Relationship between peripapillary atrophy and myopia progression in the eyes of young school children

Eye (Lond). 2021 Feb;35(2):665-671. doi: 10.1038/s41433-020-0945-6. Epub 2020 May 12.

Abstract

Background/objectives: Myopia progression is of great concern because of its association with an increased risk of sight-threatening conditions. This study aims to determine whether certain clinical and optic disc features are associated with the rate of myopia progression.

Subjects/methods: In this retrospective longitudinal observational study, we reviewed the medical records of 95 patients aged 6-11 years with myopia (spherical equivalent refractive error (SER) at baseline ≤ -0.5 D) and collected data regarding medical history, comprehensive ophthalmologic examination, and fundus photography. Using fundus photographs, we measured the ratio of horizontal to vertical disc diameter (HVDR), ratio of maximum β-zone peripapillary atrophy (β-PPA) width to vertical disc diameter (PVDR), and optic disc torsion. Outcome measurements included 2-year myopia progression (D/year) and overall myopia progression during the entire follow-up with a mean of 51 months.

Results: Mean age at initial visit was 7.67 ± 1.50 years and mean SER at baseline was -2.91 ± 1.68 D (range, -5.75 to -0.50 D). In the univariate analysis, age, parental myopia, SER at baseline, HVDR, and PVDR were significantly associated with myopia progression (P < 0.05). In the multivariate analysis, however, only age at initial visit and PVDR were significant factors associated with both 2-year and overall myopia progression.

Conclusions: Children with younger age and smaller β-PPA at baseline showed a faster myopia progression. This study suggests that the width of β-PPA, regardless of SER, might be used as a quantitative parameter to predict the potential for further myopia progression associated with scleral stretching.

Publication types

  • Observational Study

MeSH terms

  • Atrophy / pathology
  • Child
  • Humans
  • Myopia*
  • Optic Atrophy* / diagnosis
  • Optic Disk* / pathology
  • Retrospective Studies
  • Schools