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Long-term visual prognosis of infantile-onset high myopia.

PURPOSE: To investigate the clinical course and changes of refractive status in infantile-onset myopic children who received fully corrected glasses and to determine their visual prognosis. METHODS: In all, 57 children with infantile-onset high myopia (spherical equivalent over -5.0 D prior to the age of 5 years) were included in this study. All children received initial full-correction glasses at the mean age of 3.52 years. The cycloplegic refraction, axial length, and the best-corrected visual acuity were collected every 6 months. The mean follow-up time was 9.36 years. RESULTS: We noted that the tendency toward progression or regression of myopia appeared to be related to the degree of refractive error. Lower grades of high myopia (-5.0 to -7.75 D) showed a greater tendency to progress than those of the highest initial myopic refraction level (< or = -11.0 D). While the latter group exhibited a more-substantial regression rate than those cases of the lower initial refraction level. About 80% of infantile-onset high myopes demonstrated a final best-corrected vision of greater than 20/40, with 37% of children revealing a best-corrected vision level even better than 20/25. CONCLUSION: Clinical course of infantile high myopia is different to school myopia. Usually, higher degree of high myopia showed a stable state of myopia, or even possible regression, whereas the lower grades of high myopia revealed a strong tendency to progress.

Age of Onset↗

The increasing prevalence of myopia: implications for Australia.

Myopia is often regarded as a minor priority in public health research, yet the public health costs of myopia are considerable, both due to the costs of optical correction and from the costs imposed by the morbidity resulting from myopia in terms of associated eye disease (glaucoma, posterior subcapsular cataract), and the visual impairment and blindness that can result from myopia due to myopic retinal degeneration and retinal detachment. There is clear evidence for a high and increasing prevalence of myopia in East Asia, apparently driven by increasing educational pressures and urbanization. Data from the USA, Europe and Australia are consistent with the data from Asia in terms of the role of these risk factors. However, the evidence for an increasing prevalence of myopia is more problematic, due to the lack of adequate longitudinal studies, and the confounding effects of age-related hypermetropization. It is concluded that the prevalence of myopia is probably increasing in Australia, although the changes are of much lower magnitude than n East Asia. Longitudinal studies are, therefore, clearly required to quantify changes in the prevalence of myopia in Australia, for accurate assessment of the public health impacts and to assist with the development of preventive approaches.

Adult↗

Age, reading, and myopia.

This paper tests whether the use-abuse theory or the biological theory of myopia explains the appearance and progression of myopia among 12--17 year olds in the United States. The use-abuse theory predicts that current amount of reading and cumulative exposure to reading, as indicated by years of schooling, explain myopia. The biological theory predicts that either age from birth or age from puberty explains any tendency for myopia to appear and progress among children or adolescents. Regression analysis shows that education explains all the tendency for myopia to appear and progress among 12--17-years-olds. When we control for education, age is not related to increased myopia. Myopia progresses, on the average, 0.22 D per academic year. However, education explains only a small fraction of the variance in myopia.

Adolescent↗

Does education explain ethnic differences in myopia prevalence? A population-based study of young adult males in Singapore.

PURPOSE: To study interethnic variation in myopia prevalence and severity in young adult males in Singapore and to determine whether these variations are related to differences in education level. METHODS: A population-based survey of refractive errors in a cohort of 15,095 military conscripts between July 1996 and June 1997 using noncycloplegic autorefraction and a standard questionnaire. Prevalence rates of myopia (<-0.5 D) and severe myopia (<-6.0 D) were determined for Chinese, Malay, and Indian men; prevalence rate ratios were compared after adjusting for education level. RESULTS: Singapore has one of the highest prevalences of myopia (79.3%) and severe myopia (13.1%), with Chinese having higher rates (82.2%, 95% confidence interval 81.5, 82.9) compared with Indians (68.7%, 95% confidence interval 65.1, 67.1) and Malays (65.0%, 95% confidence interval 62.9, 67.1). Education was strongly associated with prevalence and severity of myopia. However, significant interethnic variation persisted after adjusting for education. CONCLUSIONS: There is a high prevalence of myopia in Singapore. Although prevalence and severity of myopia were strongly associated with education, interethnic variation observed was not fully explained by differences in education level.

