Considering even emmetropic eyes elongate, what are the limits of myopia control efficacy? This novel analysis explores the absolute axial elongation of treated and untreated myopes in the MiSight 3-year clinical trial in comparison to previously published models of myopic and emmetropic eye growth. The results indicate a potential limit to the short-term percentage efficacy of myopia control treatments.
Previous multi-ethnicity studies have shown ‘normal’ axial elongation in emmetropic children to be around 0.1mm / year. In this study, 700 Chinese schoolchildren with stable emmetropia showed 0.2mm per year axial elongation from age 7-11, which reduced with age and ceased at age 15. This appears higher than measured in Singaporean Chinese children in the SCORM study, 20 years ago.
It’s known that emmetropizing children undergo axial eye growth of around 0.1mm per year. Is this amount of growth in myopes also ‘physiologic’? In this study, data from six myopia control clinical trials was analyzed to find the axial growth component which did not result in a change in refraction. For myopes, this ‘physiologic’ growth appears to be less than 0.1mm per year, which has implications for judging progression and treatment success.
A combination of higher baseline myopia, parental myopia and faster 3-year progression in earlier childhood were strongly predictive of teenage high myopia in this study. Young patients with these combination of factors should receive closer clinical monitoring and timely interventions to slow myopia progression.
Being able to assess myopia progression in a similar way to height and weight using growth curves is beneficial for both practitioners and patients as it provides a comparison against a calculated average, helping to predict future high myopes and track progression and control outcomes. How to growth charts from European and Asian studies compare? We explore the comparisons, advantages and disadvantages of using growth charts for axial length in myopia.
Childhood refractive error is dictated by several factors including parental myopia and how much time they may spend outdoors each day. Influenced by these factors the shape and size of the eye constantly changes during growth with axial length most influenced as myopia increases. This longitudinal study sought to model these changes in Chinese children.
Education and myopia have had a long association, both anecdotally and from research findings with studies in general finding strong correlations with education and prolonged close work rather than a definite causative link. This study investigated the impact of education on refractive error by examining the relationship between increasing the school leaving age and myopia.
This population-based study set out to produce a percentile growth chart for axial length based on the data collected from European children and adults, and in doing so they found a stronger correlation between the refractive error and axial length in myopes compared to the same measurements in emmetropes.
By implementing analysis across a continuous range of accommodation between 0 and 6.00D, and including distance accommodation facility, the authors investigated the relationship between accommodation and myopic progression in Chinese myopic children.
How well does prior progression predict progression for the next year? The results provide a simple clinical message while also indicating the complexity of this field.
