Brennan NA, et al. Annual myopia progression and subsequent year progression in Singaporean children. Presented at: Association for Research in Vision and Ophthalmology meeting; May 6, 2020 (virtual meeting).
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