Long-term changes in refractive error in children with myopic tilted optic disc compared to children without tilted optic disc

Invest Ophthalmol Vis Sci. 2013 Dec 3;54(13):7865-70. doi: 10.1167/iovs.13-12987.

Abstract

Purpose: To compare changes in the spherical equivalent (SE) refractive error between children with and without myopic tilted optic disc.

Methods: Changes in SE refractive error were compared between a group of 88 children with -1.5 diopters or more of myopia with myopic tilted disc and a group of 108 age- and initial SE refractive error-matched children without tilted disc. Factors that significantly influenced changes in SE refractive error were analyzed using mixed models.

Results: Patients in the myopic tilted disc group were followed for 5.3 ± 3.1 years, on average, and patients in the nontilted disc group were followed for an average of 5.3 ± 2.3 years. An overall tendency toward myopic progression during the follow-up period was noted in both groups. According to univariate analysis, patients with a poorer baseline best-corrected visual acuity (BCVA) and tilted discs tended to have greater myopia over time (P < 0.001 and P = 0.009, respectively). Myopic progression in the tilted disc group was significantly greater than that in the nontilted disc group (P < 0.001) after adjusting for sex and initial BCVA.

Conclusions: Patients with myopic disc tilt showed greater myopic progression over time. These data suggest that myopic disc tilt represents a prognostic factor for further myopic progression, but it is unclear whether the disc tilt directly affects the progression rate of myopia or is a noncontributory consequence of other underlying mechanisms. The temporal relationship between the onset of the disc tilt and the myopic progression should be further studied using a prospective design.

Keywords: children; myopia; tilted disc.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Myopia / pathology*
  • Myopia / physiopathology
  • Optic Disk / pathology*
  • Prognosis
  • Refraction, Ocular*
  • Retrospective Studies
  • Time Factors
  • Tomography, Optical Coherence
  • Visual Acuity