{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:25:25Z","timestamp":1787318725994,"version":"build-2736575974"},"reference-count":30,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Program of Shanghai Municipal Health Commission","award":["202340065"],"award-info":[{"award-number":["202340065"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82273648"],"award-info":[{"award-number":["82273648"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Public Health Outstanding Talent of Shanghai Municipal Health and Health Commission","award":["GWVI-11.2-YQ27"],"award-info":[{"award-number":["GWVI-11.2-YQ27"]}]},{"name":"Key R&D Program of Ministry of Science and Technology","award":["2021YFC2702100"],"award-info":[{"award-number":["2021YFC2702100"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2025,10,26]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To investigate the prevalence and severity of adult myopia progression among highly myopic individuals aged 18\u201325 years, identify its associated factors and evaluate its association with pathologic myopia (PM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively included participants aged 18\u201325 years with consecutive follow-ups from the Shanghai Child and Adolescent Large-scale Eye Study database. Annual changes of cycloplegic spherical equivalent (\u0394SE) and axial length (\u0394AL) were calculated. Adult myopia progression is defined as \u0394SE \u2264\u22120.50 D\/year or \u0394AL\u22650.10\u2009mm\/year. PM was diagnosed based on META-Analysis for Pathologic Myopia criteria (category\u22652) and optical coherence tomography (OCT) images.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among all included 345 eyes, the mean \u0394SE was \u22120.28 D\/year (95%\u2009CI \u22120.31 to \u22120.20; p&lt;0.001) and 64 (18.6%) were classified as having adult myopia progression. The mean \u0394AL was 0.09\u2009mm\/year (95%\u2009CI 0.09 to 0.10; p&lt;0.001), with axial elongation observed in 138 (40.0%) eyes. Both age (\u0394SE: \u03b2=0.045, p=0.005; \u0394AL: \u03b2=\u22120.015, p&lt;0.001) and baseline AL (\u0394SE: \u03b2=\u22120.044, p=0.028; \u0394AL: \u03b2=0.020, p&lt;0.001) were identified as factors associated with \u0394SE and \u0394AL. No differences in \u0394SE (95%\u2009CI \u20130.08 to 0.11; p=0.759) or \u0394AL (95%\u2009CI \u20130.04 to 0.01; p=0.190) were found between PM and non-PM groups, and neither metric improved PM discrimination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among high myopic individuals aged 18\u201325 years, 18.6% exhibited adult myopia progression and 40.0% showed axial elongation. Age and baseline AL were associated with adult myopia progression, but no clear link was found between adult myopia progression and the development of PM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjo-2025-328046","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T18:20:20Z","timestamp":1763403620000},"page":"684-690","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Adult myopia progression in high myopes aged 18\u201325 years: evidence from a population-based cohort"],"prefix":"10.1136","volume":"110","clinical-trial-number":[{"clinical-trial-number":"nct03666052","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Haotian","family":"Wu","sequence":"first","affiliation":[{"name":"Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China"},{"name":"Ophthalmology, Shanghai General Hospital, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zihan","family":"Ni","sequence":"additional","affiliation":[{"name":"Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3611-8778","authenticated-orcid":false,"given":"Ziyi","family":"Qi","sequence":"additional","affiliation":[{"name":"Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China"},{"name":"Ophthalmology, Shanghai General Hospital, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianyu","family":"Cheng","sequence":"additional","affiliation":[{"name":"Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7359-911X","authenticated-orcid":false,"given":"Tianwei","family":"Qian","sequence":"additional","affiliation":[{"name":"Ophthalmology, Shanghai General Hospital, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3493-5699","authenticated-orcid":false,"given":"Lingyi","family":"Zhao","sequence":"additional","affiliation":[{"name":"Ophthalmology, Shanghai General Hospital, Shanghai, China"},{"name":"Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanjiao","family":"Wang","sequence":"additional","affiliation":[{"name":"Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinliuxing","family":"Yang","sequence":"additional","affiliation":[{"name":"Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2279-9514","authenticated-orcid":false,"given":"Jingjing","family":"Wang","sequence":"additional","affiliation":[{"name":"Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Zhang","sequence":"additional","affiliation":[{"name":"Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4246-4343","authenticated-orcid":false,"given":"Xun","family":"Xu","sequence":"additional","affiliation":[{"name":"Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China"},{"name":"Ophthalmology, Shanghai General Hospital, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8938-1879","authenticated-orcid":false,"given":"Xiangui","family":"He","sequence":"additional","affiliation":[{"name":"Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China"},{"name":"Ophthalmology, Shanghai General Hospital, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,11,17]]},"reference":[{"key":"2026052002050976000_110.6.684.1","doi-asserted-by":"crossref","first-page":"Mi","DOI":"10.1167\/iovs.18-25983","article-title":"Myopia - 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