J Willem L Tideman1, Jan Roelof Polling2, Vincent W V Jaddoe3, Johannes R Vingerling4, Caroline C W Klaver5. 1. Department of Ophthalmology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands. 2. Department of Ophthalmology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Orthoptics & Optometry, University of Applied Sciences, Faculty of Health, Utrecht, The Netherlands. 3. Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Paediatrics, Erasmus Medical Centre, Rotterdam, The Netherlands. 4. Department of Ophthalmology, Erasmus Medical Centre, Rotterdam, The Netherlands. 5. Department of Ophthalmology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Ophthalmology, Radboud Medical Centre, Nijmegen, The Netherlands. Electronic address: c.c.w.klaver@erasmusmc.nl.
Abstract
PURPOSE: To identify risk factors for axial length (AL) elongation and incident school myopia. DESIGN: Population-based prospective birth-cohort study. PARTICIPANTS: Four thousand seven hundred thirty-four children examined at 6 and 9 years of age from the Generation R Study in Rotterdam, The Netherlands. METHODS: Axial length and corneal radius (CR) were measured with an IOLMaster 500 and daily life activities and demographic characteristics were obtained by questionnaire. Three thousand three hundred sixty-two children (71%) were eligible for cycloplegic refractive error measurements. Linear regression models on AL elongation were used to create a risk score based on the regression coefficients resulting from environmental and ocular factors. The predictive value of the prediction score for myopia (≤-0.5 diopter) was estimated using receiver operating characteristic curves. To test if regression coefficients differed for baseline AL-to-CR ratio, interaction terms were calculated with baseline AL-to-CR ratio and environmental factors. MAIN OUTCOME MEASURES: Axial length elongation and incident myopia. RESULTS: From 6 to 9 years of age, average AL elongation was 0.21±0.009 mm/year and myopia developed in 223 of 2136 children (10.4%), leading to a myopia prevalence at 9 years of age of 12.0%. Seven parameters were associated independently (P < 0.05) with faster AL elongation: parental myopia, 1 or more books read per week, time spent reading, no participation in sports, non-European ethnicity, less time spent outdoors, and baseline AL-to-CR ratio. The discriminative accuracy for incident myopia based on these risk factors was 0.78. Axial length-to-CR ratio at baseline showed statistically significant interaction with number of books read per week (P < 0.01) and parental myopia (P < 0.01). Almost all predictors showed the highest association with AL elongation in the highest quartile of AL-to-CR ratio; incidental myopia in this group was 24% (124/513). CONCLUSIONS: Determination of a risk score can help to identify school children at high risk of myopia. Our results suggest that behavioral changes can offer protection particularly in these children.
PURPOSE: To identify risk factors for axial length (AL) elongation and incident school myopia. DESIGN: Population-based prospective birth-cohort study. PARTICIPANTS: Four thousand seven hundred thirty-four children examined at 6 and 9 years of age from the Generation R Study in Rotterdam, The Netherlands. METHODS: Axial length and corneal radius (CR) were measured with an IOLMaster 500 and daily life activities and demographic characteristics were obtained by questionnaire. Three thousand three hundred sixty-two children (71%) were eligible for cycloplegic refractive error measurements. Linear regression models on AL elongation were used to create a risk score based on the regression coefficients resulting from environmental and ocular factors. The predictive value of the prediction score for myopia (≤-0.5 diopter) was estimated using receiver operating characteristic curves. To test if regression coefficients differed for baseline AL-to-CR ratio, interaction terms were calculated with baseline AL-to-CR ratio and environmental factors. MAIN OUTCOME MEASURES: Axial length elongation and incident myopia. RESULTS: From 6 to 9 years of age, average AL elongation was 0.21±0.009 mm/year and myopia developed in 223 of 2136 children (10.4%), leading to a myopia prevalence at 9 years of age of 12.0%. Seven parameters were associated independently (P < 0.05) with faster AL elongation: parental myopia, 1 or more books read per week, time spent reading, no participation in sports, non-European ethnicity, less time spent outdoors, and baseline AL-to-CR ratio. The discriminative accuracy for incident myopia based on these risk factors was 0.78. Axial length-to-CR ratio at baseline showed statistically significant interaction with number of books read per week (P < 0.01) and parental myopia (P < 0.01). Almost all predictors showed the highest association with AL elongation in the highest quartile of AL-to-CR ratio; incidental myopia in this group was 24% (124/513). CONCLUSIONS: Determination of a risk score can help to identify school children at high risk of myopia. Our results suggest that behavioral changes can offer protection particularly in these children.
Authors: Shi Yao Lu; Shu Min Tang; Fen Fen Li; Ka Wai Kam; Pancy O S Tam; Wilson W K Yip; Alvin L Young; Clement C Tham; Chi Pui Pang; Jason C Yam; Li Jia Chen Journal: Invest Ophthalmol Vis Sci Date: 2020-08-03 Impact factor: 4.799
Authors: Alfred Pozarickij; Clair A Enthoven; Neema Ghorbani Mojarrad; Denis Plotnikov; Milly S Tedja; Annechien E G Haarman; J Willem L Tideman; Jan Roelof Polling; Kate Northstone; Cathy Williams; Caroline C W Klaver; Jeremy A Guggenheim Journal: Invest Ophthalmol Vis Sci Date: 2020-02-07 Impact factor: 4.799