Oculometry findings in high myopia at adult age: considerations based on oculometric follow-up data over 28 years in a cohort-based Danish high-myopia series

PURPOSE: To present and discuss oculometry data in a series of adults with high myopia followed between the ages of 26 and 54 years. Emphasis is on axial length (AL) findings and corneal curvature radius (Crad). METHODS: Thirty-four out of the 39 individuals recruited as teenagers from a Copenhagen 1948 birth cohort with myopia of at least 6 D have had current follow-up exams, to include AL measurements (by ultrasound, 1974-2002; the latter year also with the Zeiss IOLMaster) and keratometry. The cross-sectional and longitudinal analyses are based primarily on the eyes with high myopia; however, the fellow eye is also assessed in unilateral cases. RESULTS: At age 54 years, the maximum myopia in the series was -26 D; the highest AL value was 35.4 mm. The myopia had increased in most, with an increase from the 26-year oculometry baseline averaging 1.0 D [standard deviation (SD) 1.84]. Ultrasound measurements over the 28 years gave a significant correlation between axial eye elongation and myopia progression of adult age (r = 0.65). The regression line was y = 0.43 + 0.36x, with myopia increase on the x-axis. Throughout sessions, the association between AL and refraction was given by correlation coefficients numerically above 0.8, whereas AL and Crad had r-values of 0.3-0.5. However, a mean Crad in the sample of 7.66 (SD 0.28) mm meant that the more general expectancy of rather flat corneas in high myopia was not fulfilled. Our data further suggested a reduction in lens power over the study period. CONCLUSION: In relation to refraction, AL and Crad remain the two main oculometry parameters. Apparently the correlation patterns regarding the cornea that are broadly valid for axial ametropia in the population cannot be extended to the marginal high myopia tail of the distribution. A significant proportion of eyes with high myopia thus had steeper corneas than expected, as a so-called index contribution (albeit a small one) to the marginal refractive error.