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The progression of myopia in school age children: data from the Columbia Medical Plan
C I Braun1, V Freidlin, R D Sperduto
1National Eye Institute, National Institutes of Health, Bethesda, MD 20892-2510, USA.
Insights
Pediatric myopia progresses faster in children diagnosed at a younger age and with higher initial refractive error. Girls aged 8-10 showed faster myopia progression than boys.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Clinical Research
Background:
- Myopia, a common refractive error, significantly impacts visual health in children.
- Understanding the progression patterns of pediatric myopia is crucial for timely intervention.
Purpose of the Study:
- To characterize the clinical course and progression of myopia in a pediatric population.
- To investigate the influence of age at diagnosis, gender, race, and initial refraction on myopia progression.
Main Methods:
- Longitudinal data analysis of 501 children aged 5-15 years from health maintenance organization records.
- Examination of factors including age at diagnosis, gender, race, and initial refractive error.
- Calculation of mean annual myopia progression rates and cumulative event rates.
Main Results:
- Myopia progression was significantly faster in children diagnosed at younger ages (5-7 years) compared to older children (11-15 years).
- Children with initial myopia greater than -1.00 diopter showed faster progression than those with less myopia.
- A gender effect was observed, with faster myopia progression in girls than boys between ages 8-10.
Conclusions:
- Younger age at diagnosis and greater initial myopia severity are associated with more rapid myopia progression in children.
- Early detection and monitoring are essential, particularly for girls in the prepubertal years.
- Race did not significantly influence myopia progression in this cohort.
Abstract:
The purpose of this study was to characterize the clinical course of myopia in a selected pediatric population. The computerized records of a health maintenance organization provided longitudinal data on 501 children aged 5 to 15 years. We examined the influence of age at diagnosis, gender, race, and initial refraction on progression of myopia. Mean follow-up was 34 months, with 75% of children having follow-up longer than 16 months. The mean rate of myopic progression was greater for children whose myopia was diagnosed at a younger age (5-7 years, -0.56 diopters/year versus 11-15 years, -0.28 diopters/year; p < 0.0001). Children with more than one diopter of myopia at first diagnosis progressed faster than children with less than or equal to one diopter of myopia (mean rate -0.48 diopter/year versus -0.41 diopter/year; p = 0.05). Cumulative event rate curves suggest a gender effect in the prepuberty years of 8 to 10, with myopia progressing faster in girls than boys (p = 0.003). Progression of myopia did not differ between white and non-white children. More rapidly progression of myopia is associated with younger age at initial diagnosis and greater severity of initial myopic refraction.
