Changes in astigmatism and anisometropia with progressing myopia in COMET

近视在全球范围内的高患病率及其作为公共卫生问题的突出性强调了 研究有希望的近视儿童治疗方法的重要性， 矫正近视评估试验（COMET），并增加对 眼睛生长的机制，如以下目标中提出的，将分析13年的随访- 来自彗星队列的数据。COMET招募了469名不同种族的近视儿童， 提供了标准化的，可靠的测量屈光不正和眼部组成部分， 眼睛3年随访后保留率为99%，13年后保留率为79%。这个有价值的数据集 提供了一个独特的机会，调查机制的眼睛生长最终在散光 屈光参差以及近视，这些主题在最初的目标中没有涉及。鉴于 据报道，散光和近视之间的联系，一个关键的未回答的问题是如何光学 散光的前节不对称与轴向伸长有关 潜在的进行性近视大多数COMET分析都是基于儿童的，使用的是 两只眼睛，而不是每只眼睛分别，因为计划的一些新的分析。之甚少 已知两只眼睛中不同生长速率导致屈光参差的机制， 这也将被调查。对于大多数参与者来说，彗星的早期与 眼睛快速生长和近视进展，眼睛缓慢生长和近视稳定， 因此，可以对不同阶段的机制进行调查。的结果 这些分析将阐明与眼睛前部和后部生长有关的因素， 两眼之间，并帮助确定眼睛生长是否导致散光， 屈光参差主要是被动的（预编程的）或主动的（视觉引导的）。新的数据还 可用于更新近视、散光矫正的临床指南， 屈光参差

The high prevalence of myopia worldwide and its prominence as a public health issue emphasize the importance of investigating promising treatments for myopic children, as was done in the Correction of Myopia Evaluation Trial (COMET), and of gaining increased understanding of mechanisms of eye growth, as proposed in the following aims which will analyze 13 years of follow- up data from the COMET cohort. COMET enrolled 469 ethnically diverse myopic children, who provided standardized, reliable measurements of refractive error and ocular components from both eyes. Retention was 99% after 3 years of follow-up and 79% after 13 years. This valuable dataset presents a unique opportunity to investigate mechanisms of eye growth eventuating in astigmatism and anisometropia as well as myopia, topics not addressed in the original aims. Given the reported association between astigmatism and myopia, a key unanswered question is how optical asymmetries in the anterior segment underlying astigmatism are related to axial elongation underlying progressing myopia. Most COMET analyses were child-based, using the average of the two eyes rather than each eye separately, as planned for some of the new analyses. Little is known about the mechanism of different growth rates in the two eyes resulting in anisometropia, which also will be investigated. For most participants the early years of COMET were associated with rapid eye growth and myopia progression, with slower eye growth and myopia stabilization in the later years, thus allowing for an investigation of mechanisms at different stages. The results of these analyses will elucidate factors related to growth in the front and back of the eye, and between the two eyes, and help to determine if eye growth resulting in astigmatism and anisometropia is mainly passive (pre-programmed) or active (visually-guided). The new data also may be used to update clinical guidelines for correction of myopia, astigmatism, and anisometropia.