Temporal Trends And Regression Models In Myopia Progression In Chinese School Age Children

Aim This study aimed to determine the longitudinal changes in the spherical equivalent(SE)of refractive error,explore the possible related risk factors and investigate the patterns and temporal trends in myopia progression in Chinese school age children.Methods We collated refraction and demographic data from children aged 6 to 14 years seen at Joint Shantou International Eye Center between 2008 and 2019.Approximately 226371 datasets from 148237 individual children(53.6 % male and 46.4 % female)with mean age of 10.12 ± 2.38 years at the initial visit were analyzed.In total,15841 children who were followed for at least 2 years and had at least three cycloplegic refractive error evaluations were enrolled.Mixed-effect regression analysis was conducted.The myopia progression rates and patterns of refraction development in different periods were compared.Results The analysis in children with myopia at baseline demonstrated that younger age,later visit,lower myopic SE,lower degree of astigmatism at the initial visit were associated with a greater rate of myopia progression.For children with emmetropia at baseline,a greater rate of changes in SE was associated with female sex,younger age,later visit,lower degree of astigmatism at the initial visit and higher myopic SE.Among children with hyperopia at baseline,a greater rate of changes in SE was associated with female sex,lower degree of astigmatism at the initial visit and lower hyperopic SE.In children with myopia at baseline,a statistically significant increasing trend in myopia progression was observed as the mean annual rates of myopia progression rate rose from-0.62D/y in 2008 to-0.80D/y in 2017(F=12.723,P<0.001)and the proportion of children with rapidly myopic shift increased from10.3% to 24.5%.Among children with emmetropia at baseline,the mean rate of changes in SE significantly increased from 2010 to 2017(F= 3.205,P=0.002)and the proportion of children with rapidly myopic shift increased from in 15.7% in2008 to 31.0% in 2017.Conclusion Our study found an increasing trend in myopia progression rates and the proportion of children with rapidly myopic shift in different periods,suggesting that Chinese children presented a steady increase in myopia progression.