Rationale and protocol for the 7- and 8-year longitudinal assessments of eye health in a cohort of young adults in the Raine Study

Lee, Samantha Sze‐Yee; Lingham, Gareth; Yazar, Seyhan; Sanfilippo, Paul; Charng, Jason; Chen, Fred K.; Hewitt, Alex W.; Ng, Fletcher; Hammond, Christopher J; Straker, Leon; Eastwood, Peter R.; MacGregor, Stuart; Rose, Kathryn A.; Lucas, Robyn; Guggenheim, Jeremy A.; Saw, Seang Mei; Coroneo, Minas T.; He, Miao; Mackey, David A.

doi:10.1136/bmjopen-2019-033440

Cited by 8 publications

(8 citation statements)

References 118 publications

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“…The 20- and 28-year examinations were conducted in 2010 to 2012 and 2018 to 2020, respectively, at the Lions Eye Institute (Perth, Western Australia) and have been described in detail previously. 24 , 25 At both visits, participants underwent ocular biometry (IOLMaster version 5; Carl Zeiss Meditec AC, Jena, Germany) and conjunctival ultraviolet autofluorescence (CUVAF) photography (as an objective measure of ocular sun exposure), 26 among other tests. Autorefraction (Nidek ARK-510A Autorefractometer; Nidek Co. Ltd., Tokyo, Japan) was performed at least 20 minutes after instillation of 1% tropicamide.…”

Section: Methodsmentioning

confidence: 99%

Choroidal Thickening During Young Adulthood and Baseline Choroidal Thickness Predicts Refractive Error Change

Lee

Alonso‐Caneiro

Lingham

et al. 2022

Invest. Ophthalmol. Vis. Sci.

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Purpose The purpose of this study was to explore the age-related change in choroidal thickness (ChT) and test the hypothesis that baseline ChT is predictive of refractive error change in healthy young adults. Methods Participants underwent spectral-domain optical coherence tomography (SD-OCT) imaging and autorefraction at 20 (baseline) and 28 years old. The enhanced depth imaging mode on the SD-OCT was used to obtain images of the choroid. Scans were exported from the SD-OCT and analyzed with a custom software that automatically measures the central ChT. The longitudinal change in subfoveal ChT and association between baseline subfoveal ChT and 8-year change in refractive error (spherical equivalent) were determined using linear mixed models. Results In total, 395 eyes of 198 participants (44% men; 18–22 years at baseline) were included. Over 8 years, mean spherical equivalent decreased by 0.25 diopters (D) and axial length increased by 0.09 mm. Subfoveal choroid thickened by 1.3 µm/year (95% confidence interval [CI] = 0.6–2.0), but this was reduced by 0.9 µm/year (95% CI = 1.6–0.2) for every 1 mm increase in axial length. For every 10 µm increase in baseline ChT, average annual change in spherical equivalent and axial length reduced by 0.006 D/year and 0.003 mm/year, respectively. Conclusions In a community-based cohort of young adults, the choroid continued to change during early adulthood. Choroidal thickening was less in eyes that were longer at baseline, and the choroid thinned in eyes that showed myopia progression. The association between baseline ChT and longitudinal changes in spherical equivalent and axial length supports the hypothesis that ChT may be predictive of refractive error development and/or myopia progression.

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Section: Methodsmentioning

confidence: 99%

Choroidal Thickening During Young Adulthood and Baseline Choroidal Thickness Predicts Refractive Error Change

Lee

Alonso‐Caneiro

Lingham

et al. 2022

Invest. Ophthalmol. Vis. Sci.

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“…The 20-year and 28-year follow-up assessments were conducted from January 2010 to August 2012 and from March 2018 to March 2020, respectively. 19,20 In brief, both eye examinations included conjunctival ultraviolet autofluorescence (CUVAF) photography, ocular biometry (IOLMaster V.5; Carl Zeiss Meditec AG), postmydriatic autorefraction/keratometry (Nidek ARK-510A; NIDEK), and lens thickness measurement (Oculus Pentacam; OculusOptikgerate GmbH), among others. Autorefraction was performed at least 20 minutes after instillation of 1 drop of tropicamide, 1%.…”

