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Zhu S, Song Y, Yang B, Wang X, Ma W, Dong G, Liu L. The relationship between accommodative and binocular function with myopia progression in myopic children undergoing orthokeratology. Cont Lens Anterior Eye 2024; 47:102171. [PMID: 38631934 DOI: 10.1016/j.clae.2024.102171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 04/11/2024] [Accepted: 04/11/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE To determine the relationship between changes in accommodative and binocular function with myopia progression in myopic children over a two-year follow-up period, and to determine when changes in visual functions stabilized after switching from spectacles to orthokeratology (Ortho-K). METHODS This prospective, self-controlled study followed thirty-six participants (aged 8-14 years) for two years after they switched from spectacles to Ortho-K. Accommodative and binocular function were assessed prior to and 1, 3, 6, 12, 18 and 24 months after commencing Ortho-K. Measurements included accommodative amplitude, accommodative response, accommodative facility, accommodative convergence/accommodation (AC/A), ocular alignment, positive relative accommodation (PRA), negative relative accommodation (NRA), horizontal vergence range, reading ability and stereoacuity. Myopia progression was quantified by the change in axial length. RESULTS Ocular alignment, monocular and binocular accommodative facility, and PRA stabilized after 1 month. The distance blur point in the convergence range, the distance break and recovery point in the divergence range, accommodative amplitude, calculated AC/A, stereoacuity and reading ability stabilized within 6 months. After two years of Ortho-K, NRA significantly increased (p = 0.044), while it showed no significant difference after one-year of lens wear (p = 0.49). The distance break point in the convergence range showed no significant difference (p = 0.20), but significantly decreased after one-year (p = 0.005). There were no significant correlations between the change in axial length with changes in accommodative or binocular function (p > 0.05). CONCLUSION Accommodative and binocular function changed significantly after switching from spectacles to Ortho-K and most of the parameters stabilized within the first 6 months. There was no association between the change in accommodative or binocular function and myopia progression.
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Affiliation(s)
- Shenlin Zhu
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China; Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Yutong Song
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China; Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Bi Yang
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China; Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Xue Wang
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China; Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Ma
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China; Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Guangjing Dong
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China; Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Longqian Liu
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China; Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, China.
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Sun Y, Peng Z, Zhao B, Hong J, Ma N, Li Y, Tang S, Xu Q, Hong H, Wang K, Fu J, Wei WB. Comparison of trial lens and computer-aided fitting in orthokeratology: A multi-center, randomized, examiner-masked, controlled study. Cont Lens Anterior Eye 2024:102172. [PMID: 38806329 DOI: 10.1016/j.clae.2024.102172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 04/16/2024] [Accepted: 04/18/2024] [Indexed: 05/30/2024]
Abstract
PURPOSE To compare the efficacy and safety between traditional lens fitting and computer-aided fitting methods for orthokeratology (OrthoK) in the Chinese population. METHODS A multi-center, examiner-masked, randomized controlled study was conducted with a one-year follow-up period, enrolling 280 participants with spherical equivalent (SE) ranging from -0.5D to -4.0D. Participants were assigned to either the computer-aided orthokeratology fitting group (trial group) or the traditional lens fitting group (control group) using stratified randomization based on age (8 to 13 years, 13 to 18 years, and ≥ 18 years) to ensure a minimum of 30 cases in each sub-age group. Ocular examinations included visual acuity, objective and subjective refraction, corneal endothelial cell density, corneal topography, intraocular pressure, axial length, and ocular health assessment. Successful lens-correction was defined as the residual refraction with the OK lens, which should not exceed ± 0.5D, and/or an uncorrected visual acuity of no worse than 0.1 logMAR. Statistical analysis involves t-tests, analysis of variance, and Chi-squared tests. RESULTS 215 subjects were included in the statistical analysis (109 in the trial group and 106 in the control group). In both groups, compared to baseline data, the uncorrected visual acuity (UCVA) improved significantly, with SE reduced and central corneal curvature flattened greatly after wearing OrthoK lens (P < 0.05 for all). Compared to the control group, the trial group exhibited a higher successful rate in correcting UCVA (93.6 % vs. 84.0 %, P = 0.03) and slightly better correction in refraction (77.1 % vs. 66.0 %, P = 0.07) at 1-month follow-up. However, no significant differences were observed in the axial length elongation, corneal changes, or the incidence of adverse events between the two groups. CONCLUSION These findings indicate the higher efficiency and slightly better performance in correcting myopia and improving UCVA of computer-aided lens fitting approach compared to the traditional one, but similar outcomes in controlling axial elongation.
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Affiliation(s)
- Yunyun Sun
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Zisu Peng
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China; Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China; College of Optometry, Peking University Health Science Center, Beijing, China; Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Bowen Zhao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Jie Hong
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Nan Ma
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Yan Li
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China; Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China; College of Optometry, Peking University Health Science Center, Beijing, China; Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Simeng Tang
- Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing, China
| | - Qiong Xu
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China; Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China; College of Optometry, Peking University Health Science Center, Beijing, China; Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Hui Hong
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Kai Wang
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China; Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China; College of Optometry, Peking University Health Science Center, Beijing, China; Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China.
| | - Jing Fu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China.
| | - Wen-Bin Wei
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China; Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing, China.
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Chen Y, Gu VY, Xu Y, Ye B, Kang X, Li B. Bilateral axial length growth patterns of myopic anisometropes undergoing sequential monocular to binocular orthokeratology treatment. Cont Lens Anterior Eye 2024:102192. [PMID: 38806328 DOI: 10.1016/j.clae.2024.102192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 04/04/2024] [Accepted: 05/22/2024] [Indexed: 05/30/2024]
Abstract
PURPOSE To investigate bilateral axial length (AL) growth patterns and interactions of myopic eyes in anisometropic children during unilateral orthokeratology (OK) treatment in their singularly myopic eyes (Eyes1), followed by bilateral treatment when their second eyes (Eyes2) developed myopia. METHODS This study enrolled 94 eyes from 47 anisometropes (20 males). All patients had undergone monocular OK treatment for > 1 year followed by binocular treatment for > 1 year. Axial growth of Eyes1 and Eyes2 during the first year of monocular treatment (Stage 1), average annual axial elongation during the monocular treatment period, and axial elongation during the first year of binocular treatment (Stage 2) were respectively termed: S1E1 and S1E2, Annual E1 and Annual E2, and S2E1 and S2E2. Associations between AL growth and age, sex, interval time, and ocular parameters were analysed using correlation and generalised estimating equation (GEE) analysis. RESULTS During the monocular period, Eyes1 showed less AL growth (S1E1: 0.05 ± 0.18 mm; Annual E1: 0.05 ± 0.21 mm) than Eyes2 (S1E2: 0.51 ± 0.24 mm; Annual E2: 0.52 ± 0.25 mm) (all p < 0.001). During the binocular period, there was no significant difference between S2E1 and S2E2(0.21 ± 0.14 mm v. 0.19 ± 0.17 mm, p = 0.951). Between monocular and binocular periods, Eyes1 had significantly higher S2E1 compared to S1E1 and Annual E1 (both p < 0.001), and Eyes2 had significantly lower S2E2 than S1E2 and Annual E2 (both p < 0.001). In the GEE model, spherical equivalent refraction (SER) and between periods interval time showed independently significant associations with AL growth after adjusting for age and sex. CONCLUSION Orthokeratology can significantly control AL growth in unilateral myopia. AL growth of the initial myopic OK-treated eyes accelerated relative to the monocular period when contralateral eyes developed myopia and assumed OK treatment. During the binocular treatment phase, OK lenses showed moderate and comparable effects on AL retardation across both eyes.
