The Onset and Progression of Myopia Slows in Chinese 15-Year-Old Adolescents Following Vocational Rather Than Academic School Pathways

PURPOSE.The purpose of this study was to investigate the changes in spherical equivalent(SE) and axial length (AL) and cumulative incidence of myopia and high myopia inChinese 15-year-old adolescents entering a non-academic stream of senior high schooleducation. METHODS.A total of 880 first-born twins with a baseline age range of 7 to 15 years wereenrolled and followed annually until 18 years of age. Cycloplegic refractions and ALwere examined. Educational exposure was divided into academic high school (AHS) andvocational high school (VHS) streams. A piecewise linear mixed-effects model was usedto estimate the effect of education exposures on SE development, the slope before theage of 15 years (beta(2)), and the slope change at the age of 15 years (beta(3)) was comparedbetween the 2 groups. RESULTS.The curves of refractive development in a myopic direction changed in parallelin the AHS and VHS group before 15 years. For nonmyopic children,beta(2)was-0.19 and-0.20 diopters (D)/year (P=0.270), and beta 3was 0.16 and 0.14 D/year (P=0.270), inthe AHS and VHS groups, respectively. Among patients with myopia,beta(2)was-0.52 and-0.54 D/year (P=0.500), and beta(3)was 0.37 and 0.32 D/year (P=0.004), in the AHS andVHS groups, respectively. The trends in AL were similar. The 3-year cumulative incidenceof myopia was 35.3% (AHS) versus 14.7% (VHS;P<0.001), and that of high myopia was5.7% and 3.3% (P=0.129). CONCLUSIONS.Students undertaking a VHS rather than an AHS education have slowermyopic shifts in refraction and less incident myopia after the age of 15 years.