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Myopia Control

Why Each Diopter Matters

Bullimore, Mark A. MCOptom, PhD, FAAO1*; Brennan, Noel A. MScOptom, PhD, FAAO2

Optometry and Vision Science: June 2019 - Volume 96 - Issue 6 - p 463–465
doi: 10.1097/OPX.0000000000001367

SIGNIFICANCE Reducing the incidence or prevalence of any disease by 40% is of huge public health significance. Slowing myopia by 1 diopter may do just that for myopic maculopathy—the most common and serious sight-threatening complication of myopia. There is a growing interest in slowing the progression of myopia due to its increasing prevalence around the world, the sight-threatening consequences of higher levels of myopia, and the growing evidence-based literature supporting a variety of therapies for its control. We apply data from five large population-based studies of the prevalence of myopic maculopathy on 21,000 patients. We show that a 1-diopter increase in myopia is associated with a 67% increase in the prevalence of myopic maculopathy. Restated, slowing myopia by 1 diopter should reduce the likelihood of a patient developing myopic maculopathy by 40%. Furthermore, this treatment benefit accrues regardless of the level of myopia. Thus, while the overall risk of myopic maculopathy is higher in a –6-diopter myope than in a –3-diopter myope, slowing their myopic progression by 1 diopter during childhood should lower the risk by 40% in both.

1University of Houston, College of Optometry, Boulder, Colorado

2Johnson & Johnson Visioncare, Inc., Jacksonville, Florida *

Submitted: January 7, 2019

Accepted: February 28, 2019

Funding/Support: None of the authors have reported funding/support.

Conflict of Interest Disclosure: MAB is a consultant for a number of companies including Acucela (Seattle, WA); Apellis Pharmaceuticals, Inc. (Crestwood, KY); Alcon Laboratories, Inc. (Fort Worth, TX); Carl Zeiss Meditec AG (Dublin, CA); CooperVision, Inc. (Victor, NY); Essilor of America (Lewisville, TX); Eyenovia, Inc. (New York, NY); Genentech, Inc. (San Francisco, CA); Innovega, Inc. (Seattle, WA); jCyte, Inc. (Newport, CA); Johnson & Johnson Visioncare, Inc. (Jacksonville, FL); Novartis Pharma AG (Basel, Switzerland); and Tear Film Innovations (San Diego, CA). NAB is an employee of Johnson & Johnson Visioncare, Inc.

Author Contributions and Acknowledgments: Conceptualization & Writing: MAB; Writing – Review & Editing: NAB.

The ideas expressed here have been enhanced by discussions with Paul Chamberlain (Cooper Vision, Inc.).

Online date: May 21, 2019

© 2019 American Academy of Optometry