Refractive change over 5 years and associated factors in the Gutenberg Health Study

Abstract

Purpose : There is only little knowledge existing about the refractive change over the course of a lifetime, particularly in adulthood. Therefore, the aim of this study was to examine the 5-year change in refractive error in phakic eyes and its risk factors in the retrospective population-based Gutenberg Health Study, representing a German general population.

Methods : The Gutenberg Health Study is a German population-based cohort study including 15,010 participants aged 35-74 years at baseline examination (2007-2012). After 5 years, a follow-up examination was carried out (82% participation). At both examinations, objective refraction was measured. Phakic eyes at follow-up examination were included in this analysis. 5-year change of spherical equivalent was computed and age- and sex-stratified analysed. Linear regression analysis was conducted analysing potential risk factors, namely sex, age spherical equivalent, intraocular pressure, cardiovascular parameters (HbA1c, HDL-cholesterol, LDL-cholesterol, triglycerides, body-mass index, physical activity, smoking) as well as level of education and occupation.

Results : 10,156 subjects were included. An age-related shift of refractive error of was identified, namely -0.07 D for age 35-44 years, 0.20 D for 45-54, 0.19 D for 55-64, and -0.03 D for age 65-74 years. Smokers had a hyperopic shift (B=0.03; p=0.02), while higher intraocular pressure (B=-0.006 per mmHg; p<0.001) and female sex (B=-0.04; p<0.001) were linked with a myopic shift. Education, occupation and other cardiovascular parameters were not associated with change in refractive error.

Conclusions : The Gutenberg Health Study demonstrates a U-like shift in refractive error with a myopic change at younger and older age and a hyperopic shift at age 43 to 70 years. Smoking is associated with a hyperopic shift whereas a higher IOP is associated with a myopic shift. Educational level and occupation were not linked to a change in refractive error at age 35 to 74 years.

This is a 2021 ARVO Annual Meeting abstract.