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Affiliation(s)
- Yiye Chen
- Department of Ophthalmology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Victoria Y Gu
- Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
| | - Yangyang Xu
- Department of Ophthalmology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Ye
- Department of Ophthalmology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoli Kang
- Department of Ophthalmology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Bin Li
- Department of Ophthalmology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Pattan HF, Liu X, Tankam P. In vivo assessment of human corneal epithelial cells in orthokeratology lens wearers: A pilot study. Optom Vis Sci 2024; 101:263-271. [PMID: 38683973 DOI: 10.1097/opx.0000000000002130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024] Open
Abstract
SIGNIFICANCE Central corneal epithelial thinning associated with midperipheral epithelial thickening has been reported as the main factor contributing to the effectiveness of orthokeratology (ortho-k) in myopia control. Yet, the cellular mechanism governing the regional change in refractive power remains elusive. PURPOSE This study aimed to evaluate the correlation between the regional change in corneal epithelial thickness and cell density in ortho-k wearers. METHODS A new human prototype of a polarization-dependent optical coherence microscope was developed to enable noncontact and noninvasive in vivo imaging of corneal epithelial cells in ortho-k wearers with and without their ortho-k lens. The epithelial thickness and cell density were evaluated at the central and midperipheral corneal locations in four ortho-k wearers and four spectacle wearers serving as controls. RESULTS Polarization-dependent optical coherence microscope achieved in vivo volumetric imaging of all epithelial cell types in ortho-k wearers with and without their lens over a field of view of 0.5 × 0.5 mm 2 with an isotropic resolution of ~2.2 mm. The central epithelial thinning and midperipheral epithelial thickening were consistent across all ortho-k wearers. However, the inconsistency in their regional epithelial cell density highlighted a great variability in individual response to ortho-k treatment. There was no strong correlation between epithelial thickness and cell density, especially at the midperipheral cornea, in ortho-k participants. CONCLUSIONS This study constitutes our first step toward uncovering the cellular mechanism underlying the effectiveness of ortho-k in myopia control. Future studies will focus on the longitudinal evaluation of epithelial cells before and during ortho-k treatment to identify factors governing individual response to ortho-k treatment and ultimately inform the dynamics of epithelial cells taking place during the ortho-k treatment.
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Affiliation(s)
- Hadiya F Pattan
- School of Optometry, Indiana University, Bloomington, Indiana
| | - Xiao Liu
- School of Optometry, Indiana University, Bloomington, Indiana
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Thakur S, Maldoddi R, Vangipuram M, Kalivemula M, Ch SNSH, Karthikesh A, Verkicharla PK. Peripheral Refraction Using Ancillary Retinoscope Component (P-ARC). Transl Vis Sci Technol 2024; 13:7. [PMID: 38568607 PMCID: PMC10996980 DOI: 10.1167/tvst.13.4.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 02/19/2024] [Indexed: 04/05/2024] Open
Abstract
Purpose To assess the agreement of retinoscope-based peripheral refraction techniques with the criterion standard open-field autorefractor. Methods Fifty young adults (mean age, 24 ± 3 years) participated in this study. Two masked, experienced senior examiners carried out central refraction and peripheral refraction at the temporal 22° (T22°) and nasal 22° (N22°) eccentricities. Peripheral refraction techniques were (a) peripheral refraction using ancillary retinoscope component (P-ARC), (b) retinoscopy with eye rotation, and (c) open-field autorefractor. Peripheral refraction with retinoscopy values was compared with an open-field autorefractor (Shinn Nippon NVision-K) to assess the agreement. All measurements were taken from the right eye under noncycloplegic conditions. Results The mean difference ±95% limits of agreement of peripheral refraction values obtained using P-ARC from T22° (+0.11 diopters [D] ± 1.20 D; P = 0.20) or N22° (+0.13 D ± 1.16 D; P = 0.13) were comparable with open-field autorefractor. The eye rotation technique compared to autorefractor showed a significant difference for T22° (+0.30 D ± 1.26 D; P = 0.002); however, there was an agreement for N22° (+0.14 D ± 1.16 D; P = 0.10). With respect to the identification of peripheral refraction patterns, examiners were able to identify relative peripheral hyperopia in most of the participants (77%). Conclusions Peripheral refraction with P-ARC was comparable with open-field autorefractor at T22° and N22° eccentricities. Peripheral retinoscopy techniques can be another approache for estimating and identifying peripheral refraction and its patterns in a regular clinical setting. Translational Relevance Retinoscope with P-ARC has high potential to guide and enable eye care practitioners to perform peripheral refraction and identify peripheral refraction patterns for effective myopia management.
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Affiliation(s)
- Swapnil Thakur
- Myopia Research Lab - Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, LV Prasad Eye Institute, Hyderabad, India
| | - Rakesh Maldoddi
- Myopia Research Lab - Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, LV Prasad Eye Institute, Hyderabad, India
| | - Manogna Vangipuram
- Center for Technology Innovation, LV Prasad Eye Institute, Hyderabad, India
| | - Manasa Kalivemula
- Center for Technology Innovation, LV Prasad Eye Institute, Hyderabad, India
| | | | - Anche Karthikesh
- Center for Technology Innovation, LV Prasad Eye Institute, Hyderabad, India
| | - Pavan K Verkicharla
- Myopia Research Lab - Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, LV Prasad Eye Institute, Hyderabad, India
- Infor Myopia Centre (prevention & control), LV Prasad Eye Institute, Hyderabad, India
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Yamasaki K, Dantam J, Sasanuma K, Hisamura R, Mizuno Y, Hui A, Jones L. Impact of in vitro lens deposition and removal on bacterial adhesion to orthokeratology contact lenses. Cont Lens Anterior Eye 2024; 47:102104. [PMID: 38161140 DOI: 10.1016/j.clae.2023.102104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/22/2023] [Accepted: 12/11/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE The purpose of this study was to explore the impact of several contact lens (CL) care solutions on the removal of proteins and lipids, and how deposit removal impacts bacterial adhesion and solution disinfection. METHODS Lysozyme and lipid deposition on three ortho-k (rigid) and two soft CL materials were evaluated using an ELISA kit and gas chromatography respectively. Bacterial adhesion to a fluorosilicone acrylate material using Pseudomonas aeruginosa with various compositions of artificial tear solutions (ATS), including with denatured proteins, was also investigated. The impact of deposition of the different formulations of ATS on biofilm formation was explored using cover slips. Finally, the lysozyme and lipid cleaning efficacy and disinfection efficacy against P. aeruginosa and Staphylococcus aureus of four different contact lens care solutions were studied using qualitative analysis. RESULTS While maximum lysozyme deposition was observed with the fluorosilicone acrylate material (327.25 ± 54.25 µg/lens), the highest amount of lipid deposition was recorded with a fluoro-siloxanyl styrene material (134.71 ± 19.87 µg/lens). Adhesion of P. aeruginosa to fluorosilicone acrylate lenses and biofilm formation on cover slips were significantly greater with the addition of denatured proteins and lipids. Of the four contact lens care solutions investigated, the solution based on povidone-iodine removed both denatured lysozyme and lipid deposits and could effectively disinfect against P. aeruginosa and S. aureus when contaminated with denatured proteins and lipids. In contrast, the peroxide-based solution was able to inhibit P. aeruginosa growth only, while the two multipurpose solutions were unable to disinfect lenses contaminated with denatured proteins and lipids. CONCLUSION Bacterial adhesion and biofilm formation is influenced by components within artificial tear solutions depositing on lenses, including denatured proteins and lipids, which also affects disinfection. The ability of different solutions to remove these deposits should be considered when selecting systems to clean and disinfect ortho-k lenses.
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Affiliation(s)
| | - Jaya Dantam
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Ontario, Canada
| | | | | | - Yohei Mizuno
- Kobe Research Center, OPHTECS Corporation, Kobe, Japan
| | - Alex Hui
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Ontario, Canada; School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW Sydney, Australia.
| | - Lyndon Jones
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Ontario, Canada; Centre for Eye and Vision Research (CEVR), Hong Kong Special Administrative Region, Hong Kong
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Kim M, Paik JS, Kim D, Hwang HS, Han K, Na KS. Current status of contact lenses usage in Korea: A population-based cohort study 2021. PLoS One 2024; 19:e0296279. [PMID: 38507419 PMCID: PMC10954094 DOI: 10.1371/journal.pone.0296279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 12/09/2023] [Indexed: 03/22/2024] Open
Abstract
PURPOSE To investigate trends in contact lens usage in a nationally representative sample of the Korean population in 2021. METHODS For this retrospective study, we analyzed data of 3,601 Korean participants aged 10-59 years, from the Korea National Health and Nutrition Examination Survey (KNHANES 2021 version), who underwent eye examination, of whom 1,136 individuals (274 men and 862 women) were contact lens users. The demographic trend among Korean contact lens wearers was examined using statistical analyses to investigate the changes in their contact lens-wearing experience, duration of lens use, type of lens used, location of purchase, presence of an Eye Care Practitioner(ECP)'s prescription, lens-related ophthalmic complications, and type of lenses worn at the time of complications, according to sex. Multivariable logistic regression analysis was conducted to examine the association of each variable with the rate of complications and use of soft lenses. RESULTS The average age of the contact lens users was 33.42±0.33 years, with 70.36% (weighted percentage) of users being women who used contact lenses for significantly longer periods than men (p<0.001). Additionally, only wearing of cosmetic lenses was significantly correlated with the occurrence of complications (p = 0.006), and 6.76% of users purchased lenses without a prescription. Multivariate analysis among the contact lens users revealed a significant relationship between the complication rate and female sex (p = 0.002), pre-existing eye disease diagnosed by ECPs (p = 0.0288), and duration of contact lens use (p<0.0001). CONCLUSION We identified sex differences in contact lens usage trends in Korea. The main changes observed were an increase in middle-aged lens users and a decrease in female users compared to that in the early 2000s. In addition, contact lens complications were significantly associated with sex and pre-existing eye disease. Therefore, those wearing contact lenses for extended periods should exercise caution and consult eye care specialists in the presence of any symptoms.
