Abstract
Purpose :
The prevalence of myopia is increasing all over the world. Predictions made in 2016 suggest that 50% of the world population will be myopic (<-0.5D) by 2050 and 10% will be highly myopic (≤-6D). The COVID-19 pandemic is likely to cause an even steeper rise. It is unknown how well current data match with these predictions. We aim to determine the change in myopia prevalence and axial length in a multi ethnic cohort of children followed from 6 to 18 years in an urban area in Western Europe.
Methods :
A total of 6320 study participants from the population based birth cohort study Generation R completed eye examinations at ages 6, 9, 13, and 18 years during the time period 2002-2022. 2119 of 18 year-olds have been examined until December 2022. The eye examination included best-corrected LogMAR visual acuity using ETDRS method; automated refraction in cycloplegic refraction using Topcon RM-A2000 autorefractor; and measurement of eye biometry using Zeiss IOL-master 500. Myopia was defined as spherical equivalent (SE) ≤-0.5D. Emmetropia was defined as SE between -0.5> and <+2.0; hyperopia was defined as SE>+2.0.
Results :
The prevalence of myopia has increased with age from 2.4% at age 6; 11.6% at age 9; 22.5% at age 13; and 28.9% at age 18. Average axial length was 22.63 at age 6; 23.37 at age 9; 23.74 at age 13; 23.97 at age 18 in boys, and 22.09 at age 6; 22.84 at age 9; 23.26 at age 13; 23.52 at age 18 in girls. Girls showed a faster eye growth between age 9 and 13 (P=0.04). Consequently, girls had a slightly higher risk of myopia from age 13 onwards (HR 1.18 95% CI 1.06: 1.32). When stratifying for refractive error at baseline, myopes grew fastest (0.18 ± 0.07 mm/year), emmetropes and hyperopes had similar growth (0.11 ± 0.09 mm/year vs 0.10 ±0.10 mm/year: P=0.77). When stratifying for refractive error at the end of follow up myopes (0.17 ± 0.05 mm/year) still grew the fastest, emmetropes also grew significantly faster than hyperopes ( 0.09 ± 0.02 mm/year vs 0.07 ± 0.02 mm/year; P=0.0009).
Conclusions :
The prevalence of myopia in European adolescents appears to be somewhat lower than the trend that was predicted by Holden et al. in 2016, although these young people may still progress further for several years. As expected, axial elongation differs significantly between refractive errors.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.