Adolescent↗

Treating myopia with acoustic biofeedback: a prospective study on the evolution of visual acuity and psychological distress.

OBJECTIVE: The effects of a visual training technique on changes in myopia, visual acuity, and psychological distress were studied in a controlled prospective study. METHOD: A group of 33 female students with myopia < or = 3.50 diopters (D) underwent visual training using an acoustic biofeedback technique. A group of 22 female students with myopia and a group of 27 students with emmetropia formed the two control groups, matched for school, age, sex, and refractive error. Manifest and cycloplegic refraction, visual acuity, personality profile (CPI), and psychological distress (SCL-90) were measured at the baseline (T0), at 10 weeks (T1), and after 12 months (T2). RESULTS: At T2, myopia significantly progressed both in the treated and in the untreated students with myopia. Visual acuity improved only in the treated myopia group (despite refraction objectively being worse). No differences were found among the personality profiles in the three groups. All items indicative of psychological suffering improved in the group treated for myopia whose visual acuity was ameliorated. CONCLUSIONS: The visual training technique led to no improvement in objective measures of visual acuity, but did lead to an improvement in one relatively subjective measure of visual acuity and a parallel improvement in psychological conditions. The students with myopia who were treated consequently had a greater sense of general well-being.

Accommodation, Ocular↗

High myopia progression and visual impairment in a nonselected group of Danish 14-year-olds followed over 40 years.

PURPOSE: The purpose of this study was to document the adult age progression of myopia and the incidence of visual impairment in a representative sample of Danish adolescents with high myopia. METHODS: This study consisted of a scheduled regular ophthalmic follow-up over 40 years of 39 otherwise unselected Copenhagen 14 year olds with uni- and bilateral myopia of at least -6 D, as screened from a 1948 birth-year school cohort comprising 9243 pupils. Thirty-six of the 39 had satisfactory refractive and corrected visual acuity data for a longitudinal analysis. RESULTS: Myopia progression for the full period ranged from 0 to 14 D, and the peak myopia value increased from -14 to -26 D. The mean progression from age 16 to 26 years was 2.09 D, and from age 26 and on it was 1 D. Using both eyes and relevant correction, at the preliminary end point of 54 years, 32 of the 36 had a corrected visual acuity (VA) of 0.5 or better. Four had a corrected VA of < or = 0.3, but the visual loss was partly explained by other eye pathology. Significant visual reduction in single eyes mainly affected the subgroup of eyes with unilateral high myopia (n = 9). CONCLUSIONS: With only a slight overrisk recorded as associated with high myopia (in three or four of 36 subjects), the adult visual prognosis for working age appeared better than usually claimed. There seems to be a correlation between degree of myopia at age 14 and consecutive visual loss, but it was not possible to identify subjects at high risk at that early age.

Adolescent↗

Nonsurgical and surgical methods of sclera reinforcement in progressive myopia.

