Long-term changes in refractive error in children with myopic tilted optic disc compared to children without tilted optic disc.

PURPOSE: To compare changes in the spherical equivalent (SE) refractive error between children with and without myopic tilted optic disc.

METHODS

Changes in SE refractive error were compared between a group of 88 children with -1.5 diopters or more of myopia with myopic tilted disc and a group of 108 age- and initial SE refractive error-matched children without tilted disc. Factors that significantly influenced changes in SE refractive error were analyzed using mixed models.

RESULTS

Patients in the myopic tilted disc group were followed for 5.3 ± 3.1 years, on average, and patients in the nontilted disc group were followed for an average of 5.3 ± 2.3 years. An overall tendency toward myopic progression during the follow-up period was noted in both groups. According to univariate analysis, patients with a poorer baseline best-corrected visual acuity (BCVA) and tilted discs tended to have greater myopia over time (P < 0.001 and P = 0.009, respectively). Myopic progression in the tilted disc group was significantly greater than that in the nontilted disc group (P < 0.001) after adjusting for sex and initial BCVA.

CONCLUSIONS

Patients with myopic disc tilt showed greater myopic progression over time. These data suggest that myopic disc tilt represents a prognostic factor for further myopic progression, but it is unclear whether the disc tilt directly affects the progression rate of myopia or is a noncontributory consequence of other underlying mechanisms. The temporal relationship between the onset of the disc tilt and the myopic progression should be further studied using a prospective design.