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Affiliation(s)
- Minsun Kim
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ji-Sun Paik
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Daran Kim
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ho Sik Hwang
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Kyung-Sun Na
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Wu LY, Lin WP, Wu R, White L, Abass A. FEA-Based Stress-Strain Barometers as Forecasters for Corneal Refractive Power Change in Orthokeratology. Bioengineering (Basel) 2024; 11:166. [PMID: 38391654 PMCID: PMC10886155 DOI: 10.3390/bioengineering11020166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 02/24/2024] Open
Abstract
PURPOSE To improve the effectivity of patient-specific finite element analysis (FEA) to predict refractive power change (RPC) in rigid Ortho-K contact lens fitting. Novel eyelid boundary detection is introduced to the FEA model to better model the effects of the lid on lens performance, and stress and strain outcomes are investigated to identify the most effective FEA components to use in modelling. METHODS The current study utilises fully anonymised records of 249 eyes, 132 right eyes, and 117 left eyes from subjects aged 14.1 ± 4.0 years on average (range 9 to 38 years), which were selected for secondary analysis processing. A set of custom-built MATLAB codes was built to automate the process from reading Medmont E300 height and distance files to processing and displaying FEA stress and strain outcomes. Measurements from before and after contact lens wear were handled to obtain the corneal surface change in shape and power. Tangential refractive power maps were constructed from which changes in refractive power pre- and post-Ortho-K wear were determined as the refractive power change (RPC). A total of 249 patient-specific FEA with innovative eyelid boundary detection and 3D construction analyses were automatically built and run for every anterior eye and lens combination while the lens was located in its clinically detected position. Maps of four stress components: contact pressure, Mises stress, pressure, and maximum principal stress were created in addition to maximum principal logarithmic strain maps. Stress and strain components were compared to the clinical RPC maps using the two-dimensional (2D) normalised cross-correlation and structural similarity (SSIM) index measure. RESULTS On the one hand, the maximum principal logarithmic strain recorded the highest moderate 2D cross-correlation area of 8.6 ± 10.3%, and contact pressure recorded the lowest area of 6.6 ± 9%. Mises stress recorded the second highest moderate 2D cross-correlation area with 8.3 ± 10.4%. On the other hand, when the SSIM index was used to compare the areas that were most similar to the clinical RPC, maximum principal stress was the most similar, with an average strong similarity percentage area of 26.5 ± 3.3%, and contact pressure was the least strong similarity area of 10.3 ± 7.3%. Regarding the moderate similarity areas, all components were recorded at around 34.4% similarity area except the contact pressure, which was down to 32.7 ± 5.8%. CONCLUSIONS FEA is an increasingly effective tool in being able to predict the refractive outcome of Ortho-K treatment. Its accuracy depends on identifying which clinical and modelling metrics contribute to the most accurate prediction of RPC with minimal ocular complications. In terms of clinical metrics, age, Intra-ocular pressure (IOP), central corneal thickness (CCT), surface topography, lens decentration and the 3D eyelid effect are all important for effective modelling. In terms of FEA components, maximum principal stress was found to be the best FEA barometer that can be used to predict the performance of Ortho-K lenses. In contrast, contact pressure provided the worst stress performance. In terms of strain, the maximum principal logarithmic strain was an effective strain barometer.
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Affiliation(s)
- Lo-Yu Wu
- Department of Power Mechanical Engineering, Nation Tsing Hua University, Hsinchu 300, Taiwan
- Research and Development Center, Brighten Optix Corporation, Taipei 111, Taiwan
| | - Wen-Pin Lin
- Research and Development Center, Brighten Optix Corporation, Taipei 111, Taiwan
- Department of Optometry, University of Kang Ning, Taipei 114, Taiwan
| | - Richard Wu
- Research and Development Center, Brighten Optix Corporation, Taipei 111, Taiwan
- College of Optometry, Pacific University, Forest Grove, OR 97116, USA
| | - Lynn White
- Research and Development Department, LWVision, Leicester LE18 1DF, UK
| | - Ahmed Abass
- Department of Materials, Design and Manufacturing Engineering, School of Engineering, University of Liverpool, Liverpool L69 3GH, UK
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Wang F, Wu G, Xu X, Wu H, Peng Y, Lin Y, Jiang J. Orthokeratology combined with spectacles in moderate to high myopia adolescents. Cont Lens Anterior Eye 2024; 47:102088. [PMID: 37977905 DOI: 10.1016/j.clae.2023.102088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 10/26/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE Wearing ortho-k lenses overnight may not fully correct their daytime refractory errors of adolescents with moderate to high myopia. There are three common ways to deal with the daytime residual refractive error (RRE): 1) wearing spectacles to correct the RRE; 2) wear ortho-k lenses during the daytime instead of overnight.; 3) not correcting the residual refractive error. According to previous laboratory studies, myopic peripheral refraction is associated with better myopic control. This study had two aims:1) to compare relative peripheral refractive error (RPRE) among these ways after one-month stabilization; 2) to assess the axial length changes over 2 years of ortho-k lens overnight wear combined with spectacle glasses. METHODS This was a prospective, non-controlled, non-randomized, observational study in which a total of 27 subjects (20 females, 7 males, mean age 12.48 ± 2.23Y) with spherical equivalent refractive error from -5.00 to -8.25D were enrolled. All participants in the study wore orthokeratology (ortho-k) lenses overnight for a minimum of one month. Subsequently, their peripheral refractive error (PRE) was assessed using an open-field autorefractor. During the assessment, the participants underwent three conditions in a random order in a same morning: 1) unaided eye after orthokeratology (referred to as the Unaided-eye condition), 2) wearing glasses to correct any remaining refractive errors after orthokeratology (referred to as the Spec-RE condition), and 3) wearing ortho-k lenses during the daytime (referred to as the Continuous OK wear condition). After testing, all subjects were instructed to wear ortho-k lenses overnight and glasses during the daytime to correct their RRE for the next 2 years, during which time the progression of their axial length was followed up. RESULTS 1) RPRE in either Unaided-eye or Spec-RE condition subjects were significantly more myopic than those in the Continuous OK wear condition. 2) No difference in RPRE was seen between Unaided-eye and Spec-RE conditions. 3) Axial length growth was 0.05 ± 0.20 mm and 0.17 ± 0.32 mm (mean ± standard deviation) at 1-year and 2-year follow-ups after the initial visit, respectively, which were comparable to mild myopia patients after orthokeratology. 4) After orthokeratology, axial length change had negative correlation with the initial age (p = 0.001, r = -0.616) and residual diopter (p = 0.022). CONCLUSIONS For myopes above refraction < -5.00D, wearing Ortho-k lenses overnight and glasses to correct the RRE in the daytime is recommended to ensure good visual quality and have more myopic RPRE for potential myopia control.
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Affiliation(s)
- Feifu Wang
- National Clinical Research Centerfor Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Ge Wu
- National Clinical Research Centerfor Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Xindi Xu
- The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Haoran Wu
- National Clinical Research Centerfor Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Yiyi Peng
- National Clinical Research Centerfor Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Yiran Lin
- National Clinical Research Centerfor Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Jun Jiang
- National Clinical Research Centerfor Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China.