PURPOSE: As shown by the clinical picture of progressive myopia, derangements in biomechanical properties of sclera may be more or less manifested. The study aims at the development of a discriminating approach to their correction. METHODS: Patients with the condition were given a sclera strengthening injection, in which a dose of liquid polymeric composition is injected under the Tenon's capsule on the scleral surface. After polymerization, the composition forms over the scleral surface a layer of elastic foamed gel. RESULTS: Complex experiments on 146 rabbit eyes showed that the injected material promotes collagen formation. Gradually dissolving, the gel stimulates the growth of connective tissue on the surface of the sclera, whose stress-strain parameters improve. A thorough clinical study of 240 eyes of patients aged 8-25 years with progressive 6-10 D myopia showed that the refraction remained stable in 79.6% eyes 1 year after the sclera strengthening injection and in 52.9% cases 4-9 years after the sclera strengthening injection. At the same time, fellow intact eyes have shown, respectively, 40.3% and 13.3% of myopia stabilization, and 212 untreated eyes of the control group 26.0% and 11.1%, respectively. 612 children and adolescents with high myopia and a yearly progression of over 1.0 D were subjected to a scleroplastic operation. It was found that the myopia remained stable in 95.7% cases 1 year after the operation, and in 71.9%, 7 years after the operation. If myopia progression continued after a sclera strengthening injection or scleroplasty, a second procedure was performed. Second interventions were effected on 118 eyes of 102 patients, including 42 eyes where a sclera strengthening injection followed a sclera strengthening injection, 27 eyes where scleroplasty followed a sclera strengthening injection, 31 eyes where a sclera strengthening injection followed scleroplasty, and 18 eyes on which a second scleroplasty was performed. Second interventions provide a double decrease of myopia progression rate and, in 63% of patients, stop the progression altogether. CONCLUSION: It can be concluded that nonsurgical and surgical techniques of correcting the biomechanical properties of sclera for the treatment of progressive myopia as well as discriminative methods of determining the indications to these procedures have proven to be effective.

Acrylamides↗

Laser in situ keratomileusis for different degrees of myopia.

PURPOSE: To determine the efficacy, predictability, stability and safety of laser in situ keratomileusis (LASIK) in treating patients with different degrees of myopia. METHODS: We enrolled 386 eyes of 200 consecutive patients who underwent LASIK and divided them into four groups according to their degree of preoperative spherical equivalent (SE). Group 1 eyes ranged between - 1.00 and - 3.99 dioptres (D) (low myopia). Group 2 eyes ranged between - 4.00 and - 5.99 D (moderate myopia). Group 3 eyes ranged between - 6.00 and - 9.99 D (high myopia). Group 4 eyes were over - 9.99 D (extreme myopia). Follow-up was at 1 day, 1 week and 1, 3, 6, 12 and 18 months postoperatively. RESULTS: Our study included 386 eyes of 200 patients with SE ranging from - 3.00 to - 16.00 D (mean - 7.14 +/- 2.87 D). All eyes were seen at 1 day postoperatively. A total of 360 eyes (93%) were examined at 1 week, 330 eyes (85%) at 1 month, 281 eyes (73%) at 3 months, 247 eyes (64%) at 6 months, 199 eyes (52%) at 12 months and 142 eyes (37%) at 18 months. The postoperative data from 1 day to 12 months were used because of the low follow-up rate at 18 months postoperatively. Group 1 consisted of 30 eyes. The mean SE was - 3.52 +/- 0.43 D preoperatively and - 0.40 +/- 0.58 D at 1 month, - 0.46 +/- 0.60 D at 6 months and - 0.42 +/- 0.50 D at 12 months postoperatively. Uncorrected visual acuity (UCVA) was 20/40 or better in 95% of eyes at 1 day and in 100% of eyes at 6 and 12 months postoperatively. Group 2 consisted of 151 eyes. The mean SE was - 5.36 +/- 0.67 D preoperatively and - 0.54 +/- 0.78 D at 1 month, - 0.56 +/- 0.90 D at 6 months and - 0.55 +/- 0.82 D at 12 months postoperatively. Uncorrected VA was 20/40 or better in 95% of eyes at 1 day and in 100% of eyes at 6 and 12 months postoperatively. Group 3 consisted of 167 eyes. The mean SE was - 8.15 +/- 0.94 D preoperatively and - 0.58 +/- 0.90 D at 1 month, - 0.67 +/- 1.00 D at 6 months and - 0.64 +/- 0.95 D at 12 months postoperatively. Uncorrected VA was 20/40 or better in 90% of eyes at 1 day and in 98% of eyes at 6 and 12 months postoperatively. Group 4 consisted of 38 eyes. The mean SE was - 11.09 +/- 1.10 D preoperatively and - 1.25 +/- 1.20 D at 1 month, - 1.13 +/- 1.30 D at 6 months and - 1.20 +/- 1.25 D at 12 months postoperatively. Uncorrected VA was 20/40 or better in 78% of eyes at 1 day, in 94% at 6 months and in 90% at 12 months postoperatively. Intraoperative complications (free cap) occurred in two eyes and postoperative complications were observed in three eyes, making the total complications rate 1.29% (5/386). Seven eyes lost one Snellen line of BCVA, five lost two lines and two lost more than two lines (total: 3.64%, 14/386). CONCLUSION: In conclusion, LASIK is effective, predictable and safe for correcting myopia but is more accurate for correcting myopia up to -10.00 D. With more improvement in algorithms and ablation profile, we believe that LASIK can offer better results for higher myopia.

