Axial Length Growth Trajectories in Children Transitioning to Myopia

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Myopia Research

Background:

• Myopia, a common refractive error, is characterized by excessive axial elongation of the eye.
• Understanding axial length (AL) growth patterns is critical for identifying risk factors and developing interventions for myopia.
• Longitudinal studies tracking AL changes in children are essential for characterizing myopia progression.

Purpose of the Study:

• To compare axial length (AL) growth trajectories in children who developed myopia versus those who remained nonmyopic.
• To identify specific growth patterns associated with incident myopia in a pediatric cohort.
• To inform the timing and necessity of myopia control interventions.

Main Methods:

• Retrospective longitudinal cohort study involving 895 Chinese children aged 4-15 years at baseline.
• Participants were categorized into nonmyopic and incident myopia groups based on refractive error development over at least 2 years.
• Generalized estimating equations modeled AL growth rates, considering age, baseline AL, gender, and parental myopia.

Main Results:

• Children in the postmyopia onset stage exhibited significantly faster AL growth compared to premyopia onset and nonmyopic groups (P < .001).
• This accelerated growth was most pronounced in younger children (up to age 7 for premyopia vs. postmyopia, up to age 10 for nonmyopic vs. postmyopia).
• Baseline AL was significantly associated with postmyopia onset growth rate, while gender and parental myopia were not significant predictors.

Conclusions:

• Axial length growth significantly accelerates following the onset of myopia, particularly in children under 10 years old.
• These findings highlight the critical window for intervention in early-onset myopia.
• Prompt implementation of myopia control strategies is recommended for children experiencing myopia onset.