Six Year Refractive Change among White Children and Young Adults: Evidence for Significant Increase in Myopia among White UK Children

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Abstract

ObjectiveTo determine six-year spherical refractive error change among white children and young adults in the UK and evaluate differences in refractive profiles between contemporary Australian children and historical UK data.DesignPopulation-based prospective study.ParticipantsThe Northern Ireland Childhood Errors of Refraction (NICER) study Phase 1 examined 1068 children in two cohorts aged 6–7 years and 12–13 years. Prospective data for six-year follow-up (Phase 3) are available for 212 12–13 year olds and 226 18–20 year olds in each cohort respectively.MethodsCycloplegic refractive error was determined using binocular open-field autorefraction (Shin-Nippon NVision-K 5001, cyclopentolate 1%). Participants were defined by spherical equivalent refraction (SER) as myopic SER ≤-0.50D, emmetropic -0.50D<SER<+2.00 or hyperopic SER≥+2.00D.Main Outcome MeasuresProportion and incidence of myopia.ResultsThe proportion of myopes significantly increased between 6–7 years (1.9%) and 12–13 years (14.6%) (p<0.001) but not between 12–13 and 18–20 years (16.4% to 18.6%, p = 0.51). The estimated annual incidence of myopia was 2.2% and 0.7% for the younger and older cohorts respectively. There were significantly more myopic children in the UK at age 12–13 years in the NICER study (16.4%) than reported in Australia (4.4%) (p<0.001). However by 17 years the proportion of myopia neared equivalence in the two populations (NICER 18.6%, Australia 17.7%, p = 0.75). The proportion of myopic children aged 12–13 years in the present study (2006–2008) was 16.4%, significantly greater than that reported for children aged 10–16 years in the 1960’s (7.2%, p = 0.01). The proportion of hyperopes in the younger NICER cohort decreased significantly over the six year period (from 21.7% to 14.2%, p = 0.04). Hyperopes with SER ≥+3.50D in both NICER age cohorts demonstrated persistent hyperopia.ConclusionsThe incidence and proportion of myopia are relatively low in this contemporary white UK population in comparison to other worldwide studies. The proportion of myopes in the UK has more than doubled over the last 50 years in children aged between 10–16 years and children are becoming myopic at a younger age. Differences between the proportion of myopes in the UK and in Australia apparent at 12–13 years were eliminated by 17 years of age.
LanguageEnglish
Pages1-19
Number of pages19
JournalPLoS ONE
Volume11
Issue number1
Early online date19 Jan 2016
DOIs
Publication statusE-pub ahead of print - 19 Jan 2016

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Myopia
Refraction
young adults
Young Adult
Northern Ireland
childhood
Refractive Errors
incidence
Incidence
Cyclopentolate
Hyperopia
myopia
prospective studies
Binoculars
Population
Prospective Studies

Keywords

  • myopia
  • refractive error
  • children
  • NICER study

Cite this

@article{53ee922864c74f1f95afa5120eecc54d,
title = "Six Year Refractive Change among White Children and Young Adults: Evidence for Significant Increase in Myopia among White UK Children",
abstract = "ObjectiveTo determine six-year spherical refractive error change among white children and young adults in the UK and evaluate differences in refractive profiles between contemporary Australian children and historical UK data.DesignPopulation-based prospective study.ParticipantsThe Northern Ireland Childhood Errors of Refraction (NICER) study Phase 1 examined 1068 children in two cohorts aged 6–7 years and 12–13 years. Prospective data for six-year follow-up (Phase 3) are available for 212 12–13 year olds and 226 18–20 year olds in each cohort respectively.MethodsCycloplegic refractive error was determined using binocular open-field autorefraction (Shin-Nippon NVision-K 5001, cyclopentolate 1{\%}). Participants were defined by spherical equivalent refraction (SER) as myopic SER ≤-0.50D, emmetropic -0.50D<SER<+2.00 or hyperopic SER≥+2.00D.Main Outcome MeasuresProportion and incidence of myopia.ResultsThe proportion of myopes significantly increased between 6–7 years (1.9{\%}) and 12–13 years (14.6{\%}) (p<0.001) but not between 12–13 and 18–20 years (16.4{\%} to 18.6{\%}, p = 0.51). The estimated annual incidence of myopia was 2.2{\%} and 0.7{\%} for the younger and older cohorts respectively. There were significantly more myopic children in the UK at age 12–13 years in the NICER study (16.4{\%}) than reported in Australia (4.4{\%}) (p<0.001). However by 17 years the proportion of myopia neared equivalence in the two populations (NICER 18.6{\%}, Australia 17.7{\%}, p = 0.75). The proportion of myopic children aged 12–13 years in the present study (2006–2008) was 16.4{\%}, significantly greater than that reported for children aged 10–16 years in the 1960’s (7.2{\%}, p = 0.01). The proportion of hyperopes in the younger NICER cohort decreased significantly over the six year period (from 21.7{\%} to 14.2{\%}, p = 0.04). Hyperopes with SER ≥+3.50D in both NICER age cohorts demonstrated persistent hyperopia.ConclusionsThe incidence and proportion of myopia are relatively low in this contemporary white UK population in comparison to other worldwide studies. The proportion of myopes in the UK has more than doubled over the last 50 years in children aged between 10–16 years and children are becoming myopic at a younger age. Differences between the proportion of myopes in the UK and in Australia apparent at 12–13 years were eliminated by 17 years of age.",
keywords = "myopia, refractive error, children, NICER study",
author = "Sara McCullough and Lisa O'Donoghue and Kathryn Saunders",
year = "2016",
month = "1",
day = "19",
doi = "10.1371/journal.pone.0146332",
language = "English",
volume = "11",
pages = "1--19",
journal = "PLoS ONE",
issn = "1932-6203",
number = "1",

