Relationship between peripapillary atrophy and myopia progression in the eyes of young school children

Myopia progression is of great concern because of its association with an increased risk of sight-threatening conditions. This study aims to determine whether certain clinical and optic disc features are associated with the rate of myopia progression.

In this retrospective longitudinal observational study, we reviewed the medical records of 95 patients aged 6-11 years with myopia (spherical equivalent refractive error (SER) at baseline ≤ -0.5 D) and collected data regarding medical history, comprehensive ophthalmologic examination, and fundus photography. Using fundus photographs, we measured the ratio of horizontal to vertical disc diameter (HVDR), ratio of maximum β-zone peripapillary atrophy (β-PPA) width to vertical disc diameter (PVDR), and optic disc torsion. Outcome measurements included 2-year myopia progression (D/year) and overall myopia progression during the entire follow-up with a mean of 51 months.

Mean age at initial visit was 7.67 ± 1.50 years and mean SER at baseline was -2.91 ± 1.68 D (range, -5.75 to -0.50 D). In the univariate analysis, age, parental myopia, SER at baseline, HVDR, and PVDR were significantly associated with myopia progression (P < 0.05). In the multivariate analysis, however, only age at initial visit and PVDR were significant factors associated with both 2-year and overall myopia progression.

Children with younger age and smaller β-PPA at baseline showed a faster myopia progression. This study suggests that the width of β-PPA, regardless of SER, might be used as a quantitative parameter to predict the potential for further myopia progression associated with scleral stretching.