Adult↗

High myopia with cone dysfunction.

All 3 children, 2 boys and 1 girl (the probands), in a family had high myopia and subnormal visual acuities. The boys had high myopia in both eyes, the girl had high myopia in 1 eye and low myopia in the other eye. Both of the boys had a protanomalous colour vision defect. The colour vision testing of the high myopic eye of the girl was not successful, the other eye had normal colour vision. In the electroretinogram examination, both cone and rod responses were decreased in 2 of the children. In the family study, results of an eye examination of 30 relatives were available. No other cases of high myopia or subnormal visual acuities were found. The father of the children, 1 of the paternal relatives, and 5 of the maternal relatives had low myopia. One maternal male cousin of the probands had a protanomalous colour vision defect. In the genealogical study, no relationship was found between the families of the father and the mother of the probands going back to the fifth generation. The heredity of this disorder is difficult to define. It could be autosomal dominant or recessive if the myopia only are taken into consideration. If the high myopias and cone dysfunction are considered to be parts of the same syndrome, the heredity could be x-chromosomal recessive or autosomal recessive.

Adolescent↗

Laser intrastromal keratomileusis for high myopia and myopic astigmatism.

BACKGROUND: Laser intrastromal keratomileusis (LASIK) is an evolving technique which enables high degrees of myopia (> 8.0 dioptres) and myopic astigmatism to be corrected. This paper describes initial experience with this procedure. It also details the methodology, the results, the problems encountered, and discusses retreatment procedures. METHODS: 51 eyes (48 primary cases and three retreatments) underwent LASIK for simple myopia or compound myopic astigmatism. After the keratotomy was fashioned with a Chiron corneal shaper, the ablation was performed with either a Summit or Meditec excimer laser. The actual preoperative astigmatism ranged from -0.5 D to -6.0 D (in the astigmatic myopic LASIK (AML) series), while the range of preoperative myopia in the combined myopic LASIK (ML) and AML series was -8.0 D to -37.0 D. Of the ML cases, group 1 (-8.0 to 15.0 D (dioptres)), group 2 (> -15.0 to -20.0 D), and group 3 (> -20.0 D) had mean preoperative myopia values (spherical equivalent) of -11.26 D, -16.84 D and -27.78 D. The same groupings (1, 2, and 3) for the AML cases had respective values of -9.702, -17.4, and -23.08. In the AML series the mean preoperative astigmatism was -2.109 D. Follow up ranged from 8 to 27 months (mean 15.8 months). Six of the cases required retreatment. RESULTS: There was a reduction in best corrected visual acuity (BCVA) (of 1 Snellen line) in seven of the primary cases (14.5%) (three in the ML group and four in the AML group), and in one of the retreatment cases. The BCVA improved in 28 cases (58%) in the primary treatment group. The mean correction attempted (spherical equivalent) for the ML groups 1, 2, and 3 was 10.51 D, -14.5 D, and -27.78 D, versus a mean correction achieved of -9.445 D, -15.625 D, and -21.571 D. Similarly, for the AML groups, attempted correction values were -9.702 D, -17.4 D, and -23.08 D, while the values achieved were -6.95 D, -51.425 D, and -15.708 D. Regression was minimal and stabilisation of the refractive result was achieved in all groups, except group 3 of the ML series, by the 3 month examination period. The mean postoperative astigmatism in the AML series was -0.531 D. Vector analysis of the AML series showed that the mean surgically induced astigmatism was +0.93 D. The most common complication encountered was undercorrection, which occurred in 35 cases-23 cases in the ML group and 12 cases in the AML series. Twenty eight per cent of the ML cases, and 25% of the AML cases were within plus or minus 1.5 D of the attempted refraction. CONCLUSION: For the correction of high myopia and myopic astigmatism, LASIK results in less postoperative pain and relatively little subepithelial haze compared with high myopic photorefractive keratectomy. Furthermore, a stable refraction and reasonably predictable outcome occurs much earlier. High myopia up to -37.0 D can be corrected, albeit with some limitations at the extremes of myopia-in terms of the amount of myopia correctable; this represents a limitation of the technique. Retreatment is a technically straightforward and effective way to treat undercorrection. Undercorrection, the main complication seen in our series, should become less common when the ablation algorithms are further refined.

