Myopia management has evolved significantly, and among the advancements, measuring axial length has become a cornerstone for accurately assessing and managing myopia progression. Axial length is the measurement from the anterior surface of the cornea to the retinal pigment epithelium. Here’s why focusing on axial length is essential for understanding and addressing myopia:
1. Provides Objective Repeatability and Reliability
- Axial length (AL) measurements offer superior repeatability and reliability compared to traditional refractive error assessments. Optical biometers like the Topcon MYAH® deliver consistent and accurate readings, enabling precise tracking of even minor changes in axial length. Overall, non-contact optical biometers offer exceptional resolution (∼0.012 mm) and precision (∼0.01 mm), which adds to their reliability. Unlike subjective refractive error measurements that can be influenced by examiner technique and patient variability, axial length provides a more stable and objective measure. This stability is especially valuable in cases where discrepancies between refractive error and axial length might occur, such as in eyes with significant myopia but normal axial length. Focusing on axial length allows practitioners to gain a clearer, more accurate view of myopia progression, making it an essential component of effective myopia management.
2. Predicts Risk for Myopia
- Axial length screening plays a vital role in identifying the early signs of myopia development. Often, increased axial elongation occurs before noticeable changes in myopia are observed, enabling timely intervention to prevent significant progression. Early detection allows for the implementation of preventative measures, such as lifestyle changes or early treatment, which can help slow myopia’s advancement and reduce long-term risks. Additionally, comparing individual axial length measurements against normative growth curves which account for gender and ethnicity, helps practitioners assess the likelihood of myopia progression and associated risks.
3. Aids in Prescribing Personalized Interventions
- Understanding axial length is essential for assessing individual myopia risk and tailoring treatment plans accordingly. Axial elongation is a primary risk factor for developing ocular diseases associated with progressive myopia. By measuring axial length, practitioners can evaluate the risk profile of each child, allowing for customized treatment decisions. This personalized approach includes determining the optimal timing for starting treatment, selecting appropriate interventions, and scheduling follow-up monitoring. Individualized strategies enhance treatment outcomes and ensure more effective management of myopia.
4. Effectively Monitor Treatment Efficacy
- Monitoring axial length provides a precise evaluation of both myopia progression and treatment effectiveness. This is particularly important for interventions like orthokeratology (Ortho-K) lenses, which work by flattening the cornea to temporarily correct refractive error. Since Ortho-K lenses alter corneal shape, refractive error assessments alone may not accurately reflect myopia progression. Axial length measurements, however, directly capture changes in eye structure, providing a clear indication of whether interventions are effectively slowing myopia progression or if adjustments are needed.
5. Enhances Patient Education
- Axial length data is invaluable for educating parents about their child’s myopia risks and treatment options. Tools like the MYAH’s Parental Summary report are particularly useful in this regard. This report visually tracks the progression of axial length over time, providing clear, accessible evidence of how myopia is evolving and how various interventions may be impacting progression. By presenting this data, practitioners can effectively illustrate the importance of different treatments and their outcomes. This visual representation is pivotal for helping parents understand their child’s myopia management better and can lead to improved adherence to recommended strategies and ultimately, better outcomes in managing and treating myopia.
Summary
Measuring axial length offers a repeatable, reliable, and insightful approach to managing myopia. By leveraging this key metric, eye care practitioners can enhance diagnostic accuracy, personalize treatment plans, monitor effectiveness, and improve patient education, ultimately leading to more comprehensive and successful management of myopia.
