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Jonathan Li, Carla Lanca, Hla Myint Htoon, Yee Ling Wong, Donald Tan, Charumathi Sabanayagam, Seang-Mei Saw; Longitudinal 19-year myopia progression among Singaporean children with high myopia. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6450.
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© ARVO (1962-2015); The Authors (2016-present)
To examine the progression of myopia in highly myopic Singaporean children from childhood to young adulthood.
We included Chinese, Malay and Indian children (n=106, 90% Chinese, 56% male) from three schools who participated in the Singapore Cohort Study of Risk Factors for Myopia (SCORM) with high myopia (spherical equivalent [SE] ≤ -5 diopters [D]). Cycloplegic refraction and biometry were performed at baseline (aged 7-9 years), every year for 9 years until last adolescent follow-up (aged 12-17), and a subsequent ten-year follow-up (aged 21-27). Fundus photography and choroidal thickness from swept-source optical coherence tomography (SS-OCT) were analyzed at the last follow-up. Myopia progression was defined as mean annual change in SE.
The mean baseline age was 7.8 years. SE (mean ± SD) at baseline, last adolescent visit, and 19-year adult visit were -2.81 ± 1.85, -6.69 ± 1.26 and -7.01 ± 1.56, respectively. Myopia progression and axial length change from baseline to adolescence (-0.58 ± 0.25 D/year, 0.21 ± 0.08 mm/year) were both significantly higher compared to adolescence to young adulthood (-0.03 ± 0.08 D/year, 0.04 ± 0.04 mm/year respectively, both P<0.001). In multivariate linear regression models, baseline SE was associated with earlier age of onset of myopia, myopia progression from baseline to adolescence, and more severe adult SE (all P<0.001), but not with myopia progression from adolescence to young adulthood (P=0.32). Adolescent and young adult SE were associated with both decreased choroidal thickness and presence of tessellated fundus (both P<0.001) at last follow-up.
Children with high myopia progress more rapidly from childhood to adolescence than from adolescence to young adulthood, with minimal progression after adolescence. Children with early onset myopia and greater severity of baseline myopia have faster myopia progression through adolescence and more severe adult myopia. More severe adolescent and adult myopia is associated with thinner choroidal thickness and presence of tessellated fundus, features which have been associated with myopic macular degeneration. Treatment of early onset myopes with increased risk of developing myopic macular degeneration would need to occur during earlier phases of life.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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