Adolescent↗

Academic achievement, close up work parameters, and myopia in Singapore military conscripts.

AIM: To determine the relation of refractive error to environmental factors, including close up work, in Singapore military conscripts. METHODS: A cross sectional study was conducted on 429 Singapore military conscripts. Non-cycloplegic refraction and A-scan biometry were performed in both eyes. A detailed questionnaire was administered by in-person interview to obtain information about current and past near work activity, extra tuition lessons, educational experiences, and family demographics. RESULTS: Myopia associated with the conscript having been educated in the (gifted, special, or express) educational streams (adjusted odds ratio (OR) = 3.8, 95% confidence interval CI 2.0-7.3), and having completed pre-university education (OR=4.1, 95% CI 1.9-8.8). The reported close up work activity at age 7 years did correlate with age of onset of myopia (p<0.001). In parallel, supplemental tuition lessons in primary school has (OR=2.6, 95% CI 1.4-4.9) associated with conscript myopia. Parental myopia was positively associated with myopia (p<0.001), but this relation disappeared when adjusted for environmental factors. Current (p=0.83) and past close up work activity at age 7 years (p=0.13) did not correlate with myopia. CONCLUSION: Educational level and educational stream positively related to myopia. A relation was observed with reported close up work activity in early childhood and with tuition classes during elementary school, but not with current close up work activity. These results underscore the strong influence of environment in myopia pathogenesis but a role for close up work activity remains indeterminate.

Adult↗

Familial high myopia linkage to chromosome 18p.

A locus for autosomal dominant high myopia was reported on chromosome 18p. We sought to confirm this finding and narrow the reported interval by analyzing high myopia among families of Hong Kong Chinese, in whom myopia is common. In 15 families with a possibly autosomal dominant inheritance of high myopia (>or=-6 dpt) in at least 2 generations, 10 chromosome 18p markers were analyzed for linkage with high myopia. Two-point linkage analysis showed trends toward linkage of markers D18S476 and D18S62 with high myopia, with maximum logarithm of odds (LOD) scores of at least 1.1 and 1.7, respectively. Multipoint analysis of those 2 markers gave a maximum LOD score of at least 2.1. To attempt to account for likely genetic heterogeneity, 5 families showing evidence of linkage of the 2 markers with high myopia were selected for further multipoint linkage analysis, resulting in a maximum LOD score of 2.4 at D18S476. While multiple genetic and environmental factors likely contribute to myopia, these data are consistent with the possibility of a locus on chromosome 18p.

Asian People↗

Prevalence, incidence, and progression of myopia of school children in Hong Kong.

