Collaborative Observational Study of Myopia in COMET Children 2 (COSMICC2) Chair

描述（由申请人提供）：关于近视进展的减缓、最终稳定和相关危险因素的数据有限。青少年性近视通常被认为在15 -16岁时停止发展，然而来自成年人的数据显示，这种发展有时至少会持续到20多岁。对COMET儿童近视合作观察研究（COSMICC）受试者屈光数据的分析显示，目前，在平均年龄为17岁的队列中，只有42%的人近视停止进展。这组不同种族的近视受试者有7-8年的标准化、可靠的屈光不正和眼部成分测量，保持率高达93%。因此，该队列提供了一个独特的机会来描述近视的进展和稳定，并了解它们如何受到本研究和文献中确定的内在因素（例如，年龄、种族）和环境因素（例如，佩戴的镜片类型、工作地点附近和户外活动）的影响。由于在我们的一些研究对象中发现了较高的近视发生率（22% > 6.0 D），我们还计划研究进展和轴向伸长增加与眼内压（IOP）、角膜中央厚度（CCT）和黄斑厚度的关系。这些结果将有助于识别近视相关病理风险增加的个体，并有助于指导干预措施的选择和时机，包括视力矫正手术。通过对这一群体进行额外5年的研究，本申请旨在实现以下目标。目的1：使用Gompertz和其他功能来描述COSMICC队列中58%的进行性近视的病程，并基于先前确定的内在危险因素（年龄、种族和父母近视）建立预测模型。目的2：在这一特征明确的近视队列中，检验与环境风险因素（例如，佩戴的镜片类型、近距离工作和户外活动）有关的近视进展和稳定的假设。目的3：在COSMICC受试者中，检验IOP、CCT和黄斑厚度与眼轴伸长变化和近视进展相关的假设。这个应用程序是为COSMICC2学习椅。4个临床中心和协调中心分别提交了申请。

DESCRIPTION (provided by applicant): Limited data are available on the slowing of myopia progression, its eventual stabilization, and related risk factors. Juvenile-onset myopia typically is thought to stop progressing at 15 -16 years of age, yet data from adults show that progression can sometimes continue at least through the 20's. Analysis of refraction data from subjects enrolled in the Collaborative Observational Study of Myopia in COMET Children (COSMICC) shows that currently, at an average age of 17 years, myopia has stopped progressing in only 42% of the cohort. This group of ethnically diverse myopic subjects has 7-8 years of standardized, reliable measurements of refractive error and ocular components, with outstanding retention of 93%. Thus, this cohort provides a unique opportunity to characterize progression and stabilization of myopia and to learn how they are influenced by intrinsic (e.g., age, ethnicity) and environmental factors (e.g., type of lens worn, near work and outdoor activities) identified from this study and from the literature. With the higher amounts of myopia found in some of our subjects (22% with > 6.0 D), we also plan to investigate the association of increased progression and axial elongation with intraocular pressure (IOP), central corneal thickness (CCT), and macular thickness. These results will help to identify individuals with increased risk of myopia-related pathology as well as help guide the selection and timing of interventions, including vision correction surgery. By studying this cohort for an additional 5 years, this application seeks to accomplish the following aims. Aim 1: To use the Gompertz and other functions to characterize the course of myopia in the 58% of the COSMICC cohort with progressing myopia and to develop predictive models based on previously identified, intrinsic risk factors (age, ethnicity, and parental myopia). Aim 2: To test hypotheses related to environmental risk factors (e.g., type of lens worn, near work and outdoor activities) for myopia progression and stabilization in this well-characterized cohort of myopes. Aim 3: To test hypotheses related to the association of IOP, CCT, and macular thickness with changes in axial elongation and myopia progression in COSMICC subjects. This application is for the COSMICC2 Study Chair. Separate applications have been submitted by the 4 clinical centers and the Coodinating Center.