Myopia Progression Rates in Urban Children Wearing Single-Vision Spectacles

Abstract

Purpose To conduct a meta-analysis on the rates of myopia progression in urban children of Asian and predominately European ethnicities who are corrected with traditional single-vision spectacles. Methods A search of the National Library of Medicine’s PubMed literature database for articles on myopia progression was conducted using the terms ‘myopi*progression’ and MeSH terms ‘myopia’ and ‘disease progression’, and limited to publications from January 1990 and only for papers reporting data for humans < 16 years of age. Studies were excluded if they were non-randomized, did not use cycloplegic autorefraction, had a sample size less than 30 individuals, examined high myopia (worse than −6.0D) or special subject groups, presented myopia as part of a syndrome or condition, were retrospective, or used controls wearing optical corrections other than spectacles. Results Of 175 articles identified, 20 remained after applying the exclusion criteria. The estimated myopia progression at a mean age of 9.3 years after one year of follow-up was −0.55 D (95% C.I. −0.39 to −0.72 D) for populations of predominantly European extraction and −0.82 D (95% C.I. −0.71 to −0.93 D) for Asians. The estimated progression rates were dependent on baseline age, with decreasing progression as age increased. The rates also varied with gender. For an average baseline age of 8.8 years, estimated annual progression (combined ethnicities) was −0.80 D/year for females (95% CI: −0.51 to −1.10), and a significantly slower (p<0.01) −0.71 D/year for males (95% CI: −0.42 to −1.00). Conclusions In children wearing single-vision spectacles, higher myopia progression rates were found in urban Asians compared to urban populations of predominantly European descent. Younger children and females demonstrated greater annual rates of progression of myopia.

Axial Length in Orthokeratology Patients: Large Case Series

“…Two independent research groups, using genome-wide association studies, have identified 20 genetic loci that have been linked to myopia [7]. Environmental factors such as long periods of near work, type of optical correction, and limited outdoor time also affect myopia development [8][9][10][11]. One study reported that increasing time spent outdoors can delay the onset of myopia [12].…”

Binocular Visual Function in Orthokeratology Contact Lens Wear for Myopia

“…This is not unexpected given that myopia in children tends to progress with age (Donovan et al 2012) and hence become greater in magnitude with time. Three of four binocular vision measures showed significant change from single vision spectacle to OK wear in this study, and each of these measures showed strong interrelationship with the others on partial correlations.…”

“…In adults, lower baseline myopia was correlated with a lower (less accurate) tonic accommodation measure (Chapter 5), with these lower myopes also showing the biggest improvements in divergence (BIFR -Chapter 4) in OK wear. As previously discussed in Chapter 4, in both cases this is likely related to time of myopia progression -higher myopia in children is likely associated with myopia progression (Donovan et al 2012) while in adults, late-onset myopia generally results in a lower refractive error than early-onset. (Grosvenor 1987, Bullimore et al 1992 Late-onset myopes have been shown to have reduced accommodative function compared emmetropes and early-onset myopes, , McBrien and Millodot 1988, Rosenfield and Gilmartin 1990 …”

“…This may be related to refractive stability in both age groups investigated. The higher paediatric myope is likely to be a faster progressor, (Donovan, Sankaridurg et al 2012) and elevated accommodative-convergence has been found in new and progressing (Edwards et al 2002) paediatric myopes. Conversely, progressing myopes in young adulthood, who generally have lower refractions, (Grosvenor 1987, Bullimore et al 1992 In SCL correction, all BV function results were within normal ranges except for lower than average BIFR and PRA, and higher than average accommodation lag.…”

“…These progression rates decreased as age increased, and an overall higher rate of progression was noted in females (-0.80D/year) than males (-0.71D/year). (Donovan et al 2012) Myopia progression in young adult myopes has been shown to be minimal, (Goss et al 1985) with …”