{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:18:16Z","timestamp":1787026696970,"version":"build-2736575974"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T00:00:00Z","timestamp":1717113600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Myopia is a major global health issue, especially among children and adolescents. Understanding its traits and progression is vital for proper management and prevention. This study aimed to fill a gap in research by analyzing demographic and refractive data concerning myopia among children and adolescents in Croatia, with the goal of providing insights into myopia prevalence, progression rates, and associated risk factors within the Croatian population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This retrospective study utilized a comprehensive dataset from pediatric ophthalmology clinics at the University Eye Department, University Hospital \u201cSveti Duh,\u201d Zagreb, Croatia. The dataset included electronic medical records spanning from January 2008 to July 2023, encompassing demographic and refractive data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data analysis focused on individuals aged 4 to 18\u2009years who were diagnosed with primary myopia and\/or compound myopic astigmatism. Ophthalmic examinations, including visual acuity tests, cycloplegic refraction, and assessments for eye comorbidities, were conducted by experienced pediatric ophthalmologists. Statistical analysis, including t-tests, survival analysis, and logistic regression, was performed to assess myopia prevalence, progression rates, and associated factors. These analyses were adjusted for covariates such as age, parental myopia, and gender.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study included 895 individuals, 51 premyopes, 813 low myopes, and 31 high myopes. The average age of diagnosis was 11.37\u2009\u00b1\u20093.59\u2009years for premyopes, 11.18\u2009\u00b1\u20093.53\u2009years for low myopes, and 11.44\u2009\u00b1\u20094.35\u2009years for high myopes. The fastest progression occurred in 2021 and 2022, \u22120.5\u2009\u00b1\u20090.12 D\/y for premyopes and\u2009\u2212\u20090.45\u2009\u00b1\u20090.1 D\/y for low myopes. Premyopic progression to low myopia was associated with age 7\u20139\u2009years (HR 2.42, 1.53 to 3.21) and both parents being myopic (HR 920.27. 850.16 to 950.53). Low myopic individuals with both myopic parents displayed the fastest 11\u201324\u2009months after first visit progression rates, \u22120.69 (\u22120.52 to \u22120.87) D\/y, while the 7\u20139 age group demonstrated \u22120.36 (\u22120.24 to \u22120.45) D\/y. Low myopes aged 7\u20139\u2009years with baseline SE between \u22126 D and\u2009\u22124 D were more strongly associated with \u2264\u2009\u2212\u20090.5 D progression (OR\u2009=\u20092.0, 95% CI \u22121.00 to 2.39).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study highlights the importance of environmental factors, genetics, and age in addressing myopia progression among Croatian youth, urging further research for effective local intervention strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2024.1405743","type":"journal-article","created":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T00:55:16Z","timestamp":1717116916000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["The CroMyop study: myopia progression in Croatian children and adolescents\u2014a 15-year retrospective analysis"],"prefix":"10.3389","volume":"11","author":[{"given":"Ana Maria","family":"Varo\u0161anec","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leon","family":"Markovi\u0107","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zdenko","family":"Sonicki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,5,31]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1008858","DOI":"10.3389\/fpubh.2022.1008858","article-title":"Editorial: myopia: public health challenges and interventions","volume":"10","author":"Iribarren","year":"2022","journal-title":"Front Public Health"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.1016\/j.ophtha.2016.01.006","article-title":"Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050","volume":"123","author":"Holden","year":"2016","journal-title":"Ophthalmology"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"6270","DOI":"10.1167\/iovs.10-5528","article-title":"Ethnic differences in the prevalence of myopia and ocular biometry in 10- and 11-year-old children: the child heart and health study in England (CHASE)","volume":"51","author":"Rudnicka","year":"2010","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref4","year":""},{"key":"ref5","first-page":"5","article-title":"High myopia and its risks","volume":"32","author":"Williams","year":"2019","journal-title":"Community Eye Health"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1167\/iovs.61.4.49","article-title":"The complications of myopia: A review and Meta-analysis","volume":"61","author":"Haarman","year":"2020","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1276","DOI":"10.1111\/opo.13022","article-title":"Systematic review and meta-analysis on the agreement of non-cycloplegic and cycloplegic refraction in children","volume":"42","author":"Wilson","year":"2022","journal-title":"Ophthalmic Physiol Opt"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"CD004916","DOI":"10.1002\/14651858.CD004916.pub3","article-title":"Interventions