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Racial and Ethnic Differences in Myopia Progression in a Large, Diverse Cohort of Pediatric PatientsLuong, Tiffany Q; Shu, Yu-Hsiang; Modjtahedi, Bobeck S; Fong, Donald S; Choudry, Nozhat; Tanaka, Yoko; Nau, Claudia L
Investigative ophthalmology & visual science, 11/2020, Volume: 61, Issue: 13Journal Article
The purpose of this study was to characterize the differences in myopic progression in children by race/ethnicity and age. Patients enrolled in Kaiser Permanente Southern California between 2011 and 2016 and between the ages of 4 and 11 years old with a documented refraction between -6 and -1 diopters (Ds) were included in this retrospective cohort study. Patients with a history of amblyopia, strabismus, retinopathy of prematurity, or prior ocular surgery were excluded from analyses. Patients' race/ethnicity and language information were used to create the following groups for analysis: white, Black, Hispanic, South Asian, East/Southeast Asian, Other Asian, and other/unknown. A growth curve analysis using linear mixed-effects modeling was used to trace longitudinal progression of spherical equivalents over time, modeled by race/ethnicity. Analyses adjusted for potential confounders, including body mass index (BMI), screen time, and physical activity. There were 11,595 patients who met the inclusion criteria. Patients were 53% girls, 55% Latino, 15% white, 9% black, 9% East/Southeast Asian, and 2% South Asian. Mean age (standard deviation SD) at the time of initial refraction was 8.9 years (1.6 years). Patients had an average (SD) of 3.4 (1.5) refractions, including the baseline measurement, during the study period. A three-way interaction model that assessed the effects of age at baseline, time since baseline, and race/ethnicity found that children of East/Southeast Asian descent showed significantly faster myopia progression across time (P < 0.001). East/Southeast Asian patients who presented with myopia between 6 to < 8 years progressed similarly to white patients in the same age group and significantly faster compared with white patients in other age groups. Myopia progression differed significantly between East/Southeast Asian and white patients depending on the patients' age.
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