Potential Negative Feedback between Age and Baseline Axial Length on Axial Elongation in High Myopia

IF 4.6 Q1 OPHTHALMOLOGY

Ophthalmology science Pub Date : 2025-09-04 DOI:10.1016/j.xops.2025.100937

Mariko Murata MD, Masahiro Miyake MD, PhD, MPH, Kenji Suda MD, PhD, Yuki Mori MD, PhD, Kazuya Morino MD, PhD, Wakako Okayama MD, Akitaka Tsujikawa MD, PhD

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Abstract

Purpose

To evaluate the axial elongation in highly myopic eyes and assess the effects of age, sex, baseline axial length (AL), cataract surgery (CS), pathologic myopia (PM), baseline intraocular pressure (IOP), and genetic risk scores (GRSs).

Design

Retrospective cohort study.

Participants

This study included 614 eyes from 367 individuals with high myopia.

Methods

The study assessed axial elongation rates and their associations with age, sex, baseline AL, CS, PM, and baseline IOP including potential interactions among these factors. Additionally, the study examined whether incorporating GRS improved the predictive model for axial elongation.

Main Outcome Measures

Axial elongation rate in highly myopic eyes.

Results

The study included 367 participants (217 [59.1%] females, 150 [40.9%] males) with a mean age of 58.9 ± 14.4 years and a mean AL of 28.6 ± 2.0 mm. The mean follow-up duration was 4.7 ± 2.7 years, and the average axial elongation rate was 0.031 ± 0.030 mm/year. Cataract surgery was associated with significantly slower axial elongation (P < 0.001). Multivariate analysis revealed that axial elongation increased with age and baseline AL but decreased with CS and an age–AL interaction. The best-fitting model excluded GRS, thus achieving a lower Akaike information criterion score (–573.4) than models including GRS.

Conclusions

Axial elongation persists in highly myopic eyes (0.031 mm/year) but slows over time, owing to baseline AL–age interactions. Genetic risk scores have limited predictive utility in adulthood. This highlights the need for further research on genetic and environmental determinants of myopia progression.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

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年龄与基线眼轴长度对高度近视眼轴伸长的潜在负反馈

目的评价高度近视眼的眼轴伸长，并评价年龄、性别、基线眼轴长度（AL）、白内障手术（CS）、病理性近视（PM）、基线眼压（IOP）和遗传风险评分（GRSs）对高度近视眼轴伸长的影响。设计回顾性队列研究。这项研究包括367名高度近视患者的614只眼睛。方法本研究评估了轴向伸长率及其与年龄、性别、基线AL、CS、PM和基线IOP的关系，包括这些因素之间的潜在相互作用。此外，该研究还检查了是否纳入GRS改进了轴向伸长的预测模型。主要观察指标：高度近视眼的眼轴伸长率。结果共纳入367例患者，其中女性217例（59.1%），男性150例（40.9%），平均年龄58.9±14.4岁，平均AL 28.6±2.0 mm。平均随访4.7±2.7年，平均轴向伸长率0.031±0.030 mm/年。白内障手术与较慢的眼轴伸长相关（P < 0.001）。多变量分析显示轴向伸长率随年龄和基线AL增加而增加，但随CS和年龄- AL相互作用而减少。最佳拟合模型排除了GRS，因此获得的赤池信息标准得分（-573.4）低于包含GRS的模型。结论高度近视眼的眼球伸长持续存在（0.031 mm/年），但随着时间的推移，由于基线al -年龄的相互作用而减慢。遗传风险评分在成年期的预测效用有限。这突出了对近视进展的遗传和环境决定因素进行进一步研究的必要性。财务披露专有或商业披露可在本文末尾的脚注和披露中找到。

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