SynthesisOphthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)2024
Factors associated with pathologic myopia onset and progression: A systematic review and meta-analysis.
Synthesis in Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Influence of environmental, economic, dietary, and behavioural factors on high myopia onset in children: a 4-year large-scale cohort study.Journal of global health · 2026Article
- Epidemiology of pathologic myopia in UK adults with high myopia.The British journal of ophthalmology · 2026Article
- Association between first-year axial elongation and 10-year myopia progression in children wearing orthokeratology lenses: a ten-year longitudinal study.Frontiers in cell and developmental biology · 2026Article
- Choroidal thickness and peripapillary RNFL in relation to axial length and progression in myopic children.Frontiers in bioengineering and biotechnology · 2026Article
- Fundus Refraction Offset as an Individualized Myopia Biomarker.JAMA ophthalmology · 2025Article
- Key strategies to reduce the global burden of myopia: consensus from the international myopia summit.The British journal of ophthalmology · 2025Review
- Retinal features as predictive indicators for high myopia: insights from explainable multi-machine learning models.Frontiers in bioengineering and biotechnology · 2025Article
- Cultural roots of the myopia boom in Confucian Asia and their implications.Journal of public health policy · 2024Review
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
purposeTo synthesise evidence across studies on factors associated with pathologic myopia (PM) onset and progression based on the META-analysis for Pathologic Myopia (META-PM) classification framework.
methodsFindings from six longitudinal studies (5-18 years) were narratively synthesised and meta-analysed, using odds ratio (OR) as the common measure of association. All studies adjusted for baseline myopia, age and sex at a minimum. The quality of evidence was rated using the Grades of Recommendation, Assessment, Development and Evaluation framework.
resultsFive out of six studies were conducted in Asia. There was inconclusive evidence of an independent effect (or lack thereof) of ethnicity and sex on PM onset/progression. The odds of PM onset increased with greater axial length (pooled OR: 2.03; 95% CI: 1.71-2.40; p < 0.001), older age (pooled OR: 1.07; 1.05-1.09; p < 0.001) and more negative spherical equivalent refraction, SER (OR: 0.77; 0.68-0.87; p < 0.001), all of which were supported by an acceptable level of evidence. Fundus tessellation was found to independently increase the odds of PM onset in a population-based study (OR: 3.02; 2.58-3.53; p < 0.001), although this was only supported by weak evidence. There was acceptable evidence that greater axial length (pooled OR: 1.23; 1.09-1.39; p < 0.001), more negative SER (pooled OR: 0.87; 0.83-0.92; p < 0.001) and higher education level (pooled OR: 3.17; 1.36-7.35; p < 0.01) increased the odds of PM progression. Other baseline factors found to be associated with PM progression but currently supported by weak evidence included age (pooled OR: 1.01), severity of myopic maculopathy (OR: 3.61), intraocular pressure (OR: 1.62) and hypertension (OR: 0.21).
conclusionsMost PM risk/prognostic factors are not supported by an adequate evidence base at present (an indication that PM remains understudied). Current factors for which an acceptable level of evidence exists (limited in number) are unmodifiable in adults and lack personalised information. More longitudinal studies focusing on uncovering modifiable factors and imaging biomarkers are warranted.
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