Myopia Progression in Adults: A Retrospective Analysis.

SIGNIFICANCE: Studies on adult myopia progression are limited. This retrospective analysis of a large dataset of young adult myopes characterizes myopia progression during adulthood. Purpose. To determine the mean annual progression of myopia and to estimate the proportion of progressors in adult myopes.

METHODS: Longitudinal, non-cycloplegic subjective refraction data for young adult myopes (spherical equivalent refractive error -0.5D or more), age ranging from 18-30 years, was retrospectively analyzed. The mean annual progression, as well as the proportion of progressors (at least -0.50 D shift between visits and annualized progression of -0.25D or more), were estimated.

RESULTS: A total of 354 myopes, 230 (64.7%) females, with a mean [SD] age of 22.2 [3.8] years were considered. Mean [SD] annualized progression was -0.10 [0.21] D, -0.08 [0.2] D and -0.04 [0.21] D in 18-21-year, 22-26 year and 27-30-year age groups respectively (P = .003). The difference between 18-21 and 27-30 year age groups was significant (P = .05) while all other pairwise comparisons were not significant. The proportion (95% CI) of progressors in the 18-21, >21-26, and > 26-30 year groups was 18.3% (14.9, 21.7), 10.9% (7.1, 14.7), and 8.8% (4.4, 13.1) respectively. The proportion of progressors working or studying in a higher learning/academic environment was 16.2% with an OR (95%CI) for progression of 2.07 (1.15 - 3.74) compared to those in non-academic environments (P = .02), with no significant effect of gender or ethnicity.

CONCLUSIONS: This study is consistent with other studies on myopia in young adults which show that myopia does not progress by substantial amounts throughout the adult years, particularly after the age of 21 years. While future studies may be challenged by the small rates of change and the small proportion of progressors, further research is needed to understand the implications of adult myopia progression on clinical management.