Search

Purpose: To compare 3‐year myopic progression between Finnish and Singaporean children. Methods: Myopic progression was compared between 9‐year‐old (mean age 9.7 ± 0.4 years, n = 92) and 11‐year‐old (mean age 11.7 ± 0.4 years, n = 144) Finnish (Finnish RCT) children and Singaporean children matched by age and refraction (SCORMMatched, n = 403) and 7‐ to 8‐year‐old Singaporean children matched only by refraction (SCORM Young, n = 186). Spherical equivalent (SE) was between −0.50 and −3.00 D. Refraction with cycloplegia was controlled annually for 3 years. Information on parental myopia, mother's education, time spent on near‐work and outdoor time was gathered by parental questionnaire. Results: Three‐year myopic progression was −2.08 ± 0.96 D and −1.30 ± 0.69 D in the Finnish RCT and Singaporean SCORM Matched 9‐year‐olds, respectively, and −1.34 ± 0.78 D, and −0.52 ± 0.44 D in the 11‐year‐olds, respectively (p < 0.001 between all groups). Myopic progression was fastest (−2.69 ± 0.89 D) in the SCORM 7‐year‐olds and similar between the SCORM Matched 9‐year‐olds and Finnish RCT 11‐year‐olds (p = 0.55). The Finnish RCT and SCORM Matched children showed significant differences in both daily near‐work time (1.8 ± 1.0 versus 3.4 ± 1.9 hours per day, p < 0.001) and outdoor time (2.6 ± 0.9 versus 0.5 ± 0.4 hours per day, p < 0.001). These differences did not, however, explain the differences in myopic progression between the groups. More time spent outdoors was associated with less myopic progression in the Finnish RCT (r = 0.17, p = 0.009) group only. In the whole materials, greater myopic progression was associated with younger age at baseline (p < 0.001), younger age was associated with mother's higher education (p < 0.001), and mothers higher education was associated with myopia in both parents (p < 0.001). Conclusion: Age at baseline was the most significant factor associated with myopic progression. However, at the same age and with the same initial refraction, the Finnish and Singaporean children showed different myopic progression. This result remains unexplained. Thus, age of myopia onset should be considered when comparing myopic progression between different samples and conducting treatment trials. Parental myopia may be a weak indicator of heredity of myopia. [ABSTRACT FROM AUTHOR]

Importance Evidence‐based guidelines are essential for glaucoma screening to work effectively. Background: To derive a vertical cup‐to‐disc ratio (VCDR) cut‐off for glaucoma screening in a multi‐ethnic Asian population. Design The Singapore Epidemiology of Eye Diseases (SEED) study is a population‐based study conducted from 2004 to 2011 in a single tertiary care research institute. Participants: SEED comprised of 10 033 Chinese, Malay and Indian adults aged ≥40 (response rate 75.6%). After excluding participants with a history of glaucoma medication or surgery, 9673 participants were included for analysis. Methods: A systematic eye examination, which included applanation tonometry, visual field testing, gonioscopy and dilated fundus examination was conducted. Main Outcome Measure: Diagnosis of glaucoma. Results: The distribution of VCDR and VCDR asymmetry were relatively homogenous in this multi‐ethnic Asian population, with a 97.5th percentile value of 0.67 and 0.17, respectively. In the absence of more definite signs of glaucoma, VCDR ≥0.60 and VCDR asymmetry ≥0.20 provided the best balance between sensitivity (95.1%) and specificity (90.9%) in detecting glaucoma. For larger optic disc (≥2.0 mm), VCDR ≥0.65 with VCDR asymmetry ≥0.20 provided the best balance between sensitivity (84.8%) and specificity (93.2%). Conclusion and relevance: Overall, VCDR ≥0.60 with VCDR ≥0.20 asymmetry provides a good balance between sensitivity and specificity in detecting glaucoma. For larger optic disc, VCDR ≥0.65 should be considered instead to mitigate against false‐referrals due to larger physiological disc cupping. Our findings may act as a reference to populations with similar VCDR distribution. [ABSTRACT FROM AUTHOR]