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Published on: April 3, 2016
Axial Length Growth Trajectories in Children Transitioning to Myopia
Wai Cheung Liu1, Hongcheng Guo2, Carly Siu Yin Lam1
1School of Optometry (W.C.L., H.C., C.S.Y.L., and T.W.L.), The Hong Kong Polytechnic University, Hong Kong; Centre for Eye and Vision Research (CEVR) (W.C.L., C.S.Y.L., and T.W.L.), Hong Kong; Research Centre for SHARP Vision (W.C.L., C.S.Y.L., and T.W.L.), School of Optometry, The Hong Kong Polytechnic University, Hong Kong; Centre for Myopia Research (W.C.L., C.S.Y.L., and T.W.L.), School of Optometry, The Hong Kong Polytechnic University, Hong Kong.
Insights
Axial length (AL) growth accelerates significantly after myopia onset in children, especially before age 10. Early myopia control interventions are crucial for managing this accelerated eye growth.
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.
Purpose:
To characterize axial length (AL) growth trajectories in children who developed myopia compared with children who remained nonmyopic.
Design:
Retrospective longitudinal cohort study.
Participants:
Clinical data from 895 Chinese children (aged 4-15 years at baseline) with nonmyopic refractive error (spherical equivalent refraction> -0.50 D) at baseline spanned at least 2 years. They were categorized into nonmyopic (n = 541) and incident myopia (n = 354) groups, based on whether they developed myopia (SE ≤ -0.50 D) during follow-up. Children in the incident myopia group contributed data to both premyopia onset and postmyopia onset stages.
Methods:
Right eye data were used for all analyses. Participants were classified as myopic based on the right eye's spherical equivalent refraction, regardless of the left eye status. AL was measured at multiple visits, and the rate of AL growth between visits calculated. Generalized estimating equations were used to model AL growth rate, accounting for within-subject correlations. Age, baseline AL, gender, and parental myopia were included as predictors in the model.
Main Outcome Measures:
Annual AL growth rate (mm/y).
Results:
Generalized estimating equations modeling revealed significant differences in AL growth rates; children in the postmyopia onset stage exhibited significantly faster AL growth compared to both the children in the premyopia onset stage and nonmyopic group (P < .001). This difference was most pronounced in younger children and diminished with age. Postmyopia onset AL growth was significantly faster than premyopia onset growth up to age 7 and the nonmyopic group up to age 10 (P < .05). All groups showed an age-related decline in AL growth rate, with the decline being most pronounced in children in the postmyopia onset stage, followed by the nonmyopic group, and then children in the premyopia onset stage Baseline AL was significantly associated with postmyopia onset AL growth rate (P < .001) but not with premyopia onset (P = .22) or nonmyopic (P = .07) growth rates. Neither gender nor parental myopia significantly impacted AL growth rate.
Conclusions:
AL growth accelerates significantly after myopia onset, particularly in children younger than 10. This underscores the need for prompt myopia control interventions in early-onset myopia.
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