Five-year change in refractive error and its risk factors: results from the Gutenberg Health Study

To examine the 5-year change in refractive error in phakic eyes and its risk factors in the general population.

The Gutenberg Health Study (GHS) is a population-based cohort study including 15 010 participants from Germany aged 35-74 years at baseline examination (2007-2012). After 5 years, a follow-up examination was carried out (83% participation). 5-year change of spherical equivalent (SE) was computed as difference between follow-up and baseline objective refraction. Linear and logistic regression analysis were conducted analysing potential risk factors. Only phakic eyes at follow-up examination were included.

Right eyes of 10 175 subjects were included. An age-related shift of refractive error was identified, namely -0.12 D for age 35-44 years, 0.25 D for age 45-54 years, 0.25 D for age 55-64 years and 0.12 D for age 65-74 years during the 5-year follow-up. Smokers had a hyperopic shift (OR=1.31; p<0.001), while baseline SE (OR=0.89 per dioptre; p<0.001) and female sex (OR=1.49; p<0.001) were linked with a myopic shift. Education, occupation and other cardiovascular parameters were not associated with change in refractive error.

The GHS demonstrates a parabolic shift in refractive error with a myopic shift at age 35-44 years, followed by a hyperopic shift at age 45-64 years which decreases at higher age. Smoking is associated with a hyperopic shift whereas female sex and myopic baseline SE is associated with a myopic shift. Educational level and occupation were not linked to a change in refractive error at age 35-74 years.