Abstract
Purpose :
Myopia is a public health epidemic that is associated with increased costs, reduced quality of life, and irreversible vision loss. Understanding which patients are at higher risk for myopia progression will allow targeted interventions. In this retrospective cohort study, we sought to characterize the relationship between race and myopia progression.
Methods :
Patients enrolled in Kaiser Permanente Southern California between 2011 and 2016 and were between 5-11 years with a documented refraction between -1 and -6 diopters (D) were included in this study. Patients with a history of amblyopia, strabismus, retinopathy of prematurity, or prior ocular surgery were excluded from analyses. The eye with the highest refractive error was chosen for analysis. Patients’ race-ethnicity and language information were used to create the following race-ethnicity groups for analysis: White, Black, Hispanic, South Asian, East/Southeast Asian, Other Asian, and Other/Unknown. A growth curve analysis using linear mixed-effects modeling was employed to trace longitudinal progression of spherical equivalents over time, and age stratified by race/ethnicity. Analyses were adjusted for potential confounders including gender, BMI, age at initial refraction, screen time, physical activity, and interactions between covariates.
Results :
11,398 patients met inclusion criteria, of which 53% were female, 54% were Latino, 15% were white, 9% were black, 9% were East/Southeast Asian, and 2% South Asian. Mean age (SD) at the time of initial refraction was 8.8 (1.6) years. Patients had an average (SD) of 3.4 (1.4) refractions, including the baseline measurement. South Asian and East/Southeast Asian patients had the largest proportion of patients (19%) with an SE ≥-6 and <-3 while Latino and white patients had the lowest proportion of patients within this refractive range (14%). Trends across time only differed between white children and children of East/Southeast Asian descent, with the latter showing steeper decline over time. Furthermore, we found that East/Southeast Asian patients who were diagnosed at KP with myopia between ages 6-8 progressed significantly faster compared to white patients.
Conclusions :
Myopia progression over time differs significantly between East/Southeast Asian and white patients and is accelerated even more for East/Southeast Asian children diagnosed at KP at ages 6-8. No other racial/ethnic differences were observed.
This is a 2020 ARVO Annual Meeting abstract.