Myopia progression in young adults: insights from real-world clinical data

Myopia may progress even during adulthood. Clinical trials are required to evaluate the effectiveness of myopia control interventions in adults.

This study aimed to investigate what proportion of young adults undergo myopia progression of <-0.50 D and the factors associated with this progression based on data from real-world clinical settings.

This retrospective study included 2,683 myopes with spherical equivalent (SE) ranging from -0.50D to -14.75D. The spherical and cylindrical components were separately categorised into mild, moderate, and high-magnitude groups. Myopia progression was calculated as the difference between the previous spectacle prescription (obtained from a 1-year-old spectacle) and the current refraction. A binary logistic regression model was used to obtain the odds ratio.

The mean ± standard deviation age of myopic individuals was 24.45 ± 2.74 years (range: 18-30) and annual myopia progression was -0.22 ± 0.38D. Out of 2,683 myopes, 2,341 (87.3%) had stable refraction (annual change: ≤0.25 to ≥-0.50 D), and 342 (12.7%) myopes had progression of <-0.50 D. Overall, 4.6% (n = 124/2,683) of myopes had a change in refraction of ≤-1.00 D. The younger age group (18-20 years, OR 1.63 [95% CI 1.03-2.57], p = 0.04), high-spherical equivalent (OR 2.37 [95% CI 1.28-4.38]), and high-cylinder (OR 6.60 [95% CI 3.40-12.81]) were found to be significantly (p < 0.05) associated with increased odds of myopia progression. Age of apparent myopia onset, gender, and spherical components were not associated with myopia progression (p > 0.05).

About 1 out 20 myopes in clinical settings tend to have progression of one dioptre even during adulthood. Regular monitoring of biometry in young adults with high-spherical equivalent and astigmatism could aid in the identification of those with myopia progression.