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10
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Zhang J, Li Z, Cheng Z, Wang T, Shi W. Comparison of the clinical efficacy of orthokeratology and 0.01% atropine for retardation of myopia progression in myopic children. Cont Lens Anterior Eye 2024; 47:102094. [PMID: 37985346 DOI: 10.1016/j.clae.2023.102094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 11/02/2023] [Accepted: 11/08/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVE To compare the clinical efficacy of orthokeratology (ortho-k) and 0.01% atropine for retardation of myopia progression in myopic children. METHODS This was a retrospective cohort study. A total of 282 patients, aged 8-17 years, were enrolled, including 100 children treated with ortho-k, 84 with 0.01% atropine, and 98 with single-vision spectacles. During the follow-up of 1 year, ortho-k wearers were examined at 1 day, 1 week, 1 month, 3 months after treatment, and thereafter every 3 months, while the others were examined every 3 months by measurements of uncorrected vision, intraocular pressure, refractive power, slit-lamp microscopy, corneal topography, and the lens fitting when necessary. The axial length was measured every 6 months. RESULTS Patients with ortho-k had stable uncorrected vision after 1 month of lens wear, all reaching 0 logMAR. The annual axial elongation was 0.23 ± 0.19 mm, 0.22 ± 0.20 mm, and 0.39 ± 0.27 mm in the ortho-k, atropine, and spectacle groups, respectively, with significant difference (F = 23.251, P = 0.000). The axial length was delayed to increase by 41.03% and 43.59% within a year in patients with ortho-k and atropine, respectively, as compared to patients with spectacles (F = 0.006, P = 0.936). The elongation was ≤ 0.3 mm in 69.0% and 66.7% of patients in the two groups, respectively, versus 38.8% in the spectacle group (χ2 = 17.251, P = 0.000). During the follow-up, the rate of corneal staining was 11.0% and 2.0% in the ortho-k and spectacle groups, respectively (χ2 = 8.076, P = 0.003). The use of atropine did not increase corneal staining, but the incidence of related photophobia was 4.8%. No other serious complications were observed. CONCLUSION Ortho-k lenses and 0.01% atropine can achieve similar efficacy of myopia retardation, which was significantly better than that obtained with single-vision spectacles, in myopic children. The risk of corneal staining after ortho-k wear may be slightly higher than that with spectacles, but could be well controlled.
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Affiliation(s)
- Ju Zhang
- Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China; Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, Shandong, China; School of Ophthalmology, Shandong First Medical University, Jinan, Shandong, China
| | - Zhenzhen Li
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, Shandong, China
| | - Zhiwei Cheng
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, Shandong, China
| | - Ting Wang
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, Shandong, China; School of Ophthalmology, Shandong First Medical University, Jinan, Shandong, China.
| | - Weiyun Shi
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, Shandong, China; School of Ophthalmology, Shandong First Medical University, Jinan, Shandong, China.
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11
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Logan NS, Bullimore MA. Optical interventions for myopia control. Eye (Lond) 2024; 38:455-463. [PMID: 37740053 PMCID: PMC10858277 DOI: 10.1038/s41433-023-02723-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 07/26/2023] [Accepted: 08/25/2023] [Indexed: 09/24/2023] Open
Abstract
A range of optical interventions have been developed to slow the progression of myopia. This review summarizes key studies and their outcomes. Peer-reviewed, randomized controlled clinical trials of at least 18 months duration were identified. Randomized clinical trials were identified and summarised: 13 for spectacles, 5 for overnight orthokeratology, 5 for soft contact lenses, and 3 for orthokeratology combined with low concentration atropine. Overnight orthokeratology trials were the most consistent with 2-year slowing of axial elongation between 0.24 and 0.32 mm. Other modalities were more variable due to the wide range of optical designs. Among spectacle interventions, progressive addition lenses were the least effective, slowing axial elongation and myopia progression by no more than 0.11 mm and 0.31 D, respectively. In contrast, novel designs with peripheral lenslets slow 2-year elongation and progression by up to 0.35 mm and 0.80 D. Among soft contact lens interventions, medium add concentric bifocals slow 3-year elongation and progression by only 0.07 mm and 0.16 D, while a dual-focus design slows 3-year elongation and progression by 0.28 mm and 0.67 D. In summary, all three optical interventions have the potential to significantly slow myopia progression. Quality of vision is largely unaffected, and safety is satisfactory. Areas of uncertainty include the potential for post-treatment acceleration of progression and the benefit of adding atropine to optical interventions.
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12
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Deng B, Zhou M, Kong X, Luo L, Lv H. A meta-analysis of randomized controlled trials evaluating the effectiveness and safety of the repeated low-level red light therapy in slowing the progression of myopia in children and adolescents. Indian J Ophthalmol 2024; 72:S203-S210. [PMID: 38099371 DOI: 10.4103/ijo.ijo_1037_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 08/09/2023] [Indexed: 12/19/2023] Open
Abstract
PURPOSE The aim of this study was to evaluate the effectiveness and safety of repeated low-level red light (RLRL) therapy in controlling myopia progression in children through a meta-analysis. METHODS We searched several databases including PubMed, Embase, The Cochrane Library, Web of Science, CNKI, WANFANG, CBM, and VIP with languages restricted to both Chinese and English. The search was conducted from the establishment of the databases to March 23, 2023. We collected randomized controlled trials and controlled experiments to evaluate changes in axial length (AL) and spherical equivalent (SE) before and after RLRL intervention. Two researchers performed literature screening and data extraction, and RevMan software (Ver 5.3) and StataMP 17.0 were used for meta-analysis. RESULTS A total of 141 articles were retrieved, and finally, six randomized controlled trials met the inclusion and exclusion criteria, including 820 eyes (RLRL group: 411 eyes, control group: 409 eyes). The meta-analysis results showed that the RLRL group was significantly better than the control group in controlling AL, and the difference between the two groups was statistically significant (mean difference [MD] = -0.22, 95% confidence interval [CI] [ - 0.28, -0.16]; P < 0.001). The RLRL group was also better than the control group in terms of SE, and the difference between the two groups was statistically significant (MD = 0.46, 95% CI [0.32, 0.6]; P < 0.001). Five studies reported adverse reactions in the RLRL group, and two cases stopped treatment due to the feeling of too bright light, while the others had no significant side effects in the short term. CONCLUSION RLRL therapy is a safe and effective method for controlling myopia, which can inhibit the growth of AL and slow down the progression of myopia. However, further research and validation are needed to determine its treatment efficacy and course.
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Affiliation(s)
- Bo Deng
- Department of Ophthalmology, The Affiliated Hospital of Southwest Medical University, Jiangyang District, Luzhou, Sichuan Province, P.R. China
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13
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Fan H, Zhang X, Wei Q, Zhong Q, Liu M, Li B, Li S, Zhang R, Xie A. Myopia control efficacy of peripheral defocus soft contact lenses in children and adolescents: A meta-analysis. Eur J Ophthalmol 2024:11206721241229474. [PMID: 38298013 DOI: 10.1177/11206721241229474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
OBJECTIVES To evaluate the effect of peripheral defocus soft contact lenses (PDSCLs) on controlling myopia progression in children and adolescents, and to compare it with orthokeratology (Ortho-K) and single vision lenses (SVLs). METHODS We conducted a systematic search of PubMed, the Cochrane Library, Medline, CNKI, CBM, VIP, and WanFang Data databases for randomized controlled trials (RCTs) and cohort studies that investigated the effects of PDSCLs on myopia control in children and adolescents. The published languages were limited to English and Chinese. The risk bias tool provided by the Cochrane risk-of-bias tool and Newcastle-Ottawa Scale were used to assess the risk bias of included studies of RCTs and CTs. The published biases of included studies were assessed by Egger`s test. RESULTS We included 21 studies, comprising 13 RCTs and 8 cohort studies, with a total of 1337 participants in the PDSCLs group, 428 in the Ortho-K group, and 707 in the SVLs group. The meta-analysis indicated no significant difference between PDSCLs and Ortho-K in controlling the increase of diopter (MD = 0.01, 95% CI: -0.06, 0.09; P = 0.69) and axial length (MD = -0.01, 95% CI: -0.02, 0.00; P = 0.28). Compared with SVLs, PDSCLs had a better effect in controlling the increase of diopter (MD = 0.23, 95% CI: 0.17, 0.28; P < 0.00001) and axial length (MD = -0.11, 95% CI: -0.12, -0.09; P < 0.00001) in children and adolescents. CONCLUSIONS Children and adolescents wearing PDSCLs can achieve better myopia control than those wearing SVLs, and their effect is comparable to that of Ortho-K.
