A recent study published in Ophthalmic and Physiological Optics analyzed the connection of age and gender with the progression of myopia.
Give me some background first.
Myopia is continuously becoming more widespread and prevalent across many populations, with the degree of myopia also increasing on average.
Earlier onset of myopia is associated with both faster progression, and with the condition becoming more severe in adulthood. Progression rate is also incredibly important in determining risk that patients have for other diseases down the line.
Tell me more.
Current data is limited on myopic progression rates in different populations for patients not actively undergoing management.
As such, this data could be key to determining how different populations of myopic patients can be treated with the utmost efficacy.
Now, talk about the study.
This study is a retrospective analysis that pulls data from electronic medical records (EMRs), a large data resource that includes patient data from clinical practices and norms.
Researchers used EMRs—taken from 40 optometric practices across Ireland—to evaluate the natural history of myopic progression.
What methods were used?
Data was collected from 402,294 myopic patients aged 7 to 17 years old who had multiple examination visits and were not currently undergoing myopia control treatment at the time of the study.
Sex- and age-specific population subsets were derived, while progression rates were compared to the following:
- 17 Western randomized controlled trial (RCT) control groups
- 2 European clinic-based studies
Findings?
The investigators found that, though myopia progression continued at every age group in the patient range, the highest rates of progression were at the youngest age.
Pediatric patients (aged 7) had a median progression of −0.67D/year (IQR: −1.32 to −0.25) . This slowed down to a median progression of −0.18D/year (IQR: −0.35 to 0.00) for 17-year-old patients.
To note: 1 in 6 participants in the younger age group did not experience any myopia progression, while 1 in 3 at the higher end of the age range continued to experience fast progression rates.
What about sex?
The female sex in this study exhibited faster myopic progression, which the authors suggested was due to the age of the study’s participants. (Previous research found myopia progression to be more rapid in females in childhood.)
The same difference between the sexes may not be observed in adulthood, however, suggesting that males with myopia draw level with the female progression rates over time.
Now talk about the comparison to the control.
The median progression observed in this study was overall slower than the RCT control groups.
The authors posit that clinical trial participants are not typically recruited to be population-representative.
Any limitations?
Per the authors, the study’s EMR data was obtained from only one country; further, the myopic progression rates in Ireland could potentially be lower than in other Western countries.
In addition, the use of EMR has faced criticism for lack of standardization and heterogeneity, among other drawbacks. The authors maintained, however, that this data is a representation of myopia progression in a population, and is therefore, ecologically valid.
Expert opinion?
The study authors noted the ability of progression rates to help be able to reliably predict valuable treatment for different categories of patients.
“The development of predictive analytic tools such as centile charts of refraction and axial eye growth could guide clinical decision-making, provide reference data to assess myopia control treatment efficacy and facilitate enhanced communication with patients,” they wrote.
Take home.
As myopia prevalence continues to rise across the globe, these findings aid in understanding how such nuanced factors can help aid in management and treatment efficacy.
The authors also emphasized the importance of the study’s real-world data when representing populations—a key element in continuing to shape the understanding of myopia and its progression.