Long-term changes in refractive error in children with myopic tilted optic disc compared to children without tilted optic disc.

PURPOSE: To compare changes in the spherical equivalent (SE) refractive error between children with and without myopic tilted optic disc.
METHODS: Changes in SE refractive error were compared between a group of 88 children with -1.5 diopters or more of myopia with myopic tilted disc and a group of 108 age- and initial SE refractive error-matched children without tilted disc. Factors that significantly influenced changes in SE refractive error were analyzed using mixed models.
RESULTS: Patients in the myopic tilted disc group were followed for 5.3 ± 3.1 years, on average, and patients in the nontilted disc group were followed for an average of 5.3 ± 2.3 years. An overall tendency toward myopic progression during the follow-up period was noted in both groups. According to univariate analysis, patients with a poorer baseline best-corrected visual acuity (BCVA) and tilted discs tended to have greater myopia over time (P < 0.001 and P = 0.009, respectively). Myopic progression in the tilted disc group was significantly greater than that in the nontilted disc group (P < 0.001) after adjusting for sex and initial BCVA.
CONCLUSIONS: Patients with myopic disc tilt showed greater myopic progression over time. These data suggest that myopic disc tilt represents a prognostic factor for further myopic progression, but it is unclear whether the disc tilt directly affects the progression rate of myopia or is a noncontributory consequence of other underlying mechanisms. The temporal relationship between the onset of the disc tilt and the myopic progression should be further studied using a prospective design.