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Affiliation(s)
- Haobo Fan
- Eye School of Chengdu University of TCM, Chengdu, China
- Department of Optometry and Pediatric Ophthalmology, Ineye Hospital of Chengdu University of TCM, Chengdu, China
| | - Xuemin Zhang
- Department of Optometry and Pediatric Ophthalmology, Ineye Hospital of Chengdu University of TCM, Chengdu, China
| | - Qiumei Wei
- Department of Optometry and Pediatric Ophthalmology, Ineye Hospital of Chengdu University of TCM, Chengdu, China
| | - Qiao Zhong
- Department of Optometry and Pediatric Ophthalmology, Ineye Hospital of Chengdu University of TCM, Chengdu, China
| | - Meng Liu
- Ophthalmology Department, Chongqing University Jiangjin Hospital, Chongqing, China
| | - Bingqian Li
- Department of Optometry and Pediatric Ophthalmology, Ineye Hospital of Chengdu University of TCM, Chengdu, China
| | - Shilin Li
- Department of Optometry and Pediatric Ophthalmology, Ineye Hospital of Chengdu University of TCM, Chengdu, China
| | - Renwei Zhang
- Department of Optometry and Pediatric Ophthalmology, Ineye Hospital of Chengdu University of TCM, Chengdu, China
| | - Airui Xie
- Eye School of Chengdu University of TCM, Chengdu, China
- Department of Optometry and Pediatric Ophthalmology, Ineye Hospital of Chengdu University of TCM, Chengdu, China
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14
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Lee CY, Yang SF, Chang YL, Huang JY, Lian IB, Chang CK. The Effect of Myopic Control between the Dual-Focus Contact Lenses and High-Concentration Atropine in an Asian Population. Life (Basel) 2024; 14:118. [PMID: 38255733 PMCID: PMC10817657 DOI: 10.3390/life14010118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/09/2024] [Accepted: 01/13/2024] [Indexed: 01/24/2024] Open
Abstract
We aim to investigate the myopic control effect of high-concentration atropine (ATR) and dual-focus contact lenses (DFCLs). A retrospective cohort study was conducted. A total of 182 eyes in 91 individuals who used high-concentration ATR (0.125%) and another 70 eyes in 35 individuals who used DFCLs were enrolled in the ATR and DFCL groups, respectively. The primary outcomes were spherical equivalent refraction (SER) progression and axial length (AXL) elongation. The generalized estimate equation was utilized to yield the adjusted odds ratio (aOR) and 95% confidence interval (CI) of cycloplegic SER progression and AXL elongation between groups. According to the multivariable analysis, the change in cycloplegic SER progression was similar between the DFCL and ATR groups (aOR: 1.305, 95% CI: 0.247-2.515, p = 0.803). The DFCL group demonstrated a numerically higher rate of AXL elongation compared to the ATR group (aOR: 1.530, 95% CI: 0.980-1.894, p = 0.051). In the subgroup analysis, cycloplegic SER progression was insignificant between ATR and DFCL users in different subgroups (all p > 0.05). The DFCL patients with moderate astigmatism and high AXL (both p < 0.001) presented a high risk of AXL elongation. In conclusion, DFCL usage demonstrated similar myopic control of cycloplegic SER and AXL compared to high-concentration ATR, while DFCLs showed lower AXL control, mainly in patients with moderate astigmatism and high AXL.
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Affiliation(s)
- Chia-Yi Lee
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
- Nobel Eye Institute, Taipei 115, Taiwan
- Department of Ophthalmology, Jen-Ai Hospital Dali Branch, Taichung 412, Taiwan
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 402, Taiwan
| | - Yu-Ling Chang
- Department of Medical Education, Cathay General Hospital, Taipei 106, Taiwan
| | - Jing-Yang Huang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 402, Taiwan
| | - Ie-Bin Lian
- Institute of Statistical and Information Science, National Changhua University of Education, Changhua 500, Taiwan
| | - Chao-Kai Chang
- Nobel Eye Institute, Taipei 115, Taiwan
- Department of Optometry, Da-Yeh University, Chunghua 515, Taiwan
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15
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Costa D, De Matteis V, Treso F, Montani G, Martino M, Rinaldi R, Corrado M, Cascione M. Impact of the physical properties of contact lens materials on the discomfort: role of the coefficient of friction. Colloids Surf B Biointerfaces 2024; 233:113630. [PMID: 37956592 DOI: 10.1016/j.colsurfb.2023.113630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023]
Abstract
Contact Lens Discomfort (CLD) is the main cause in contact lens (CLs) discontinuation, referred in literature as drop-out phenomenon. Despite such evidence was reported in several clinical studies, a relationship between physico-chemical properties of CLs and CLD is not still totally understood. In this regard, the friction of CLs surfaces seems to be related to discomfort feeling events, probably due to an alteration of the lubricate function of the tear film after the CL placement inside the ocular environment. In the last years, many studies have been finalized to the friction measurements of CLs surface, finding conflicting data due to a lack in standardized protocol. The aim of this review is primarily to show evident relationships between CLs surface properties (i.e. wettability, tear evaporation, tear film quality, etc.) and the coefficient of friction (CoF), resulting therefore the most relevant physical quantity in the CLs characterization. In addition, we reported the most recent studies in CLs tribology, which highlight that the introduction of a standard protocol in CoF measurements is necessary to obtain reproducible results, considering the aim to evaluate in a more precise way the relationship between this material surface property and comfort in CLs users.
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Affiliation(s)
- D Costa
- Department of Mathematics and Physics "Ennio De Giorgi", University of Salento, Via Arnesano, Lecce 73100, Italy
| | - V De Matteis
- Department of Mathematics and Physics "Ennio De Giorgi", University of Salento, Via Arnesano, Lecce 73100, Italy; Institute for Microelectronics and Microsystems (IMM), CNR, Via Monteroni, Lecce 73100, Italy.
| | - F Treso
- Department of Mathematics and Physics "Ennio De Giorgi", University of Salento, Via Arnesano, Lecce 73100, Italy; Centro di Ricerca in Contattologia Avanzata, Via Arnesano, Lecce 73100, Italy
| | - G Montani
- Department of Mathematics and Physics "Ennio De Giorgi", University of Salento, Via Arnesano, Lecce 73100, Italy; Centro di Ricerca in Contattologia Avanzata, Via Arnesano, Lecce 73100, Italy
| | - M Martino
- Department of Mathematics and Physics "Ennio De Giorgi", University of Salento, Via Arnesano, Lecce 73100, Italy; Centro di Ricerca in Contattologia Avanzata, Via Arnesano, Lecce 73100, Italy
| | - R Rinaldi
- Department of Mathematics and Physics "Ennio De Giorgi", University of Salento, Via Arnesano, Lecce 73100, Italy; Institute for Microelectronics and Microsystems (IMM), CNR, Via Monteroni, Lecce 73100, Italy
| | - M Corrado
- Department of Mathematics and Physics "Ennio De Giorgi", University of Salento, Via Arnesano, Lecce 73100, Italy
| | - M Cascione
- Department of Mathematics and Physics "Ennio De Giorgi", University of Salento, Via Arnesano, Lecce 73100, Italy; Institute for Microelectronics and Microsystems (IMM), CNR, Via Monteroni, Lecce 73100, Italy; Centro di Ricerca in Contattologia Avanzata, Via Arnesano, Lecce 73100, Italy.
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16
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Chiu YC, Tsai PC, Lee SH, Wang JH, Chiu CJ. Systematic Review of Myopia Progression after Cessation of Optical Interventions for Myopia Control. J Clin Med 2023; 13:53. [PMID: 38202060 PMCID: PMC10779574 DOI: 10.3390/jcm13010053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/12/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Despite high discontinuation rates for myopia optical interventions, limited attention has been given to the potential rebound effects post-discontinuation. This systematic review aims to assess the extent of the rebound effects following the cessation of common clinical optical myopia-control interventions in children. A comprehensive search of PubMed, Embase, Cochrane CENTRAL, and ClinicalTrials.gov was conducted from inception to October 2023. The rebound effects, defined as changes in the axial length or spherical equivalent during and after treatment cessation, were categorized into four levels. These studies encompassed 703 participants and spanned from 2019 to 2023, with durations of treatment and cessation ranging from 6 months to 3.5 years and from 2 weeks to 5 years, respectively. This review, encompassing 14 studies, revealed a predominant strong rebound effect in orthokeratology (8 studies), a weak rebound effect in multifocal soft contact lenses (4 studies), and a variable rebound effect in peripheral-plus spectacle lenses (2 studies). Notably, with the increasing cessation duration, the rebound effects diminished, potentially linked to the reversal of choroidal thickening and the disappearance of peripheral myopic defocus. In conclusion, a temporal trend of rebound effects exists in all three myopia optical interventions, possibly contributing to their myopia control mechanisms.
