Collaborative Observational Study of Myopia in COMET Children 2: Clinial Ceneter

描述（由申请人提供）：本提案旨在要求亚拉巴马大学伯明翰临床中心继续按照COSMICC 2方案每年对127例目前入组的COSMICC参与者（自1997-98年入组以来，仅5例受试者失访）进行额外5年（总随访时间为14年）的检查。从该中心收集的数据将用于解决在主席申请中更详细描述的具体目标，并在此简要总结：1）使用数学函数（Gompertz函数和其他），以模拟58%的COSMICC进展性近视受试者的近视进展，并基于先前确定的风险因素开发预测模型和检验假设（年龄、种族、父母近视）; 2）在该充分表征的近视患者队列中检验与近视进展和稳定以及轴向延长的环境风险因素相关的4个假设;以及3）检验与COSMICC受试者中IOP、CCT和黄斑厚度的近视相关变化的发展的风险因素相关的3个假设。近视的高患病率（占美国成年人口的25%）及其作为公共卫生问题（可导致视力丧失和失明的风险因素）的突出性强调了增加对进展和最终稳定的潜在机制的理解的重要性，以便将来近视可能限于低水平。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。

DESCRIPTION (provided by applicant): This proposal is for the University of Alabama at Birmingham Clinical Center to continue to annually examine the 127 currently enrolled COSMICC participants (only 5 subjects are lost to follow-up since enrollment in 1997-98) for an additional 5 yrs (total follow-up, 14 yrs) following the COSMICC2 protocol. The data collected from this center will be used to address the specific aims described in more detail in the Chair application and summarized briefly here: 1) to use mathematical functions (the Gompertz function and others) to model myopia progression in the 58% of COSMICC subjects with progressing myopia and to develop predictive models and test hypotheses based on previously identified risk factors (age, ethnicity, parental myopia); 2) to test 4 hypotheses related to environmental risk factors for myopia progression and stabilization and axial elongation in this well-characterized cohort of myopes; and 3) to test three hypotheses related to risk factors for the development of myopia-related changes in IOP, CCT and macular thickness in COSMICC subjects. The high prevalence of myopia (25% of the US adult population) and its prominence as a public health problem (risk factor for conditions that can cause vision loss and blindness) emphasize the importance of gaining increased understanding of mechanisms underlying progression and eventual stabilization, so that in the future myopia might be limited to low levels. 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 the most from treatment.