Abstract
Purpose :
A number of tools are available for predicting future progression of myopia, an important part of clinical practice. Here we compare the Brien Holden Vision Institute (BHVI) Myopia Calculator with MyAppia.
Methods :
The BHVI calculator allows input of a child’s age, ethnicity (Asian or white), and current prescription. The free online version of MyAppia uses just age and current prescription. We determined 3-year progression for baseline values of 8 or 11 years, –1.00 or –4.00 D, and Asian or White. We also extracted the slowing of progression (efficacy) based on an input of 50% slowing.
Results :
The table shows the results from both calculators. The BHVI calculator shows a faster rate in Asians (by nearly a factor of 2) and slightly slower progression in higher myopes. In contrast, with MyAppia, progression is independent of age and baseline myopia and similar to that derived from the BHVI Calculator for Asian children. Inputting a 50% slowing produces the expected result. Unfortunately, in absolute terms, the 3-year efficacy varies by a factor of three from 0.35 to 1.18 D, when the evidence base indicates that treatment efficacy expressed in D or mm is largely independent of age, ethnicity, and myopia level. Also, a 3-year slowing of over a diopter is at odds with published data
Conclusions :
The BHVI calculator may overemphasize the difference in progression between Asians and whites—meta-analysis suggests the difference is closer to 30%. Both calculators exaggerate myopia control efficacy in younger patients and, for the BHVI calculator, in Asians when compared to the evidence base. It remains unclear whether Asians in the Western world progress at a similar rate to those in Asia.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.