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Affiliation(s)
- Yu-Chieh Chiu
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan; (Y.-C.C.); (P.-C.T.); (S.-H.L.)
| | - Ping-Chiao Tsai
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan; (Y.-C.C.); (P.-C.T.); (S.-H.L.)
| | - Ssu-Hsien Lee
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan; (Y.-C.C.); (P.-C.T.); (S.-H.L.)
| | - Jen-Hung Wang
- Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien 970, Taiwan;
| | - Cheng-Jen Chiu
- Department of Ophthalmology and Visual Science, Tzu Chi University, Hualien 970, Taiwan
- Department of Ophthalmology, Hualien Tzu Chi Hospital, the Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan
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17
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Tapasztó B, Flitcroft DI, Aclimandos WA, Jonas JB, De Faber JTHN, Nagy ZZ, Kestelyn PG, Januleviciene I, Grzybowski A, Vidinova CN, Guggenheim JA, Polling JR, Wolffsohn JS, Tideman JWL, Allen PM, Baraas RC, Saunders KJ, McCullough SJ, Gray LS, Wahl S, Smirnova IY, Formenti M, Radhakrishnan H, Resnikoff S, Németh J. Myopia management algorithm. Annexe to the article titled Update and guidance on management of myopia. European Society of Ophthalmology in cooperation with International Myopia Institute. Eur J Ophthalmol 2023:11206721231219532. [PMID: 38087768 DOI: 10.1177/11206721231219532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
Myopia is becoming increasingly common in young generations all over the world, and it is predicted to become the most common cause of blindness and visual impairment in later life in the near future. Because myopia can cause serious complications and vision loss, it is critical to create and prescribe effective myopia treatment solutions that can help prevent or delay the onset and progression of myopia. The scientific understanding of myopia's causes, genetic background, environmental conditions, and various management techniques, including therapies to prevent or postpone its development and slow its progression, is rapidly expanding. However, some significant information gaps exist on this subject, making it difficult to develop an effective intervention plan. As with the creation of this present algorithm, a compromise is to work on best practices and reach consensus among a wide number of specialists. The quick rise in information regarding myopia management may be difficult for the busy eye care provider, but it necessitates a continuing need to evaluate new research and implement it into daily practice. To assist eye care providers in developing these strategies, an algorithm has been proposed that covers all aspects of myopia mitigation and management. The algorithm aims to provide practical assistance in choosing and developing an effective myopia management strategy tailored to the individual child. It incorporates the latest research findings and covers a wide range of modalities, from primary, secondary, and tertiary myopia prevention to interventions that reduce the progression of myopia.
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Affiliation(s)
- Beáta Tapasztó
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
- Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | - Daniel Ian Flitcroft
- Temple Street Children's Hospital, Dublin, Ireland
- Centre for Eye Research Ireland (CERI) Technological University, Dublin, Ireland
| | | | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Zoltán Zsolt Nagy
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | | | | | - Andrzej Grzybowski
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan, Poland
| | - Christina Nicolaeva Vidinova
- Department of Ophthalmology, Military Medical Academy, Sofia, Bulgaria
- Department of Optometry, Sofia University "St. Kliment Ohridski", Sofia, Bulgaria
| | | | - Jan Roelof Polling
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Optometry and Orthoptics, University of Applied Science, Utrecht, The Netherlands
| | - James S Wolffsohn
- Optometry and Vision Science Research Group, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - J Willem L Tideman
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department Ophthalmology, Martini Hospital, Groningen, The Netherlands
| | - Peter M Allen
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Rigmor C Baraas
- National Centre for Optics, Vision and Eye Care, University of South-Eastern Norway, Kongsberg, Norway
| | - Kathryn J Saunders
- Centre for Optometry and Vision Science, Ulster University, Coleraine, UK
| | - Sara J McCullough
- Centre for Optometry and Vision Science, Ulster University, Coleraine, UK
| | | | - Siegfried Wahl
- Institute for Ophthalmic Research, University Tübingen, Tübingen, Germany
- Carl Zeiss Vision International GmbH, Tübingen, Germany
| | | | - Marino Formenti
- Department of Physics, School of Science, University of Padova, Padova, Italy
| | - Hema Radhakrishnan
- Division of Pharmacy and Optometry, University of Manchester, Manchester, UK
| | - Serge Resnikoff
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
- Brien Holden Vision Institute, Sydney, Australia
| | - János Németh
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
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Yang Y, Wu Q, Pan W, Wen L, Luo Z, Wu H, Ran G, Yang Z, Li X. Characteristics of the Ocular Surface in Myopic Child Candidates of Orthokeratology Lens Wear. Ophthalmol Ther 2023; 12:3067-3079. [PMID: 37665499 PMCID: PMC10640462 DOI: 10.1007/s40123-023-00793-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 08/09/2023] [Indexed: 09/05/2023] Open
Abstract
INTRODUCTION The purpose of this study was to investigate the characteristics of objective ocular surface parameters using non-invasive objective instruments in children with myopia who are candidates for orthokeratology lens wear. METHODS Children with myopia who are candidates for orthokeratology lens wear were retrospectively investigated. The subjects were divided into three age groups. The Keratograph 5M and LipiView interferometry were used to assess non-invasive tear meniscus height (TMH), non-invasive tear film break-up time (NIBUT), conjunctival hyperemia redness score (RS), meibomian gland loss (MGL) score, lipid layer thickness (LLT), and blink pattern analysis, including the number of partial blinks (PB) and total blinks (TB), as well as the partial blink rate (PBR). RESULTS A total of 1119 children with myopia (2070 eyes) aged 7-18 years were selected. The mean TMH, NIBUT, and LLT of the subjects was 0.21 mm, 12.45 s, and 65.28 nm, respectively. The mean RS and upper and lower MGL scores were 0.64, 1.00, and 1.06, respectively. The mean PB, TB, and PBR was 5.13, 6.46, and 0.81, respectively. Age was significantly correlated to all ocular surface parameters (p = 0.00), except for PB. NIBUT and LLT did not differ between male participants and female participants (all p > 0.05). TMH, RS, and upper and lower MGL were significantly higher in male participants than in female participants (all p < 0.01). In addition, NIBUT was positively associated with TMH (r = 0.13, p = 0.00) and LLT (r = 0.28, p = 0.00). Both upper and lower MGL were positively correlated with TMH, PB, and TB (all p = 0.00), whereas upper MGL was negatively correlated with NIBUT and LLT (all p < 0.05). TB was negatively correlated with NIBUT and LLT (all p = 0.00). PB had no relation with TMH, NIBUT, and LLT (all p > 0.05). In addition, PBR was positively correlated with NIBUT and LLT (all p = 0.00) but not with TMH, RS, or MGL (all p > 0.05). Overall, 57.00% had a TMH ≤ 0.2 mm, 43.20% had a NIBUT ≤ 10 s, 48.10% had an LLT ≤ 60 nm, and 88.10% had a PBR > 0.4. CONCLUSIONS Child orthokeratology candidates have enhanced tear secretion and increased meibomian gland deficiency with aging. In addition, the adult dry eye diagnostic criteria may apply to orthokeratology candidates aged 12-18 years but should be lower for younger candidates. Given the proportion of abnormal risk, it is necessary to assess tear film status and blink pattern by reliable and feasible objective examination before fitting orthokeratology.
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Affiliation(s)
- Yuanfang Yang
- Aier School of Ophthalmology, Central South University, Changsha, 410015, China
- Aier Institute of Optometry and Vision Science, Changsha, 410015, China
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, 410015, China
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, 410015, China
| | - Qinghui Wu
- Changsha Aier Eye Hospital, Changsha, 410015, China
| | - Wei Pan
- Aier Institute of Optometry and Vision Science, Changsha, 410015, China
| | - Longbo Wen
- Aier Institute of Optometry and Vision Science, Changsha, 410015, China
| | - Zhiwei Luo
- Aier Institute of Optometry and Vision Science, Changsha, 410015, China
| | - Haoran Wu
- Aier Institute of Optometry and Vision Science, Changsha, 410015, China
| | - Guangyao Ran
- Aier School of Ophthalmology, Central South University, Changsha, 410015, China
- Aier Institute of Optometry and Vision Science, Changsha, 410015, China
| | - Zhikuan Yang
- Aier School of Ophthalmology, Central South University, Changsha, 410015, China
- Changsha Aier Eye Hospital, Changsha, 410015, China
- Aier Institute of Optometry and Vision Science, Changsha, 410015, China
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, 410015, China
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, 410015, China
| | - Xiaoning Li
- Changsha Aier Eye Hospital, Changsha, 410015, China.
- Aier College of Ophthalmology & Optometry, Hubei University of Science and Technology, Xianning, 437000, China.
- Aier Institute of Optometry and Vision Science, Changsha, 410015, China.
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, 410015, China.
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, 410015, China.