PURPOSE: To determine the prevalence, incidence, and progression of myopia of Chinese children in Hong Kong. METHODS: A cross-sectional survey was initially conducted. A longitudinal follow-up study was then conducted 12 months later. RESULTS: A total of 7560 children of mean age 9.33 (95% confidence interval [CI] = 9.11-9.45; range, 5-16) participated in the study. Mean spherical equivalent refraction (SER) was -0.33 D (SD = 11.56; range, -13.13 to +14.25 D). Myopia (SER <or= -0.50 D) was the most common refractive error and was found in 36.71% +/- 2.87% (SD) of children. Prevalence of myopia correlated positively with older age. Children aged 11 years were almost 15 times more likely to have myopia than were children younger than 7 years (Odds ratio [OR] = 14.81; 95% CI = 14.17-15.48). Incidence of myopia was 144.1 +/- 2.31 (SD) per 1000 primary school children per annum. Increasing age was correlated with increased incidence of myopia, with highest risk in children ages 11 years (OR = 2.27; 95% CI = 2.11-2.44). The average annual change in SER for children with myopia (SER <or= -0.50 D) was -0.63 D (SD = 3.44) compared with -0.29 D (SD = 2.96) for those who were not myopic at the beginning of the study (P < 0.001). CONCLUSIONS: The results show that the prevalence and progression of myopia in Hong Kong children was much higher than those previously reported in Western countries. The long-term socioeconomic impact of these findings warrants further studies.

Adolescent↗

Accommodation and related risk factors associated with myopia progression and their interaction with treatment in COMET children.

PURPOSE: To examine baseline measurements of accommodative lag, phoria, reading distance, amount of near work, and level of myopia as risk factors for progression of myopia and their interaction with treatment over 3 years, in children enrolled in the Correction of Myopia Evaluation Trial (COMET). METHODS: COMET enrolled 469 ethnically diverse children (ages, 6-11 years) with myopia between -1.25 and -4.50 D. They were randomly assigned to either progressive addition lenses (PALs) with a +2.00 addition (n = 235) or single vision lenses (SVLs; n = 234), the conventional spectacle treatment, and were observed for 3 years. The primary outcome measure was progression of myopia by autorefraction after cycloplegia with 2 drops of 1% tropicamide. Other measurements included accommodative response (by an open field of view autorefractor), phoria (by cover test), reading distance, and hours of near work. Independent and interaction analyses were based on the mean of the two eyes. Results were adjusted for important covariates with multiple linear regression. RESULTS: Children with larger accommodative lags (>0.43 D for a 33 cm target) wearing SVLs had the most progression at 3 years. PALs were effective in slowing progression in these children, with statistically significant 3-year treatment effects (mean +/- SE) for those with larger lags in combination with near esophoria (PAL - SVL progression = -1.08 D - [-1.72 D] = 0.64 +/- 0.21 D), shorter reading distances (0.44 +/- 0.20 D), or lower baseline myopia (0.48 +/- 0.15 D). The 3-year treatment effect for larger lags in combination with more hours of near work was 0.42 +/- 0.26 D, which did not reach statistical significance. Statistically significant treatment effects were observed in these four groups at 1 year and became larger from 1 to 3 years. CONCLUSIONS: The results support the COMET rationale (i.e., a role for retinal defocus in myopia progression). In clinical practice in the United States children with large lags of accommodation and near esophoria often are prescribed PALs or bifocals to improve visual performance. Results of this study suggest that such children, if myopic, may have an additional benefit of slowed progression of myopia.

Accommodation, Ocular↗

Deciphering the Microbiome-Gut-Eye Axis: A Mendelian Randomization Analysis of the Causal Influence of Gut Microbiota on Myopia.

