Abstract
Purpose: :
We aim to determine the effect of early and late onset puberty on the onset and progression of myopia in Singapore school children.
Methods: :
In the SCORM cohort study of 1779 school children, the longitudinal pubertal status of 892 boys and 887 girls from ages 6 to 14 years of age, were assessed. Information regarding the age of menarche and break of voice (BOV), and age of peak height velocity (PHV) were obtained. Linkage to the School Health Services records provided data on physician-assessments of pubertal status. Early puberty was defined as below 50th percentile of age of onset of menarche, BOV and PHV. Refractive error was determined by cycloplegic stand-alone autorefraction using the Canon RK-F1, and axial length was measured using A-scan biometry machine.
Results: :
Age of PHV occurred earlier in girls than boys (11.0 years versus 11.97 years, P < 0.001). The age of peak axial length (AL) velocity also occured earlier in girls than boys, but the magnitude of the gender effect was minimal (10.6 years versus 10.7 years, P = 0.04). Girls with early puberty as assessed by PHV experienced peak AL velocity at a mean age of 10.3 years versus 10.8 years in those with late puberty (P < 0.001). They also had earlier peak SE velocity at 10.0 years versus 10.56 years in those with late puberty (P < 0.001). Similarly, boys who had early puberty also achieved peak AL velocity earlier, at a mean age of 10.4 years versus 11.1 years in children with late pubertal development (P < 0.001). The age of peak SE velocity in boys with early puberty also occurred earlier at 10.1 years versus 10.6 years in those who experienced late puberty (P < 0.001). Both girls and boys who had early puberty as assessed by PHV also had earlier age of onset of myopia (9.8 years for girls with early puberty versus 10.1 years for girls with late puberty, P = 0.04; 9.9 years for boys with early puberty versus 10.4 years for boys with late puberty, P = 0.003).
Conclusions: :
Our study shows significant correlation between the onset of puberty and the age of peak AL velocity in boys and girls. Thus, the apparent faster progression of myopia observed in girls in previous studies may be related to the earlier onset of puberty in girls.
Keywords: myopia • clinical (human) or epidemiologic studies: natural history • refractive error development