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Wang Z, Chen J, Kang J, Niu T, Guo L, Fan L. Axial Length Control Is Associated With a Choroidal Thickness Increase in Myopic Adolescents After Orthokeratology. Eye Contact Lens 2023; 49:512-520. [PMID: 37728877 PMCID: PMC10659250 DOI: 10.1097/icl.0000000000001025] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVE To investigate the changes in choroidal thickness and axial length after orthokeratology in adolescents with low-to-moderate myopia and to explore the relationship between choroidal thickness and axial length variation. METHODS Thirty eyes with low-to-moderate myopia were retrospectively studied, and optometric data were collected before and after 6 months of continuous orthokeratology. Axial length and choroidal and foveal thicknesses were measured using optical biometry and enhanced depth imaging-spectral domain optical coherence tomography, respectively. RESULTS Axial length in the low myopia group increased ( P <0.001) after 6 months of orthokeratology, and the variation was greater than that in the moderate myopia group ( P <0.05). The subfoveal choroidal thickness in low and moderate myopia groups increased ( P <0.01), and the variation was greater in the moderate myopia group ( P <0.05). Choroidal thickness in all seven measured spots increased, with the variation of subfovea, nasal 1 mm to fovea, and temporal 1 mm to fovea being statistically significant ( P <0.001, P <0.05, and P <0.05). The change in axial length was negatively associated with subfoveal and average choroidal thicknesses ( P <0.01). CONCLUSION Adolescents with moderate myopia presented better axial length control after 6 months of orthokeratology. The choroidal thickness of low and moderate myopic eyes increased, and the variation was more significant in moderate myopic eyes. The axial length control effects can be associated with an increase in the subfoveal and average choroidal thickness.
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Affiliation(s)
- Zhiqian Wang
- Department of Optometry (Z.W., L.F.), Shenyang Eye Institute, The 4th People's Hospital of Shenyang, China Medical University, Shenyang, Liaoning, China; Department of Ophthalmology (J.C.), Shengjing Hospital of China Medical University, China Medical University, Shenyang, Liaoning, China; Department of Ophthalmology (J.K., T.N.), Shenyang Eye Institute, The 4th People's Hospital of Shenyang, China Medical University, Liaoning, China; and Department of Ophthalmology (L.G.), Shenyang Sinqi Eye Hospital, Shenyang, Liaoning, China
| | - Jingyi Chen
- Department of Optometry (Z.W., L.F.), Shenyang Eye Institute, The 4th People's Hospital of Shenyang, China Medical University, Shenyang, Liaoning, China; Department of Ophthalmology (J.C.), Shengjing Hospital of China Medical University, China Medical University, Shenyang, Liaoning, China; Department of Ophthalmology (J.K., T.N.), Shenyang Eye Institute, The 4th People's Hospital of Shenyang, China Medical University, Liaoning, China; and Department of Ophthalmology (L.G.), Shenyang Sinqi Eye Hospital, Shenyang, Liaoning, China
| | - Jingxiong Kang
- Department of Optometry (Z.W., L.F.), Shenyang Eye Institute, The 4th People's Hospital of Shenyang, China Medical University, Shenyang, Liaoning, China; Department of Ophthalmology (J.C.), Shengjing Hospital of China Medical University, China Medical University, Shenyang, Liaoning, China; Department of Ophthalmology (J.K., T.N.), Shenyang Eye Institute, The 4th People's Hospital of Shenyang, China Medical University, Liaoning, China; and Department of Ophthalmology (L.G.), Shenyang Sinqi Eye Hospital, Shenyang, Liaoning, China
| | - Tongtong Niu
- Department of Optometry (Z.W., L.F.), Shenyang Eye Institute, The 4th People's Hospital of Shenyang, China Medical University, Shenyang, Liaoning, China; Department of Ophthalmology (J.C.), Shengjing Hospital of China Medical University, China Medical University, Shenyang, Liaoning, China; Department of Ophthalmology (J.K., T.N.), Shenyang Eye Institute, The 4th People's Hospital of Shenyang, China Medical University, Liaoning, China; and Department of Ophthalmology (L.G.), Shenyang Sinqi Eye Hospital, Shenyang, Liaoning, China
| | - Lei Guo
- Department of Optometry (Z.W., L.F.), Shenyang Eye Institute, The 4th People's Hospital of Shenyang, China Medical University, Shenyang, Liaoning, China; Department of Ophthalmology (J.C.), Shengjing Hospital of China Medical University, China Medical University, Shenyang, Liaoning, China; Department of Ophthalmology (J.K., T.N.), Shenyang Eye Institute, The 4th People's Hospital of Shenyang, China Medical University, Liaoning, China; and Department of Ophthalmology (L.G.), Shenyang Sinqi Eye Hospital, Shenyang, Liaoning, China
| | - Liying Fan
- Department of Optometry (Z.W., L.F.), Shenyang Eye Institute, The 4th People's Hospital of Shenyang, China Medical University, Shenyang, Liaoning, China; Department of Ophthalmology (J.C.), Shengjing Hospital of China Medical University, China Medical University, Shenyang, Liaoning, China; Department of Ophthalmology (J.K., T.N.), Shenyang Eye Institute, The 4th People's Hospital of Shenyang, China Medical University, Liaoning, China; and Department of Ophthalmology (L.G.), Shenyang Sinqi Eye Hospital, Shenyang, Liaoning, China
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Yan C, Zhao F, Gao S, Liu X, Yu T, Mu Y, Zhang L, Xu J. Observation of the effect of posterior scleral reinforcement combined with orthokeratology and 0.01% atropine in the treatment of congenital myopia: a case report. BMC Ophthalmol 2023; 23:486. [PMID: 38012561 PMCID: PMC10683125 DOI: 10.1186/s12886-023-03211-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/08/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Myopia has recently emerged as a significant threat to global public health. The high and pathological myopia in children and adolescents could result in irreversible damage to eye tissues and severe impairment of visual function without timely control. Posterior scleral reinforcement (PSR) can effectively control the progression of high myopia by limiting posterior scleral expansion, improving retrobulbar vascular perfusion, thereby stabilizing the axial length and refraction of the eye. Moreover, orthokeratology and low concentrations of atropine are also effective in slowing myopia progression. CASE PRESENTATION A female child was diagnosed with binocular congenital myopia and amblyopia at the age of 3 and the patient's vision had never been rectified with spectacles at the first consultation. The patient's ophthalmological findings suggested, high refractive error with low best corrected visual acuity, longer axial length beyond the standard level of her age, and fundus examination suggesting posterior scleral staphyloma with weakened hemodynamics of the posterior ciliary artery. Thereby, PSR was performed to improve fundus health and the combination of orthokeratology and 0.01% atropine were performed to control the development of myopia. Following up to 8 years of clinical treatment and observations, the progression of myopia could be well controlled and fundus health was stable. CONCLUSION In this report, 8-year of clinical observation indicated that PSR could improve choroidal thickness and hemodynamic parameters of the retrobulbar vessels, postoperative orthokeratology combined with 0.01% atropine treatment strategy may be a good choice for myopia control effectively.
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Affiliation(s)
- Chunxiao Yan
- The Third People's Hospital of Dalian, Dalian Municipal Eye Hospital, Dalian Municipal Cancer Hospital, Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, Liaoning, China
- Dalian Medical University, Dalian, Liaoning, China
| | - Fangkun Zhao
- The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Shang Gao
- The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xiaoyu Liu
- The Third People's Hospital of Dalian, Dalian Municipal Eye Hospital, Dalian Municipal Cancer Hospital, Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, Liaoning, China
| | - Taorui Yu
- The Third People's Hospital of Dalian, Dalian Municipal Eye Hospital, Dalian Municipal Cancer Hospital, Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, Liaoning, China
- Dalian Medical University, Dalian, Liaoning, China
| | - Yanan Mu
- The Third People's Hospital of Dalian, Dalian Municipal Eye Hospital, Dalian Municipal Cancer Hospital, Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, Liaoning, China
| | - Lijun Zhang
- The Third People's Hospital of Dalian, Dalian Municipal Eye Hospital, Dalian Municipal Cancer Hospital, Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, Liaoning, China.
- Dalian Medical University, Dalian, Liaoning, China.
| | - Jun Xu
- The Third People's Hospital of Dalian, Dalian Municipal Eye Hospital, Dalian Municipal Cancer Hospital, Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, Liaoning, China.
