December 16, 2024
By Dwight Akerman, OD, MBA, FAAO, Dipl. AAO, FBCLA, FIACLE
Photo Credit: WebMD
The study by Brennan, Cheng, and Bullimore (2024) investigates the progression of myopia in adults aged 20 to 50. The research addresses an important aspect of ocular health, particularly the increasing prevalence of myopia and its potential implications for visual impairment.
The authors initiated their study with the aim of understanding the myopic shift — meaning the increase in refractive error — in adults within the specified age range. They gathered evidence from three distinct datasets that offered long-term insights into adult refractive progression.
The first dataset was derived from the U.S. population, which included prevalence data for young adults aged 18 to 24 in 1971 and 1972 and older adults aged 45 to 54 from 1999 to 2004. By applying a logit transformation to the prevalence values at varying refractive error thresholds, the researchers estimated the myopic progression occurring within these groups.
The second dataset consisted of clinical data from Germany, which outlined the progression of refractive error over a span of five to 10 years for different myopia groupings. This data was analyzed by breaking down the population into five-year age bands from 20 to 49 years, allowing for a more granular understanding of progression rates across various stages of adulthood.
The third and final dataset focused on a Japanese clinical population, which provided five-year progression rates categorized similarly to the German data. This consistent breakdown in age and refractive error allowed for a robust comparison across populations, enhancing the reliability of the findings.
The results of the study revealed important metrics regarding myopia progression. Estimates suggested that between the ages of 20 and 50, the average progression of myopia was approximately −1.10D, −1.40D, and −1.90D based on baseline refractive errors of −1.00D, −3.00D, and −6.00D, respectively. Furthermore, for the German data, the progression ranged from −1.00D to −2.90D, indicating a correlation where myopia progression increased with the severity of baseline myopia. Additionally, the Japanese data showed a weighted average of −1.00D for males and −0.90D for females, highlighting a consistent trend that showed progression diminishing with increasing age.
A key finding across all three studies illustrated that average progression rates tended to decrease as age increased. Most notably, the majority of myopia progression occurred between the ages of 20 and 30. This finding underscores the critical period in early adulthood when intervention could potentially be most beneficial for managing and slowing down the progression of myopia. The conclusions drawn from this comprehensive analysis have significant implications for public health and clinical practice. With an average progression of about −1.00D between the ages of 20 and 50, there is a clear rationale for implementing interventions to slow myopia progression in adults. This finding contradicts the commonly held belief that myopia stabilizes in the late teenage years or early adulthood and has implications for projections of the future burden of myopia.
In summary, the study provides valuable insights into the progression of adult myopia and emphasizes the necessity for timely intervention strategies to mitigate the risks of visual impairment. By understanding these patterns of refractive changes, eye care professionals can better address and manage myopia in adult patients. The findings advocate for continued research and monitoring efforts, ensuring that adults can maintain their ocular health and quality of life as they age.
Abstract
Adult Myopia Progression
Noel A. Brennan; Xu Cheng; Mark A. Bullimore
Purpose: To explore evidence for myopic shift between the ages of 20 and 50 years.
Methods: Three usable sets of data with long-term adult refractive progression were identified: (1) US population-based prevalence data for those 18 to 24 years of age in 1971 and 1972 and 45 to 54 years of age from 1999 to 2004; a logit transformation of prevalence values at different refractive error thresholds allowed estimation of myopic progression in this group. (2) German clinical data describing 5- to 10-year progression for different refractive error groupings across 5-year age bands from 20 to 49 years; these were extracted, adjusted, and analyzed. (3) Five-year progression rates with similar breakdown of age and refractive error groups as the German data but in a Japanese clinical population.
Results: Estimates of progression between 20 and 50 years for the given studies were: (1) −1.1, −1.4, and −1.9 diopters (D) for baseline refractive errors of −1, −3, and −6 D, respectively; (2) a range from −1.0 to −2.9 D, increasing with degree of baseline myopia; (3) a weighted average of −1.0 D for males and −0.9 D for females but with decreasing progression with increasing myopia. In all studies, average progression rates fell with increasing age, with most progression occurring between 20 and 30 years.
Conclusions: All three studies provide evidence of around −1 D myopia progression between the ages of 20 and 50 years. This has implications for intervention to slow progression during adulthood, as well as projections of visual impairment associated with myopia.
Brennan, N. A., Cheng, X., & Bullimore, M. A. (2024). Adult Myopia Progression. Investigative Ophthalmology & Visual Science, 65(13), 49-49.
DOI: https://doi.org/10.1167/iovs.0.0.40493
