A team of researchers recently developed a method to help identify school children at high risk of myopia. The study then suggests behavioral changes can lower this patient population’s risk of developing the condition.1

Of the 4,734 total patients evaluated at six and nine years of age, 3,362 (71%) were eligible for cycloplegic refractive error measurements. The team measured axial length (AL) and corneal radius (CR) and obtained information about daily lifestyles and demographic characteristics through questionnaires. They then created a risk score based on the regression coefficients that resulted from environmental and ocular factors to look for deviations from baseline AL-to-CR ratios.1

In subjects from six to nine years of age, the team found the average AL elongation was 0.21 ±0.009mm/year; myopia developed in 10.4% of children. They note that the myopia prevalence at age nine was 12%. They also identified seven parameters independently associated with faster AL elongation: parental myopia, at least one book read per week, time spent reading, not participating in sports, non-European ethnicity, less time spent outdoors and baseline AL-to-CR ratios.

The researchers add that the discriminative accuracy for incident myopia based on these risk factors was 0.78. Baseline AL-to-CR ratios showed statistically significant interactions with the number of books read per week and parental myopia.1

The team concludes that almost all predictors showed the highest association with AL elongation in the highest quartile of AL-to-CR ratios; incident myopia was detected in 124 of 513 patients in this group (24%).1

Joseph W. Sassani, MD, in a Practice Update commentary, said the study was “extremely well-done” and goes on to note that while the findings are not surprising, the health benefits of balancing outdoor and indoor activities extend beyond the visual system. “This is an important next step in the fight to limit the progression of myopia,” said Myron Yanoff, MD, in the same commentary.2

1. Tideman JWL, Polling JR, Jaddoe VWV, et al. Significance of environmental factors in the development of myopia in children. Ophthalmology. September 5, 2018. [Epub ahead of print].

2. Significance of environmental factors in the development of myopia in children. PracticeUpdate. September 5, 2018.