Annual myopia progression and subsequent year progression in Singaporean children

Abstract

Purpose : To investigate predictors of myopia progression for subsequent year amongst myopic children in the Singapore Cohort Study of the Risk Factors for Myopia (SCORM).

Methods : A total of 674 myopic children (353M, 321F) aged 7 to 10 (mean 8.0 ± 0.9) years from 3 schools at baseline with at least 2 follow-up visits in SCORM were included. Cycloplegic autorefraction (RK5 autokeratorefractometer) and axial length (AL) measurement (US-800 Echo scan) were performed at every visit. Multiple linear regression analysis was performed with annual future myopia progression as the dependent variable. Receiver operating characteristic (ROC) curves from multiple logistic regressions were used to derive prediction scores for future fast myopia progression defined by the median cut at different durations of different follow up years.

Results : Myopia progression in Year 1 correlated with Year 2 progression (r = 0.47; see figure). For every 1 D increase in annual myopia progression in Year 1, Year 2 progression increased by 0.35 D (p < 0.001), in a multivariate linear regression model. Children with slow myopia progression during the first year (Year 1) (>-0.50 D/year) had the slowest mean Year 2 progression (-0.44 ± 0.44 D/Year), while children with fast myopia progression (<-1.25 D) in Year 1 had the fastest mean progression (-1.01 ± 0.39 D/year) in Year 2. There was a dose-response relationship (p for trend < 0.001). Year 1 myopia progression had the highest AUC for predicting fast Year 2 progression [0.76 (95% CI 0.73-0.80)] when compared to baseline SE [0.70 (95% CI 0.66-0.73)] or age of myopia onset [0.70 (95% CI 0.66-0.73)] or parental myopia [0.70 (95% CI 0.66-0.73)], after adjusting for confounders. For Year 1 myopia progression, AUC for predicting fast Year 2 progression was 0.76 [95% CI 0.73-0.80] and higher than those for fast Year 3 [0.69 (95% CI 0.65-0.73)] or Year 4 [0.63 (95% CI 0.57-0.68)] progression.

Conclusions : One-year annual myopia progression correlates with immediate subsequent year myopia progression. However, annual progression as a single factor cannot fully predict subsequent year or long term myopia progression. Strategic management to a given individual should be determined based on multiple patient-specific factors including myopia progression in the previous year, age of myopia onset and parental myopia.

This is a 2020 ARVO Annual Meeting abstract.