Myopia progression patterns among paediatric patients in a clinical setting

Area of Science:

• Ophthalmology
• Pediatric Optometry
• Myopia Research

Background:

• Myopic progression in children is a growing concern globally.
• Understanding the natural history of untreated myopia is crucial for effective management.
• Existing data on myopia progression rates in children often lack real-world, diverse patient populations.

Purpose of the Study:

• To investigate the natural history of myopic progression in children using electronic medical record (EMR) data from Irish optometric practices.
• To establish age- and sex-specific population centiles for annual myopic progression in untreated children.
• To compare observed progression rates with data from randomized clinical trials (RCTs) and predictive models.

Main Methods:

• Retrospective analysis of EMR data from myopic patients aged 7-17 without myopia control treatment.
• Derivation of population centiles for annual myopic progression using weighted cubic splines.
• Comparison with RCT control group data and analysis using linear mixed models (LMMs) and survival analysis.

Main Results:

• Myopia progression was highest at age 7 (median: -0.67 D/year) and slowed with age (median: -0.18 D/year at age 17).
• Faster progression was predicted by female sex, higher baseline myopia, and younger age.
• RCT control groups showed higher mean progression than observed EMR data; clinic-based studies aligned more closely.

Conclusions:

• The study provides valuable progression centiles for untreated myopic children, defining the natural history of myopia.
• These findings will aid clinicians in predicting refractive outcomes without treatment.
• The data will also support monitoring treatment efficacy, especially when axial length data is unavailable.