Rapid Myopic Progression in Early Childhood is Associated with Teenage High Myopia

Abstract

Purpose : To evaluate the association of early childhood progression of spherical equivalent (SE) with high myopia (HM) in teenagers in the Singapore Cohort of Risk factors for Myopia (SCORM).

Methods : We included 1051 SCORM children followed over a mean follow-up of 6.9±1.0 years from baseline (6-11 years-old) until their teenage years (12-19 years-old). Cycloplegic autorefraction and AL measurements were performed yearly. Three-year SE and axial length (AL) progression in childhood, baseline SE and AL, and parental myopia were evaluated using multivariable logistic or linear regression models, with predictive performance of risk factors assessed using the area under the curve (AUC). The outcomes in teenagers were HM (SE≤−5 D), AL≥25 mm, SE and AL.

Results : At the last visit, 20% of teenagers had HM and 35% had AL≥25 mm. In multivariate regression analyses, every -0.3 D/year increase in 3-year initial SE progression and every 0.2 mm/year increase in 3-year initial AL progression were associated with a -1.14 D greater teenage SE and 0.54 mm greater teenage AL (p’s<0.001). The AUC (95% CI) of a combination of 3-year SE progression, baseline SE and parental myopia for teenage HM was 0.98 (0.98-0.99). The AUC for 3-year AL progression, baseline AL and parental myopia for teenage AL≥25 mm was 0.95 (0.94-0.97).

Conclusions : Three-year myopia progression in early childhood combined with baseline SE or AL, and parental myopia, were good predictors of teenage HM. Clinicians may use this combination of factors to guide timing of interventions, potentially reducing the risk of HM later in life.

This is a 2021 ARVO Annual Meeting abstract.