}

TY - JOUR

T1 - Six Year Refractive Change among White Children and Young Adults: Evidence for Significant Increase in Myopia among White UK Children

AU - McCullough, Sara

AU - O'Donoghue, Lisa

AU - Saunders, Kathryn

PY - 2016/1/19

Y1 - 2016/1/19

N2 - ObjectiveTo determine six-year spherical refractive error change among white children and young adults in the UK and evaluate differences in refractive profiles between contemporary Australian children and historical UK data.DesignPopulation-based prospective study.ParticipantsThe Northern Ireland Childhood Errors of Refraction (NICER) study Phase 1 examined 1068 children in two cohorts aged 6–7 years and 12–13 years. Prospective data for six-year follow-up (Phase 3) are available for 212 12–13 year olds and 226 18–20 year olds in each cohort respectively.MethodsCycloplegic refractive error was determined using binocular open-field autorefraction (Shin-Nippon NVision-K 5001, cyclopentolate 1%). Participants were defined by spherical equivalent refraction (SER) as myopic SER ≤-0.50D, emmetropic -0.50D<SER<+2.00 or hyperopic SER≥+2.00D.Main Outcome MeasuresProportion and incidence of myopia.ResultsThe proportion of myopes significantly increased between 6–7 years (1.9%) and 12–13 years (14.6%) (p<0.001) but not between 12–13 and 18–20 years (16.4% to 18.6%, p = 0.51). The estimated annual incidence of myopia was 2.2% and 0.7% for the younger and older cohorts respectively. There were significantly more myopic children in the UK at age 12–13 years in the NICER study (16.4%) than reported in Australia (4.4%) (p<0.001). However by 17 years the proportion of myopia neared equivalence in the two populations (NICER 18.6%, Australia 17.7%, p = 0.75). The proportion of myopic children aged 12–13 years in the present study (2006–2008) was 16.4%, significantly greater than that reported for children aged 10–16 years in the 1960’s (7.2%, p = 0.01). The proportion of hyperopes in the younger NICER cohort decreased significantly over the six year period (from 21.7% to 14.2%, p = 0.04). Hyperopes with SER ≥+3.50D in both NICER age cohorts demonstrated persistent hyperopia.ConclusionsThe incidence and proportion of myopia are relatively low in this contemporary white UK population in comparison to other worldwide studies. The proportion of myopes in the UK has more than doubled over the last 50 years in children aged between 10–16 years and children are becoming myopic at a younger age. Differences between the proportion of myopes in the UK and in Australia apparent at 12–13 years were eliminated by 17 years of age.

AB - ObjectiveTo determine six-year spherical refractive error change among white children and young adults in the UK and evaluate differences in refractive profiles between contemporary Australian children and historical UK data.DesignPopulation-based prospective study.ParticipantsThe Northern Ireland Childhood Errors of Refraction (NICER) study Phase 1 examined 1068 children in two cohorts aged 6–7 years and 12–13 years. Prospective data for six-year follow-up (Phase 3) are available for 212 12–13 year olds and 226 18–20 year olds in each cohort respectively.MethodsCycloplegic refractive error was determined using binocular open-field autorefraction (Shin-Nippon NVision-K 5001, cyclopentolate 1%). Participants were defined by spherical equivalent refraction (SER) as myopic SER ≤-0.50D, emmetropic -0.50D<SER<+2.00 or hyperopic SER≥+2.00D.Main Outcome MeasuresProportion and incidence of myopia.ResultsThe proportion of myopes significantly increased between 6–7 years (1.9%) and 12–13 years (14.6%) (p<0.001) but not between 12–13 and 18–20 years (16.4% to 18.6%, p = 0.51). The estimated annual incidence of myopia was 2.2% and 0.7% for the younger and older cohorts respectively. There were significantly more myopic children in the UK at age 12–13 years in the NICER study (16.4%) than reported in Australia (4.4%) (p<0.001). However by 17 years the proportion of myopia neared equivalence in the two populations (NICER 18.6%, Australia 17.7%, p = 0.75). The proportion of myopic children aged 12–13 years in the present study (2006–2008) was 16.4%, significantly greater than that reported for children aged 10–16 years in the 1960’s (7.2%, p = 0.01). The proportion of hyperopes in the younger NICER cohort decreased significantly over the six year period (from 21.7% to 14.2%, p = 0.04). Hyperopes with SER ≥+3.50D in both NICER age cohorts demonstrated persistent hyperopia.ConclusionsThe incidence and proportion of myopia are relatively low in this contemporary white UK population in comparison to other worldwide studies. The proportion of myopes in the UK has more than doubled over the last 50 years in children aged between 10–16 years and children are becoming myopic at a younger age. Differences between the proportion of myopes in the UK and in Australia apparent at 12–13 years were eliminated by 17 years of age.

KW - myopia

KW - refractive error

KW - children

KW - NICER study

UR - https://pure.ulster.ac.uk/en/publications/six-year-refractive-change-among-white-children-and-young-adults--3

U2 - 10.1371/journal.pone.0146332

DO - 10.1371/journal.pone.0146332

M3 - Article

VL - 11

SP - 1

EP - 19

JO - PLoS ONE

T2 - PLoS ONE

JF - PLoS ONE

SN - 1932-6203

IS - 1

ER -