A longitudinal analysis of myopia progression and its predictors in a Ghanaian clinical cohort

Objective To investigate the rate of myopia progression among a clinical cohort in Ghana. Methods A retrospective analysis was conducted using electronic medical records (EMRs) of all patients attending a tertiary eye care center in Ghana. Annual refractive data were extracted from January 2021 to December 2023. Myopia was defined as a spherical equivalent refraction (SER) of ≤ −0.50 D in at least one eye. Myopia progression was assessed by calculating the annual change in SER between visits, with progression defined as an SER change of ≤ −0.50 D/year. Given the moderate inter-eye correlation in progression rates, both eyes were analyzed independently. Results Of the 4,010 EMRs reviewed during the study period, 280 patients with myopia were identified. After applying the eligibility criteria, 231 patient records were included in the final analysis. The mean age of participants was 29.41 ± 14.92 years (range: 5–81 years), and the majority were female (60.6%; n = 140). The mean rate of myopia progression was −0.063 D/year in the right eye and −0.089 D/year in the left eye. Using a progression threshold of ≤ −0.50 D/year in at least one eye, 17.7% of participants were classified as progressors, while 82.3% were non-progressors. In multivariable regression analyses adjusted for sex, age remained a significant predictor of myopia progression in our cohort (B = -0.043, SE = 0.014, p = 0.001; AOR = 0.958, 95% CI: 0.933–0.983). Conclusion In this clinical cohort, myopia progression was generally slow, with fewer than one in five patients meeting the criteria for significant progression. Older age was independently associated with a lower risk of progression, whereas sex showed no significant association. These findings indicate that myopia progression in this predominantly adult Ghanaian population is relatively modest compared with rates reported in younger populations, and identify age as a key determinant of progression in routine clinical care.