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Leslie Hyman, PhD; Jane Gwiazda, PhD; Mohamed Hussein, PhD; Thomas T. Norton, PhD; Ying Wang, MS; Wendy Marsh-Tootle, OD; Donald Everett, MA; for the COMET Study Group

Arch Ophthalmol. 2005;123:977-987.

Objective  To identify the baseline factors independently related to 3-year myopia progression and axial elongation in COMET.

Methods  A total of 469 children were enrolled, randomly assigned to progressive addition lenses with a + 2.00 diopter (D) addition or to single vision lenses and observed for 3 years. Eligible children were 6 to 11 years old, with spherical equivalent myopia of – 1.25 to – 4.50 D, bilaterally. The primary and secondary outcomes, myopia progression by cycloplegic autorefraction and axial elongation by A-scan ultrasonography, were measured annually. Multiple linear regression was used to adjust for covariates, including treatment.

Results  Younger baseline age (6-7 vs 11 years, 8 vs 11 years, and 9 vs 11 years, P<.001; 10 vs 11 years, P = .04), female sex (P = .01), and each ethnic group compared with African Americans (Asian, P = .02; Hispanic, P = .002; mixed, P = .002; white, P = .001) were independently associated with faster 3-year progression. Children aged 6 to 7 years had the fastest progression of all age groups, progressing by a mean (± SD) of 1.31 D ± 0.13 more than children aged 11 years. Females progressed 0.16 D more than the males. Children of mixed, Hispanic, Asian, and white ethnicity progressed more than African American children by 0.49 D ± 0.16, 0.33 D ± 0.11, 0.32 D ± 0.13, 0.27 D ± 0.08, respectively. Age and ethnicity, but not sex, were independently associated with axial elongation. Among these myopic children, a 0.5 mm increase in axial length was associated with 1 D of myopia progression.

Conclusions  Younger baseline age was the strongest factor independently associated with faster myopic progression and greater axial elongation at 3 years. African American children had less myopic progression and axial elongation than the other ethnic groups.

Author Affiliations: Department of Preventive Medicine, School of Medicine, Stony Brook University, New York, NY (Drs Hyman, Wang; the COMET Group); New England College of Optometry, Boston, Mass (Dr Gwiazda; the COMET Group); Southwestern Medical School, Dallas, Tex (Dr Hussein); School of Optometry, University of Alabama at Birmingham, Birmingham, Ala (Drs Norton, Marsh-Tootle; the COMET Group); National Eye Institute, Bethesda, Md (Dr Everett), University of Houston, College of Optometry, Houston, Tex (the COMET Group); Pennsylvania College of Optometry, Philadelphia, Pa (the COMET Group).

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