Absolute risks and decision tools for communicating the risks of visual impairment from myopia-related diseases

PURPOSE. The risks of developing myopia complications are frequently reported in relative terms, which can be misleading. This study provides absolute risk estimates of visual impairment (VI) from myopia-related diseases.

METHODS. A critical integrative review provided data on frequency of myopic macular degeneration (MMD), primary open-angle glaucoma (POAG), rhegmatogenous retinal detachment (RRD), and associated VI in predominantly White and East Asian populations. The absolute risks of persons over 40 years of age with no myopia, low myopia (−2.00 D), or high myopia (−6.00 D) developing VI from each myopia-related disease were calculated by multiplying the proportion of each refractive group with the disease by the rate of VI. The sum of the risks of VI from MMD, POAG, and RRD provided an
estimate of VI risk from any of these three myopia-related diseases in adults over 40 years old.

RESULTS. VI from MMD, POAG, or RRD combined is expected in 0.4 in 100, 1.4 in 100, and 6.8 in 100 of White persons with no myopia, low myopia, or high myopia, respectively. The same risks in an East Asian population are 0.5 in 100, 2.4 in 100 and 10.3 in 100 in persons with no myopia, low myopia, or high myopia, respectively.

CONCLUSIONS. Absolute risks are provided to enable balanced discussions of the future risk that a child may have in developing VI from myopia-related diseases when considering myopia management. These estimates should be put into context using decision tools and balanced statements providing information on the likelihood of both developing VI and not developing VI.