to slow progression of myopia in children","volume":"12","author":"Walline","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"M20","DOI":"10.1167\/iovs.18-25957","article-title":"IMI \u2013 defining and classifying myopia: A proposed set of standards for clinical and epidemiologic studies","volume":"60","author":"Flitcroft","year":"2019","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1111\/opo.12305","article-title":"Age of onset of myopia predicts risk of high myopia in later childhood in myopic Singapore children","volume":"36","author":"Chua","year":"2016","journal-title":"Ophthalmic Physiol Opt"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"7871","DOI":"10.1167\/iovs.13-12403","article-title":"Myopia stabilization and associated factors among participants in the correction of myopia evaluation trial (comet)","volume":"54","author":"Hyman","year":"2013","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1097\/OPX.0b013e3182357f79","article-title":"Myopia progression rates in urban children wearing single-vision spectacles","volume":"89","author":"Donovan","year":"2012","journal-title":"Optom Vis Sci"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"562","DOI":"10.1167\/iovs.06-0408","article-title":"Role of parental myopia in the progression of myopia and its interaction with treatment in comet children","volume":"48","author":"Kurtz","year":"2007","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1104","DOI":"10.1136\/bjophthalmol-2020-318256","article-title":"Progression of myopia in children and teenagers: a nationwide longitudinal study","volume":"106","author":"Tricard","year":"2022","journal-title":"Br J Ophthalmol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1097\/00006324-200401000-00004","article-title":"Community-based study of the association of high myopia in children with ocular and systemic disease","volume":"81","author":"LOGAN","year":"2004","journal-title":"Optom Vis Sci"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"924566","DOI":"10.3389\/fpubh.2022.924566","article-title":"Prevalence of myopia: A large-scale population-based study among children and adolescents in Weifang, China","volume":"10","author":"Zhang","year":"2022","journal-title":"Front Public Health"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1186\/s12886-021-02071-6","article-title":"Prevalence of myopia in 3-14-year-old Chinese children: a school-based cross-sectional study in Chengdu","volume":"21","author":"Wang","year":"2021","journal-title":"BMC Ophthalmol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"2813","DOI":"10.1007\/s00417-021-05305-x","article-title":"Progression of myopia in a natural cohort of Chinese children during COVID-19 pandemic","volume":"259","author":"Ma","year":"2021","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1196","DOI":"10.1097\/OPX.0b013e3182640996","article-title":"Myopia progression in Chinese children is slower in summer than in winter","volume":"89","author":"Donovan","year":"2012","journal-title":"Optom Vis Sci"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"855","DOI":"10.3238\/arztebl.2020.0855","article-title":"Prevalence and time trends in myopia among children and adolescents","volume":"117","author":"Schuster","year":"2020","journal-title":"Dtsch Arztebl Int"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"853293","DOI":"10.3389\/fmed.2022.853293","article-title":"Complex interplay between COVID-19 lockdown and myopic progression","volume":"9","author":"Cai","year":"2022","journal-title":"Front Med (Lausanne)"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1772","DOI":"10.1136\/bjophthalmol-2021-319307","article-title":"Myopia incidence and lifestyle changes among school children during the COVID-19 pandemic: A population-based prospective study","volume":"106","author":"Zhang","year":"2021","journal-title":"Br J Ophthalmol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1001\/jamaophthalmol.2020.6239","article-title":"Progression of myopia in school-aged children after COVID-19 home confinement","volume":"139","author":"Wang","year":"2021","journal-title":"JAMA Ophthalmol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1652","DOI":"10.1016\/j.ophtha.2021.04.001","article-title":"COVID-19 quarantine reveals that behavioral changes have an effect on myopia progression","volume":"128","author":"Xu","year":"2021","journal-title":"Ophthalmology"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1111\/opo.13112","article-title":"Worsening vision at age 4-5 in England post-COVID: evidence from a large database of vision screening data","volume":"43","author":"Shah","year":"2023","journal-title":"Ophthalmic Physiol Opt"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"65.e1","DOI":"10.1016\/j.jaapos.2021.11.014","article-title":"Rapid progression of myopia at onset during home confinement","volume":"26","author":"Picotti","year":"2022","journal-title":"JAAPOS"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"5347","DOI":"10.3390\/ijerph18105347","article-title":"Impact of COVID-19 home confinement in Children's refractive errors","volume":"18","author":"Alvarez-Peregrina","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"e0279020","DOI":"10.1371\/journal.pone.0279020","article-title":"Myopic axial elongation in school children and the Covid-19 lockdown