COLLABORATIVE OBSERVATIONAL STUDY OF MYOPIA IN COMET CHILDREN

描述（由申请人提供）：人们一致认为，儿童近视的发展和进展是由环境和遗传因素决定的，尽管其机制和遗传/环境相互作用的程度仍然知之甚少。在人类和动物模型中的大多数近视研究都调查了近视的发病。我们对发展的时间进程和最终的结果知之甚少。 近视的稳定性以及可能影响最终稳定量和稳定年龄的因素。 近视矫正评价试验（COMET）是一项多中心、随机临床试验，旨在评价渐进多焦点镜片（帕尔斯）与单光镜片（SVL）相比是否能减缓近视进展，入组了469名近视儿童，这些儿童在3年内通过睫状肌麻痹自动验光和眼轴长度进行了每年一次的标准化近视测量。 保持良好，98.5%的儿童完成了3年随访。四年的随访将于2002年10月完成，此后不久，研究设计将从临床试验转向 纵向调查 COMET队列提供了一个独特的机会来表征近视进展，以及它如何受到COMET第一阶段确定的因素以及家族性近视的新数据（包括遗传分析）的影响。更好地了解预测近视进展和稳定的因素也将有助于指导干预措施的选择和时机，并针对那些可能从治疗中受益最多的群体。该应用程序旨在通过再收集5年来自COMET儿童的数据来实现以下目标。COMET：第二阶段的具体目标是： 目标1：开发预测模型，并确定参与近视矫正评估试验的儿童队列中9年内近视和眼轴长度变化的特征因素。 目的二：完成彗星家系的确定，并进行研究 旨在调查青少年近视的遗传位点，从那些以前的 被鉴定为高度近视 目的3：评价长期效果（即，3年以上），配戴帕尔斯或单视镜片（SVL）3年。

DESCRIPTION (provided by applicant): There is consensus that the development and progression of myopia in children are determined by both environmental and inherited factors, although their mechanisms and the amount of genetic/environmental interaction remain poorly understood. Most studies of myopia, both in human and animal models, have investigated the onset of myopia. Much less is known about the time course of progression and eventual stabilization of myopia and the factors that may influence the final amount and the age of stabilization. The Correction of Myopia Evaluation Trial (COMET), a multi-center, randomized clinical trial designed to evaluate whether progressive addition lenses (PALs) slow the progression of myopia compared to single vision lenses (SVLs), enrolled 469 myopic children who have been carefully followed with annual standardized measurements of myopia by cycloplegic autorefraction and axial length over a 3-year period. Retention has been excellent, with 98.5% of children completing 3 year follow-up visits. Four year follow up visits will be completed in October, 2002, and soon after that the study design will shift from a clinical trial to a longitudinal investigation. The COMET cohort provides a unique opportunity to characterize myopia progression and how it is influenced by factors identified in the first phase of COMET as well as new data on familial myopia, including genetic analyses. Better understanding of the factors predictive of myopia progression and stabilization also will help guide selection and timing of interventions as well as target those groups that may benefit most from treatment. This application seeks to accomplish the following aims by collecting data from COMET children for an additional 5 years. The specific aims in COMET: Phase II are: Aim 1: To develop predictive models and identify factors that characterize changes over a 9 - year period in myopia and axial length in the cohort of children who have participated in the Correction of Myopia Evaluation Trial. Aim 2: To complete ascertainment of the pedigrees of COMET families and to conduct studies designed to investigate genetic loci for juvenile-onset myopia, beginning with those previously identified for high myopia. Aim 3: To evaluate the long term effect (i.e., beyond 3 years) of having worn either PALs or single vision lenses (SVLs) for 3 years.