High Myopia Progression and Visual Impairment in a Nonselected Group of Danish 14-Year-Olds Followed Over 40 Years

Abstract

The purpose of this study was to document the adult age progression of myopia and the incidence of visual impairment in a representative sample of Danish adolescents with high myopia. This study consisted of a scheduled regular ophthalmic follow-up over 40 years of 39 otherwise unselected Copenhagen 14 year olds with uni- and bilateral myopia of at least -6 D, as screened from a 1948 birth-year school cohort comprising 9243 pupils. Thirty-six of the 39 had satisfactory refractive and corrected visual acuity data for a longitudinal analysis. Myopia progression for the full period ranged from 0 to 14 D, and the peak myopia value increased from -14 to -26 D. The mean progression from age 16 to 26 years was 2.09 D, and from age 26 and on it was 1 D. Using both eyes and relevant correction, at the preliminary end point of 54 years, 32 of the 36 had a corrected visual acuity (VA) of 0.5 or better. Four had a corrected VA of < or = 0.3, but the visual loss was partly explained by other eye pathology. Significant visual reduction in single eyes mainly affected the subgroup of eyes with unilateral high myopia (n = 9). With only a slight overrisk recorded as associated with high myopia (in three or four of 36 subjects), the adult visual prognosis for working age appeared better than usually claimed. There seems to be a correlation between degree of myopia at age 14 and consecutive visual loss, but it was not possible to identify subjects at high risk at that early age.