Refractive Criteria for Referral to a Public Danish Myopia Clinic
DOI:
https://doi.org/10.15626/rbsva716Keywords:
Myopia, referral, risk, high myopia, myopic progressionAbstract
To evaluate age -specific cycloplegic spherical equivalent refraction (cSEQ) referral criteria for identifying children at risk of becoming highly myopic according to European gender and age-specific nomograms. Further, to assess axial length progression (AL) without treatment during an observational period.
The purpose of this study was to evaluate age-specific cycloplegic spherical equivalent refraction (cSEQ) referral criteria for identifying children at risk of becoming highly myopic according to European age- and sex-specific nomograms. Further, to assess axial length (AL) progression without treatment during an observational period.
The Myopia Clinic, University Hospital of Southern Denmark, Vejle had by April 2021 introduced the following referral criteria: cSEQ at least -2 dioptres (D) for children aged 5–9 years and cSEQ at least -4D for children aged 10–12 years. We conducted a prospective observational study using these criteria and the risk of becoming highly myopic was assessed by age and sex-specific AL nomograms based on northern European cohorts. Children with an AL ≥ the 95th percentile were identified and the those fulfilling the inclusion criteria were assessed. Additionally, eye growth of ≥ 0.05 mm during an observation period was registered.
One-hundred and thirty-two children were eligible (mean observation period 200 ± 60.4 days). Ninety-six fulfilled the referral criteria (fulfilled group, 43 boys [45%], median age 9.11 years) and 36 did not (unfulfilled group, 15 boys [42%], median age 10.37 years). A significantly greater proportion of the children in the fulfilled group had an AL ≥ the 95th percentile (79% versus 61%, p = 0.035, χ2). During the observation period, 94% and 88% of children progressed ≥ 0.05 mm per 6 months in the fulfilled and unfulfilled groups, respectively. Refractive error at the time of referral was not a predictor for AL growth in either group (p = 0.67 fulfilled, p = 0.34 unfulfilled).
The referral criteria improved the detection rate for identifying children at risk of high myopia defined as an AL ≥ the 95th percentile on the nomograms. However, more than half of patients with unfulfilled referral criteria were also at risk of high myopia according to the nomograms. The AL progressed for most children during the observation period.
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