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.
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Authors | J Willem L Tideman, Jan Roelof Polling, Vincent W V Jaddoe, Johannes R Vingerling, Caroline C W Klaver |
Journal | Ophthalmology
(Ophthalmology)
Vol. 126
Issue 1
Pg. 127-136
(01 2019)
ISSN: 1549-4713 [Electronic] United States |
PMID | 30146089
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2018 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved. |
Topics |
- Axial Length, Eye
(pathology)
- Biometry
- Child
- Cohort Studies
- Cornea
(pathology)
- Environment
- Female
- Humans
- Incidence
- Leisure Activities
- Male
- Myopia
(epidemiology, prevention & control)
- Netherlands
(epidemiology)
- Prospective Studies
- ROC Curve
- Refraction, Ocular
- Risk Assessment
- Risk Factors
- Surveys and Questionnaires
- Vision Tests
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