INTRODUCTION: The intricate relationship between the gut microbiome and myopia is increasingly recognized, underscoring the need to explore its causal dynamics. Despite emerging evidence, the influence of Gut Microbiota (GM) on ocular development remains underexplored. METHODS: This study utilized Mendelian Randomization (MR) to investigate the causal impact of GM on the development of myopia. Instrumental variables (IVs) were identified from Genome-Wide Association Studies (GWAS), focusing on genetic variants significantly associated with microbiome composition. A comprehensive array of MR techniques was applied to ensure a robust estimation of causal effects and to adjust for potential confounders and pleiotropy. RESULTS: The Inverse-Variance Weighted (IVW) method was used to identify significant associations between GM and myopia. Increased risk of myopia was linked to the class Betaproteobacteria (OR=1.01, 95% CI 1.004-1.017, P=0.003), the order Burkholderiales (OR=1.009, 95% CI 1.001-1.016, P=0.02), the family Oxalobacteraceae (OR=1.005, 95% CI 1.001-1.01, P=0.023), and several genera including Eubacterium xylanophilum group (OR=1.007, 95% CI 1.001-1.013, P=0.033), and Bifidobacterium (OR=1.005, 95% CI 1-1.01, P=0.038). Protective effects were noted for the order Mollicutes RF9 (OR=0.994, 95% CI 0.99-0.999, P=0.014), the genus Allisonella (OR=0.996, 95% CI 0.993-0.999, P=0.019), the genus Lachnospiraceae UCG001 (OR=0.994, 95% CI 0.989-1, P=0.045), and the family Enterobacteraceae (OR=0.991, 95% CI 0.982-1, P=0.047) and order Enterobacteriales (OR=0.991, 95% CI 0.982-1, P=0.047). Sensitivity analyses further confirmed the robustness of these findings. DISCUSSION: This study provides causal evidence for the "Microbiome-Gut-Eye Axis" in myopia development, identifying specific gut microbiota that influence myopia risk. These findings suggest potential for microbiota-targeted interventions, warranting further research in diverse populations. CONCLUSIONS: The findings support the "Microbiome-Gut-Eye Axis" as a potential factor in myopia pathogenesis and highlight microbiota-targeted interventions as novel therapeutic strategies for managing myopia. This study lays the groundwork for further research on how modifying GM can influence eye health and offers new perspectives on preventive health strategies.

Humans↗

The progression of myopia in school age children: data from the Columbia Medical Plan.

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.

Adolescent↗

Myopia in premature infants at the age of 6 months.

The authors performed cycloplegic refractions in 180 eyes of 99 premature infants at the age of 6 months to evaluate the incidence and the degree of myopia according to the development and disease course of retinopathy of prematurity (ROP) and to investigate the effect of cryotherapy on the refractive error. The incidences of myopia were not different between premature infants without ROP and premature infants with spontaneously and totally regressed ROP (36.3%, 25.5%), and the degrees of myopia were low in both groups (-1.76 D, -2.25 D). In premature infants with totally regressed ROP after cryotherapy, the incidence of myopia was high (75.5%) but the degree of myopia was low (-3.03 D). In premature infants with cicatricial ROP, cryotreated or not, both the incidence and the degree of myopia were high (93.9%, -5.50 D). It is suggested that cryotherapy increases the incidence of myopia but the degree of myopia induced by cryotherapy is low.

Cryosurgery↗

Stimulus deprivation myopia in human congenital ptosis: a study of 95 patients.

PURPOSE: To establish differences between the frequency of suspected deprivation myopia in unilateral and bilateral congenital ptosis with and without covered optical axis. METHODS: Ametropia was evaluated in both eyes of 95 patients with congenital ptosis. The amount of refraction was documented as spherical equivalent (100% cycloplegia). Statistical analysis was performed using the chi-square and sign tests. RESULTS: In unilateral ptosis, the frequency of myopia was lower (10/68: 15%) than that of hyperopia (58/68: 85%) in the ptotic eye (P <0.001). However, myopia occurred more often in the ptotic eye (10/68: 15%) than in the fellow eye (3/68: 4.4%). Myopic anisometropia was found only in the ptotic eye (5/68 vs 0/68), but was less frequent than hyperopic anisometropia (6/68 vs 8/68). In bilateral ptosis 7/54 myopia as compared with 47/54 hyperopia were observed and 1/27 myopic anisometropia vs 6/27 hyperopic anisometropia. Covered center of the pupil, in children < or = 8 years of age, was associated with myopia more frequently in bilateral than in unilateral ptosis (6/30 vs 1/27). We found a significantly higher rate of myopia <-1 diopter and hyperopia >2 diopter in comparison of children 5 to 7 years old with first-grade school children. CONCLUSIONS: Two expected results were (1) compared with the normal population, an overall higher frequency of myopia in human congenital ptosis; (2) in unilateral ptosis, a higher frequency of myopia in the ptotic, than in the fellow eye.

Blepharoptosis↗