Clinical management

Frequency and prediction of myopic macular degeneration in adults

This Singapore study found that 10-12% of ALL adult myopes aged 40-80 years – not just high myopes – suffered either onset or progression of MMD over 12 years. Risk factors included each additional year of age and 1mm of axial length. The most significant predictive sign was tesselated fundus.

Myopia incidence and progression in young adults

This cohort study from Australia reported a 14% incidence (onset) of myopia between ages 20 and 28, with almost 40% of myopes progressing by at least 0.50D. Axial length increase was also demonstrated. Risk factors were related to ethnicity, sex, sun exposure and parental myopia but not education level. This data advocates for active myopia management throughout the 20s.

The difficulty in identifying fast-progressing myopes based on prior progression

Prediction modelling for future myopic progression was found to be more accurate when factors such as age, sex and ethnicity were considered, rather than prior progression. Myopia management should be initiated when myopia is apparent regardless of prior progression, rather than waiting to assess the progression rate.

Can previous progression predict future myopia?

The SCORM study analyzed the relationship between myopia progression a year after baseline and subsequent 2-year progression for myopic Singaporean children. Progression and age at baseline were found to be strongly associated with subsequent progression. However, they were shown to have limited predictive values and other factors are likely to determine future progression.

Can we predict success with orthokeratology?

This study investigated the accuracy of using pre-treatment axial elongation and changes in refractive sphere in predicting myopia control success in orthokeratology. Axial length was the more accurate method for categorisation of slow, moderate or rapid progression, and fast progressors benefited the most from ortho-k wear.

How we can identify future myopes

The axial length growth trajectories modelled in this study revealed that regardless of a child’s age, a myopic shift of at least -0.85D and/or 0.74mm over three years suggests future myopia development. Read more about specific risk factors for younger children, and other ocular component findings in this large study of European children.

Myopia control and no rebound with Highly Aspherical Lenslet spectacles

This cross-over study investigated children wearing highly aspherical lenslet (HAL) spectacle lenses versus single vision spectacles over three six-month periods. The HAL lenses showed consistent myopia control efficacy and no rebound effect when discontinued over one of the six-month periods.

Dry eye and myopia in teenagers

This abstract reported on the association between myopia and dry eye disease in teenagers. Interestingly, dry eye disease and reduced break up time was associated with higher myopia, but photophobia and pain were not.

IMI 2021 Yearly Digest

The IMI 2021 Yearly Digest summarized recent updates and progress in research of myopia, taking in all publications since the IMI Volume One reports published in early 2019. Each of the Volume One reports included an update – definitions, interventions, genetics, experimental models, clinical trial guidance, ethical considerations and clinical management. While further research is needed, the strengthening evidence base indicates eye care practitioners should embrace proactive myopia management.