Section: Eye Examinationmentioning

confidence: 99%

Incidence and Progression of Myopia in Early Adulthood

et al. 2022

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IMPORTANCE Myopia incidence and progression has been described extensively in children. However, few data exist regarding myopia incidence and progression in early adulthood.OBJECTIVE To describe the 8-year incidence of myopia and change in ocular biometry in young adults and their association with the known risk factors for childhood myopia. DESIGN, SETTING, AND PARTICIPANTSThe Raine Study is a prospective single-center cohort study. Baseline and follow-up eye assessments were conducted from January 2010 to August 2012 and from March 2018 to March 2020. The data were analyzed from June to July 2021. A total of 1328 participants attended the baseline assessment, and 813 participants attended the follow-up assessment. Refractive information from both visits was available for 701 participants. Participants with keratoconus, previous corneal surgery, or recent orthokeratology wear were excluded.EXPOSURES Participants' eyes were examined at ages 20 years (baseline) and 28 years. MAIN OUTCOMES AND MEASURES Incidence of myopia and high myopia; change in spherical equivalent (SE) and axial length (AL).RESULTS A total of 516 (261 male [50.6%]) and 698 (349 male [50.0%]) participants without myopia or high myopia at baseline, respectively, were included in the incidences analyses, while 691 participants (339 male [49%]) were included in the progression analysis. The 8-year myopia and high myopia incidence were 14.0% (95% CI, 11.5%-17.4%) and 0.7% (95% CI, 0.3%-1.2%), respectively. A myopic shift (of 0.50 diopters [D] or greater in at least 1 eye) occurred in 261 participants (37.8%). Statistical significance was found in longitudinal changes in SE (−0.04 D per year; P < .001), AL (0.02 mm per year; P <.001), and lens thickness (0.02 mm per year; P < .001). Incident myopia was associated with self-reported East Asian vs White race (odds ratio [OR], 6.13; 95% CI, 1.06-35.25; P = .04), female vs male sex (OR, 1.81; 95% CI, 1.02-3.22; P = .04), smaller conjunctival ultraviolet autofluorescence area (per 10-mm 2 decrease, indicating less sun exposure; OR, 9.86; 95% CI, 9.76-9.97; P = <.009), and parental myopia (per parent; OR, 1.57; 95% CI, 1.03-2.38; P = <.05). Rates of myopia progression and axial elongation were faster in female participants (estimate: SE, 0.02 D per year; 95 % CI, 0.01-0.02 and AL, 0.007 mm per year, 95 % CI, 0.00.-0.011; P Յ .001) and those with parental myopia (estimate per parent: SE, 0.01 D per year; 95% CI, 0.00-0.02 and AL, 95% CI, 0.002-0.008; P Յ .001). Education level was not associated with myopia incidence or progression.CONCLUSIONS AND RELEVANCE These findings suggest myopia progression continues for more than one-third of adults during the third decade of life, albeit at lower rates than during childhood. The protective effects of time outdoors against myopia may continue into young adulthood.

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“…The Gen2 28-year follow-up eye examination ( 12 ) was conducted from March-2018 to March-2020 and attended by 813 participants (28.3% of original cohort; it is worth noting that data collection for this follow-up ended early because of the COVID-19 pandemic). This follow-up documented the longitudinal change in eye measures in young adults, with a focus on the 8-year change in refraction and optic disc measures.…”

Section: The Raine Studymentioning

confidence: 99%

Prevalence and Risk Factors of Myopia in Young Adults: Review of Findings From the Raine Study

Lee

Mackey

2022

Front. Public Health

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Myopia tends to develop and progress fastest during childhood, and the age of stabilization has been reported to be 15–16 years old. Thus, most studies on myopia have centered on children. Data on the refractive error profile in young adulthood — a time in life when myopia is thought to have stabilized and refractive error is unaffected by age-related pathology such as cataract — are limited. The Raine Study has been following a community-based cohort of young adults representative of the general Western Australia population since their prenatal periods in 1989–1991, with eye examinations performed when participants were 20 and 28 years old. At 20 years old, prevalence of myopia in the cohort was 25.8%. Using long-term trajectory of serum vitamin D levels and conjunctival ultraviolet autofluorescence (CUVAF) area to objectively quantify sun exposure, the Raine Study confirmed a negative relationship between time spent outdoors and myopia prevalence. However, prospective studies are required to determine the amount of CUVAF area or serum vitamin D levels associated with time duration. Combining data from the Raine Study and several other cohorts, Mendelian randomization studies have confirmed a link between myopia and a genetic predisposition toward higher education. Several novel potential associations of myopia or ocular biometry were investigated, including fetal growth trajectory, which was found to be significantly associated with corneal curvature at 20 years. By age 28, myopia prevalence had increased to 33.2%. Between 20 and 28 years old, myopia progressed and axial length elongated, on average, by −0.041D/year and 0.02 mm/year, respectively. Smaller CUVAF area at follow-up, female sex, and parental myopia were significant risk factors for myopia incidence and progression between 20 and 28 years. Given the limited research in young adults, further investigations are warranted to confirm the Raine Study findings, as well as identify novel genetic or environmental factors of myopia incidence and progression in this age group.

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Rationale and protocol for the 7- and 8-year longitudinal assessments of eye health in a cohort of young adults in the Raine Study

Cited by 8 publications

References 118 publications

Choroidal Thickening During Young Adulthood and Baseline Choroidal Thickness Predicts Refractive Error Change

Choroidal Thickening During Young Adulthood and Baseline Choroidal Thickness Predicts Refractive Error Change

Incidence and Progression of Myopia in Early Adulthood

Prevalence and Risk Factors of Myopia in Young Adults: Review of Findings From the Raine Study

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