Predicting myopia progression

New data highlight fast progressors best identified using multiple factors

Cheryl Guttman Krader

Posted: Thursday, October 1, 2020

A recent survey of paediatric ophthalmologists worldwide found that the rate of myopia progression was the most common indication for initiating treatment to reduce future progression.

According to new findings from the Singapore Cohort Study of the Risk Factors for Myopia (SCORM), however, annual myopia progression as a standalone factor cannot fully predict subsequent year or long-term myopia progression. The SCORM investigators emphasised the need for patient compliance with annual visits and recommended that a personalised management strategy for reducing myopia progression should be based on multiple patient-specific factors.

The research was presented by Noel A Brennan PhD, Global Lead of Myopia Control, Johnson & Johnson Vision Care, Inc, at ARVO 2020. SCORM is a joint collaboration between the Singapore Eye Research Institute and Johnson & Johnson Vision Care.

“A number of studies have examined potential risk factors for faster progression of myopia, but to our knowledge no predictive paradigm exists. Yet, it appears from the survey of paediatric ophthalmologists that there is a perception among clinicians that a faster progression rate is the preferred method in choosing who to treat. We recommend that the decision should take into account myopia progression in the previous year along with initial refractive error, age of myopia onset, and parental myopia,” said Dr Brennan.

The analyses investigating predictors of myopia progression included data from 674 children (mean baseline age 8 years) who had ≥0.5D of myopia at baseline and completed at least two annual follow-up visits. The results showed that myopia progression in Year 1 correlated with progression in Year 2. However, the correlation coefficient (r) was only 0.47, and Year 1 myopia progression only accounted for about 20% of the variance in progression during the next year, Dr Brennan said.

“According to a multivariable model, using Year 1 annual myopia progression would fail to detect one in four fast progressors in Year 2 and misclassify one in three children as fast progressors.”

The study also showed that Year 1 myopia progression correlated significantly with Year 3 myopia progression, but the correlation was even weaker (r=0.30). There was no significant correlation between Year 1 myopia progression and Year 4 myopia progression.

Noel A Brennan: