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Willem Tideman, Jan Roelof Polling, Vincent Jaddoe, Cathy Williams, Jeremy A Guggenheim, Caroline Klaver; Axial length growth curves and the risk of myopia in European children and adults. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2401. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Treatments for progressive myopia in children are increasing in popularity, but the assessment of excessive eye growth in early childhood has proven to be challenging. Normative values for axial length are currently lacking. The aim of this study was to generate percentile curves for axial length (AL) in European children, to assess the risk of myopia and high myopia per percentile line, and to explore how these growth curves relate to those at other regions in the world.
Cross sectional analysis of three population-based studies, Generation R, ALSPAC, and Rotterdam Study III, with 12386 participants aged 6 years to adulthood from The Netherlands and the UK. All participants underwent eye measurements with AL and corneal radius (CR), with measurements of objective refractive error in Generation R at 9 years and the Rotterdam Study III. The 2nd, 5th, 10th, 25th, 50th, 75th, 90th, 95th and 98th percentile values were calculated and growth curves were plotted as a function of age. Biometric data from other regions were extracted from published population-based and school-based studies for which gender-stratified data were available. Myopia was defined as ≤-0.5D.
Children from Generation R were on average (SD) 6.2 (0.5) and 9.8 (0.3) years old at the examinations, participants from ALSPAC 15.5 (0.3) years and RS-III adults 56.8 (6.4) years old. AL increased from 22.36 (0.75) mm at 6 years; 23.10 (0.84) mm at 9 years; 23.41(0.86) mm at 15 years; to 23.67 (1.26) mm in adults. After the age of 15 years, the upper 50 percentile of the AL spectrum increased, with the greatest difference in the highest 5 percentile. At 9 years, 11.4% of the children were myopic. In the highest ten percentile in adults, the prevalence of myopia and high myopia was 97% and 23%, respectively. Of the 354 children with an increase in AL percentile score of >10 between age 6 and 9 years, 45.8% (n=162) were myopic at age 9, compared to only 4.8% (85/1781) of children with an increase in AL percentile score <10. Previously published European studies were in line with our data, while previously published Asian studies showed greater growth.
This study formulated normative values for AL for Europeans that can be used for monitoring eye growth in children. These charts will help clinicians diagnose excessive eye growth at an early age, and substantiate the instigation of intervention for progressive myopia.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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