Age not a factor when estimating myopia onset using axial length
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NEW ORLEANS — Although age should be considered when estimating the probability of myopia onset based on refractive error, risk assessments using axial length do not need to include adjustments for age, according to a presenter.
“As the eye grows, the eye approaches ametropia, the growth of the eye starts to exceed the ability of the crystalline lens to stretch and compensate for the axial elongation, and we get to the point where we are falling off the myopia cliff,” Donald O. Mutti, OD, PhD, FAAO, the E.F. Wildermuth Foundation Professor in Optometry at The Ohio State University College of Optometry, told attendees at Academy ’23. “So where is that cliff? That cliff appears to be at a very consistent location across the ages.”
To determine the effect of age on myopia onset, Mutti and colleagues analyzed participants in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error study, which included nonmyopic children aged 6 to 12 years from five clinical centers in the U.S.
The researchers found that the probability of myopia onset within 1 year for a given axial length did not vary significantly by age, reporting an estimated probability of 0.045 for a baseline axial length of 23.5 mm, which increased to 0.13 for a baseline axial length of 24.5 mm.
Further, Mutti and colleagues reported an odds ratio of 3.02 for myopia onset across all ages studied for a 1 mm difference in axial length.
“The probability of onset within 1 year as a function of axial length did not seem to vary significantly with age, and risk calculators using axial length may not need to include age,” Mutti said. “But the probability of myopia within a year as a function of refractive error does seem to vary significantly with age. Any myopia risk calculator that uses refractive error should have age in it.”
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Mutti D, et al. Axial length, age and the prediction of future myopia. Presented at: Academy; Oct. 11-14, 2023; New Orleans.
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