Myopia progression in young adults: insights from real-world clinical data.

Clinical relevance: Myopia may progress even during adulthood. Clinical trials are required to evaluate the effectiveness of myopia control interventions in adults.

Purpose: This study aimed to investigate what proportion of young adults undergo myopia progression of <-0.50 D and the factors associated with this progression based on data from real-world clinical settings.

Methods: This retrospective study included 2,683 myopes with spherical equivalent (SE) ranging from -0.50D to -14.75D. The spherical and cylindrical components were separately categorised into mild, moderate, and high-magnitude groups. Myopia progression was calculated as the difference between the previous spectacle prescription (obtained from a 1-year-old spectacle) and the current refraction. A binary logistic regression model was used to obtain the odds ratio.

Results: The mean ± standard deviation age of myopic individuals was 24.45 ± 2.74 years (range: 18-30) and annual myopia progression was -0.22 ± 0.38D. Out of 2,683 myopes, 2,341 (87.3%) had stable refraction (annual change: ≤0.25 to ≥-0.50 D), and 342 (12.7%) myopes had progression of <-0.50 D. Overall, 4.6% (n = 124/2,683) of myopes had a change in refraction of ≤-1.00 D. The younger age group (18-20 years, OR 1.63 [95% CI 1.03-2.57], p = 0.04), high-spherical equivalent (OR 2.37 [95% CI 1.28-4.38]), and high-cylinder (OR 6.60 [95% CI 3.40-12.81]) were found to be significantly (p < 0.05) associated with increased odds of myopia progression. Age of apparent myopia onset, gender, and spherical components were not associated with myopia progression (p > 0.05).

Conclusion: About 1 out 20 myopes in clinical settings tend to have progression of one dioptre even during adulthood. Regular monitoring of biometry in young adults with high-spherical equivalent and astigmatism could aid in the identification of those with myopia progression.