Does Past Myopia Progression Predict Future Progression?

Area of Science:

• Ophthalmology
• Pediatric Optometry
• Myopia Research

Background:

• Myopia progression is a significant concern in pediatric eye care.
• Accurate prediction of myopia progression is crucial for timely intervention.
• Previous refractive error and axial length changes are potential indicators of future progression.

Purpose of the Study:

• To evaluate the predictive value of prior changes in spherical equivalent refractive error (SER) and axial length (AL) for future myopia progression in children.
• To quantify the accuracy of using past SER and AL measurements to forecast subsequent myopia development.

Main Methods:

• A post hoc analysis of a randomized controlled trial involving children aged 5-12 years.
• Data from 136 children with myopia (SER -1.00 to -6.00 D) treated with 0.01% atropine or placebo for 24 months were analyzed.
• Multivariable linear regression assessed the association between SER/AL changes over the first 12 months and the subsequent 12 months.

Main Results:

• The positive predictive value of a 0.50-D SER increase in predicting a similar increase later was only 42%.
• Prior 12-month SER change showed a weak association with subsequent SER change (0.20 D per 1.00 D increase).
• Prediction intervals for future progression were negligibly improved by including prior changes in SER and AL.

Conclusions:

• Changes in SER and AL over a 12-month period are poor predictors of future myopia progression in children.
• These findings suggest limited clinical utility for using prior refractive error and axial length changes in myopia management decisions.
• The predictive value is insufficient for reliably selecting participants for myopia control clinical trials.