in Russia: the ural children myopia study","volume":"18","author":"Bikbov","year":"2023","journal-title":"PLoS One"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"186","DOI":"10.31348\/2023\/24","article-title":"The prevalence of myopia in school-age children in SLOVAKIA and the COVID-19 pandemic","volume":"79","author":"Pr\u0161ova","year":"2023","journal-title":"Cesk Slov Oftalmol"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1569","DOI":"10.3390\/life13071569","article-title":"Analysis of refractive errors in a large Italian cohort of pediatric subjects post the COVID-19 pandemic","volume":"13","author":"Lanza","year":"2023","journal-title":"Life (Basel)"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1097\/OPX.0000000000002055","article-title":"Refractive error changes due to COVID-19 pandemic confinement in children from Puerto Rico: A retrospective study","volume":"100","author":"Rodriguez","year":"2023","journal-title":"Optom Vis Sci"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"835449","DOI":"10.3389\/fpubh.2022.835449","article-title":"Pediatric myopia progression during the COVID-19 pandemic home quarantine and the risk factors: A systematic review and meta-analysis","volume":"10","author":"Yang","year":"2022","journal-title":"Front Public Health"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"510","DOI":"10.1111\/aos.13964","article-title":"Risk factors for high myopia: a 22-year follow-up study from childhood to adulthood","volume":"97","author":"Parssinen","year":"2019","journal-title":"Acta Ophthalmol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"921","DOI":"10.1038\/s41433-021-01805-6","article-title":"Myopia prediction: a systematic review","volume":"36","author":"Han","year":"2022","journal-title":"Eye (Lond)"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"3366","DOI":"10.4103\/ijo.IJO_653_22","article-title":"Correlation of parental and childhood myopia in children aged 5-16 years in North India","volume":"70","author":"Rathi","year":"2022","journal-title":"Indian J Ophthalmol"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"3524","DOI":"10.1167\/iovs.06-1118","article-title":"Parental history of myopia, sports and outdoor activities, and future myopia","volume":"48","author":"Jones","year":"2007","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1186\/s12886-022-02471-2","article-title":"Myopia in Bulgarian school children: prevalence, risk factors, and health care coverage","volume":"22","author":"Dragomirova","year":"2022","journal-title":"BMC Ophthalmol"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"M132","DOI":"10.1167\/iovs.18-25955","article-title":"IMI \u2013 clinical myopia control trials and instrumentation report","volume":"60","author":"Wolffsohn","year":"2019","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1038\/s41588-020-0599-0","article-title":"Meta-analysis of 542,934 subjects of European ancestry identifies new genes and mechanisms predisposing to refractive error and myopia","volume":"52","author":"Hysi","year":"2020","journal-title":"Nat Genet"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1167\/iovs.04-0565","article-title":"Incidence and progression of myopia in Singaporean school children","volume":"46","author":"Saw","year":"2005","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"1112","DOI":"10.1136\/bjophthalmol-2018-312573","article-title":"Refractive error and visual impairment in Ireland schoolchildren","volume":"103","author":"Harrington","year":"2019","journal-title":"Br J Ophthalmol"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1097\/00006324-198707000-00002","article-title":"Houston myopia control study: a randomized clinical trial. Part II. Final report by the patient care team","volume":"64","author":"Grosvenor","year":"1987","journal-title":"Am J Optom Physiol Opt"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1016\/j.optom.2019.06.002","article-title":"Myopia and its progression in children in London, UK: a retrospective evaluation","volume":"13","author":"Wong","year":"2020","journal-title":"J Optom"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1167\/iovs.62.10.36","article-title":"Myopia progression as a function of sex, age, and ethnicity","volume":"62","author":"Jones-Jordan","year":"2021","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"1499","DOI":"10.1016\/j.jfo.2021.07.005","article-title":"Myopia progression and axial elongation in Spanish children: efficacy of atropine 0.01% eye-drops","volume":"44","author":"Moriche-Carretero","year":"2021","journal-title":"J Fr Ophtalmol"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"e0241759","DOI":"10.1371\/journal.pone.0241759","article-title":"Myopia progression varies with age and severity of myopia","volume":"15","author":"Verkicharla","year":"2020","journal-title":"PLoS One"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1405743\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,19]],"date-time":"2024-07-19T06:31:18Z","timestamp":1721370678000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1405743\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,31]]},"references-count":46,"alternative-id":["10.3389\/fmed.2024.1405743"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2024.1405743","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,31]]},"article-number":"1405743"}}