Myopia progression rates in urban children wearing single-vision spectacles

Abstract

Purpose: To conduct a meta-analysis on the rates of myopia progression in urban children of Asian and predominately European ethnicities who are corrected with traditional single-vision spectacles.

Methods: A search of the National Library of Medicine's PubMed literature database for articles on myopia progression was conducted using the terms "myopi*progression" and MeSH terms "myopia" and "disease progression," and limited to publications from January 1990 and only for articles reporting data for humans <16 years of age. Studies were excluded if they were non-randomized, did not use cycloplegic autorefraction, had a sample size <30 individuals, examined high myopia (worse than -6.0 D) or special subject groups, presented myopia as part of a syndrome or condition, were retrospective, or used controls wearing optical corrections other than spectacles.

Results: Of 175 articles identified, 20 remained after applying the exclusion criteria. The estimated myopia progression at a mean age of 9.3 years after 1 year of follow-up was -0.55 D [95% confidence interval (CI), -0.39 to -0.72 D] for populations of predominantly European extraction and -0.82 D (95% CI, -0.71 to -0.93 D) for Asians. The estimated progression rates were dependent on baseline age, with decreasing progression as age increased. The rates also varied with gender. For an average baseline age of 8.8 years, estimated annual progression (combined ethnicities) was -0.80 D/yr for females (95% CI, -0.51 to -1.10), and a significantly slower (p < 0.01) -0.71 D/yr for males (95% CI, -0.42 to -1.00).

Conclusions: In children wearing single-vision spectacles, higher myopia progression rates were found in urban Asians compared with urban populations of predominantly European descent. Younger children and females demonstrated greater annual rates of progression of myopia.

Figure 1

Black, square markers indicate estimated annual myopia progression for Asian children at specific baseline ages. Error bars denote 2× the standard error. Diamonds plot values for the one study that provided age-specific, progression data for European children.

Figure 2

Black, square markers indicate estimated cumulative myopia progression for Asian children at specific years of follow-up. Estimates for European children are indicated by diamonds. Error bars denote 2× the standard error.