High myopia in young adults is reaching epidemic proportions in East and Southeast Asia with prevalence rates reported to range between 8% and approximately 22% from childhood to young adulthood.^1-6 Looking into this association, new research found children with initial rapid myopia progression may need closer monitoring, follow-up and possible clinical treatment interventions, since they are more likely to develop high myopia by their teenage years.¹

The study found three-year myopia progression rates in childhood, combined with their baseline spherical equivalent (SE) or axial length (AL), were good predictors of teenage high myopia.

The investigation included 928 Singapore Cohort of Risk Factors for Myopia Study children between the ages of six and 11 who were followed up for about seven years until they became teenagers (12 to 19 years old). During the follow up visits, researchers performed cycloplegic autorefraction and AL measurements, and evaluated SE and AL outcomes at three years. Myopia was defined as SE of −0.50D or less and high myopia was considered −5.00D or less. The study’s outcomes of interest were teenage high myopia and AL of 25mm or greater, in addition to teenage SE and AL measurements at the final follow-up.¹

During the last visit, approximately 10% of teenagers developed high myopia, and roughly 23% had AL of 25mm or greater. In multivariate regression analyses, every -0.3D/year increase in three-year SE progression and every 0.2mm/year increase in three-year AL progression were linked with a -1.14D greater teenage SE and 0.52mm greater teenage AL.

The area under the curve of a combination of three-year SE progression and baseline SE for teenage high myopia was 0.97, and the area under the curve of three-year AL progression and baseline AL for teenage AL of 25mm or more was 0.91.

The study results may be useful to risk-stratify and guide clinical decisions in terms of myopia control management for children, the researchers said. For children at higher risk, they suggest more aggressive treatment, including a higher frequency or concentration of atropine eye drops or combination treatment, such as atropine with multi-zone contact lenses, may be necessary for myopia control.¹

The study received support from several groups, including the Singapore Government under the Industry Alignment Fund Industry Collaboration Projects Grant, the National Medical Research Council Individual Research Grant and Johnson & Johnson Vision.