Predictors of Myopia Progression with Myopia-Control Spectacle Lenses
DOI:
https://doi.org/10.48560/rspo.43704Keywords:
Child, Eyeglasses, Myopia, Refraction, Ocular, Visual AcuityAbstract
INTRODUCTION: Myopia prevalence has increased sharply worldwide, becoming a major public health issue. As onset and progression occur mainly in childhood, early detection and intervention are essential to prevent high myopia and related complications. Spectacle designs such as DIMS, HALT, and CARE lenses slow axial elongation by modifying peripheral defocus. However, the influence of corneal astigmatism (CA) and axis orientation on treatment response remains poorly understood. This study aimed to evaluate the influence of keratometric and biometric parameters on myopia progression in children treated with myopia-control lenses.
METHODS: A retrospective observational study included 38 eyes from 19 children aged 5-18 years prescribed myopia-control lenses. Baseline and 6-12-month follow-up data were obtained. Biometric and keratometric parameters were obtained with ARGOS Optical Biometer. Myopia progression was defined using the Age-Matched Myopia Control (AMMC) system, which adjusts for age- and sex-specific AL growth. Annualized changes were calculated to account for follow-up duration. Group comparisons used the Mann-Whitney U test, and logistic regression identified predictors of progression.
RESULTS: Progression occurred in 24 eyes (63.2%), while 14 (36.8%) remained stable. Progressors were younger (10.5 vs 12 years, p = 0.037). Non-progressors showed higher baseline CA (1.53 vs 0.75 D, p = 0.006) and vitreous chamber depth (17.52 vs 16.79 mm, p = 0.046). No significant axis changes occurred (p = 0.500). In multivariate analysis adjusted for age, lower baseline CA independently predicted myopia progression (p = 0.024; OR = 0.22, 95% CI [0.06-0.82]).
CONCLUSION: Lower baseline corneal astigmatism was independently associated with greater myopia progression despite myopia-control lenses, while higher CA appeared protective, possibly by reducing peripheral hyperopic defocus. Incorporating keratometric parameters, particularly CA, into pediatric myopia assessment may enhance risk stratification and support individualized management strategies.
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