19 August 2024
1 min reading time
Key findings:
- Younger Asian girls are most likely to develop myopia, while older white boys are least likely to develop myopia.
- Lower farsightedness was also associated with a greater likelihood of developing nearsightedness.
According to a study conducted in Optometry and vision science.
“A prediction model would be useful for sample planning in clinical trials of myopia prevention because it provides estimates of the probability of conversion from emmetropia to myopia, given different sample configurations regarding age, sex, race/ethnicity, baseline refractive error, or other significant covariates,” Donald O. Mutti, OD, PhD, FAAO, The EF Wildermuth Foundation Professor of Optometry at the Ohio State University College of Optometry and colleagues wrote, “A predictive model would help the clinician counsel an individual child and his family about the likelihood of a future refractive error.”
Using data from the multicenter Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) study, Mutti and colleagues modeled the probability of myopia in children in the United States on an annual and cumulative basis by spherical equivalent of refractive error, horizontal/vertical component of astigmatism, age, sex, race, and ethnicity. They included 4,027 nonmyopic study participants aged 6 to 14 years at baseline (49.9% girls) who were followed for 1 to 7 years through eighth grade.
According to the results, the proportion of children who developed myopia by age 14 was highest among those who were younger at baseline: 18.9% of 6-year-olds and 19.9% of 7-year-olds developed myopia, compared with 5% of 13-year-olds at baseline. Younger Asian girls had the highest likelihood of developing myopia, while older white boys had the lowest.
Less hyperopia and less positive values of the horizontal/vertical component of astigmatism were also associated with a greater likelihood of developing myopia.
“Efforts to harmonize prediction calculators will be useful as more longitudinal studies become available,” Mutti and colleagues wrote. “In addition to providing a consensus prediction model, another aspect of harmonizing different longitudinal data sets would be to determine whether the probabilities associated with different risk factors have changed over time.”
perspective
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Anh V Bui, OD, MSc, FAAO
The research by Mutti and colleagues provides important insights into the development of myopia, a vision disorder that is becoming increasingly common in children. The study proposes a predictive model for the onset of myopia based on refractive errors and demographic variables. This model allows for early detection of children at higher risk of developing myopia, thus enabling the implementation of immediate preventive measures.
The study is particularly relevant to U.S. optometrists because of the large sample representing major ethnic groups in the U.S. and the data collected during the critical age range for myopia development. Key findings include a lower likelihood of myopia onset at older ages for a given refractive error, higher likelihood in girls, and higher likelihood in Asian-American children. Specifically, younger Asian-American girls had the highest likelihood of developing myopia, while older white males had the lowest likelihood.
The study also found that axial length did not contribute significantly to the predictions, suggesting that the model can be used with readily available sets of variables without incurring the additional cost of collecting axial length biometrics. This is particularly true in settings where a biometer is not available.
However, the study’s data, collected in the early 2000s, may not reflect current trends in myopia. They do not take into account time-dependent environmental factors such as increased close work or less time spent outdoors, which have been associated with the increasing prevalence of myopia. Although this prediction model is a valuable tool, it should be used in conjunction with other factors and clinical judgment for comprehensive treatment and prevention of myopia.
Anh V Bui, OD, MSc, FAAO
Pediatric optometrist, faculty member
New England College of Optometry
This perspective is supported by the Communications Committee of the American Academy of Optometry.
Announcement: Bui does not provide any relevant financial information.
Sources/Disclosures
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Announcement: Mutti reports a financial relationship with Vyluma. The relevant financial information of all other authors can be found in the study.