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21
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Chen X, Yang B, Wang X, Ma W, Liu L. The alterations in ocular biometric parameters following short-term discontinuation of long-term orthokeratology and prior to subsequent lens fitting: a preliminary study. Ann Med 2023; 55:2282745. [PMID: 37988719 PMCID: PMC10836244 DOI: 10.1080/07853890.2023.2282745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 11/06/2023] [Indexed: 11/23/2023] Open
Abstract
PURPOSE To investigate the alterations in biometric parameters among Chinese adolescents over an extended period of wearing orthokeratology lenses, as well as the subsequent changes after a one-month cessation of lens usage prior to the secondary lens fitting. METHODS Twenty-four myopic patients aged 7-14 were enrolled in this 37-month prospective observational study. Ocular biometric parameters were measured in the study. Ocular biometric parameters were assessed, and the utilization of Generalized Estimating Equations (GEE) was employed in the analysis to address the correlation between the two eyes of each participant. RESULTS The axial length (AL) increased by 0.55 mm after 36 months of lens wearing and further increased to 0.62 mm at the 37-month follow-up compared to the initial measurement. The differences in AL elongation per month between the 37-month time point and the 12-, 24-, and 36-month marks of lens wearing were found to be statistically significant (p12-month = 0.001; p24-month = 0.003; p36-month = 0.001). Following the cessation of lens wear for 1 month, there was no significant complete recovery observed in the flat and steep keratometry values. However, the intraocular pressure and anterior chamber depth returned to their baseline levels. CONCLUSIONS The AL elongation undergoes alterations during temporary discontinuation of lenses, with the flat and steep keratometry measurements remaining significantly flatter compared to the baseline. However, the intraocular pressure and anterior chamber depth return to their initial levels after one month of lens cessation.
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Affiliation(s)
- Xiaohang Chen
- Department of Ophthalmology and Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P.R. China
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, China
| | - Bi Yang
- Department of Ophthalmology and Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P.R. China
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, China
| | - Xue Wang
- Department of Ophthalmology and Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P.R. China
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Ma
- Department of Ophthalmology and Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P.R. China
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, China
| | - Longqian Liu
- Department of Ophthalmology and Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P.R. China
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, China
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22
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Bullimore MA, Liu M. Efficacy of the Euclid orthokeratology lens in slowing axial elongation. Cont Lens Anterior Eye 2023; 46:101875. [PMID: 37365049 DOI: 10.1016/j.clae.2023.101875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 06/19/2023] [Indexed: 06/28/2023]
Abstract
PURPOSE The Euclid Emerald lens designs for orthokeratology have been available in global markets for over 20 years and is used extensively by clinicians for slowing myopia progression in children. This paper comprehensively reviews data from published studies of the efficacy of this lens. METHODS A comprehensive systematic search was performed in March 2023 using Medline with the following search terms: orthokeratology AND myopi* AND (axial or elong*) NOT (review or meta). RESULTS The original search identified 189 articles, of which 140 reported axial elongation. Of those, 49 reported data on the Euclid Emerald design. Unique axial elongation data could be extracted from 37 papers-14 of which included an untreated control group. Among these, the mean 12-month efficacy-the difference in axial elongation between orthokeratology wearers and controls-was 0.18 mm (range: 0.05-0.29 mm), and the mean 24-month efficacy was 0.28 mm (range: 0.17-0.38 mm). The orthokeratology wearers in 23 studies without an untreated comparison group showed similar axial elongation to those in the 14 studies with a control group. For example, the mean 12-month axial elongation for the studies with controls was 0.20 ± 0.06 mm compared with 0.20 ± 0.07 mm for the studies without controls. CONCLUSIONS This extensive body of literature on a single device for myopia control is unique and demonstrates the efficacy of this design in slowing axial elongation in myopic children.
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Affiliation(s)
- Mark A Bullimore
- University of Houston, College of Optometry, 4901 Calhoun Rd., Houston, TX 77204, United States.
| | - Maria Liu
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, CA 94720, United States.
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Zambrano Peralta P, Ortiz Quito M, Guerrero Ortiz F, Cervantes Anaya L. Orthokeratology vs. orthokeratology combined with atropine for the control of myopia in children: systematic review. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023; 98:568-576. [PMID: 37619667 DOI: 10.1016/j.oftale.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/20/2023] [Indexed: 08/26/2023]
Abstract
The purpose of this investigation is to determine the efficacy of orthokeratology (OK) compared to orthokeratology combined with atropine (AOK) for the control of myopia in children. A systematic review that included systematic reviews with meta-analyses, as well as randomized and controlled clinical trials, was carried out in the PubMed, Web of Science, Scopus, Cochrane Library, ProQuest, Taylor & Francis, Science Direct databases, as well as a manual search. Of the Q1-Q4 journals of the Scimago Journal & Country Rank, published in the last 5 years in English and Spanish. Eighteen studies that met the eligibility criteria were considered. The articles selected included 6,866 patients for analysis, where orthokeratology combined with 0.01% atropine was found to be more effective due to its ability to reduce the progression of myopia and axial elongation. In our investigation, it was determined that there could be an additive effect in the combination of 0.01% atropine with orthokeratology in a period of 1-2 years of treatment in patients with mild myopia; however, more multiethnic studies should be carried out, in where a correct evaluation of the progression of myopia, genetic and environmental factors that may influence the results is considered.
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Affiliation(s)
| | - M Ortiz Quito
- Universidad Católica de Cuenca, Sede Matriz, Cuenca, Ecuador
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Li T, Chen Z, She M, Zhou X. Relative peripheral refraction in myopic children wearing orthokeratology lenses using a novel multispectral refraction topographer. Clin Exp Optom 2023; 106:746-751. [PMID: 36126304 DOI: 10.1080/08164622.2022.2113330] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/03/2022] [Accepted: 08/09/2022] [Indexed: 10/14/2022] Open
Abstract
CLINICAL RELEVANCE Orthokeratology (OK) lens is commonly used to control myopia progression of children. Understanding the relationship between relative peripheral refraction (RPR) and the growth rate of axial length (AL) may assist in explaining myopic progression. BACKGROUND The aim of this work is to investigate the RPR in myopic children wearing OK lenses, and to evaluate its relationship with the growth rate of AL. METHODS RPRs of 31 children wearing OK lenses and 31 children wearing single-vision glasses were measured with multispectral refraction topography (MRT). MRT shows the total RPR (TRPR), RPR in the superior area (RPR-S), RPR in the inferior area (RPR-I), RPR in the temporal area (RPR-T) and RPR in the nasal area (RPR-N), respectively. It also shows RPR in the visual field of 15° (RPR-15), 30° (RPR-30) and 45° (RPR-45), respectively. RPRs in the visual field from 15° to 30°, 30° to 45° and 15° to 45° are recorded as RPR-(30-15), RPR-(45-30) and RPR-(45-15), respectively. According to the growth rate of AL, children wearing OK lenses were further divided into slow and fast growth groups. RESULTS TRPR, RPR-I, RPR-T, RPR-N, RPR-15, RPR-30, RPR-45, RPR-(30-15), RPR-(45-30), and RPR-(45-15) of children in the OK lens group were significantly smaller than in the control group (all P < 0.05). TRPR, RPR-N, RPR-15, RPR-30, RPR-45, RPR-(30-15), and RPR-(45-15) of the slow growth group were significantly smaller than in the fast growth group (all P < 0.05). The growth rate of AL were positively correlated with TRPR (R = 0.383, P = 0.040), RPR-N (R = 0.395, P = 0.034), RPR-30 (R = 0.408, P = 0.028), RPR-45 (R = 0.377, P = 0.044), RPR-(30-15) (R = 0.390, P = 0.036). CONCLUSIONS RPRs of children show relative myopic defocus after wearing OK lenses. Furthermore, the growth rate of AL is smaller with more negative RPR.
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Affiliation(s)
- Tao Li
- Department of Ophthalmology, Jinshan Hospital of Fudan University, Shanghai, China
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Zhuoyi Chen
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Man She
- Department of Ophthalmology, Jinshan Hospital of Fudan University, Shanghai, China
| | - Xiaodong Zhou
- Department of Ophthalmology, Jinshan Hospital of Fudan University, Shanghai, China
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Su CY, Yeh LK, Huang PH, Lin WP, Huang HF, Lai CC, Fang HW. Long-term effects of tear film component deposition on the surface and optical properties of two different orthokeratology lenses. Cont Lens Anterior Eye 2023; 46:101852. [PMID: 37150645 DOI: 10.1016/j.clae.2023.101852] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 03/08/2023] [Accepted: 04/28/2023] [Indexed: 05/09/2023]
Abstract
PURPOSE To understand the effects of long-term deposition of tear film components on the surface and optical properties of orthokeratology (ortho-k) lenses, two different lenses, Brighten 22 and Optimum Extra, were tested here. METHODS Ortho-k lenses were immersed in artificial tears and cleaned with a commercial care solution repeatedly for up to 90 days. Both the daily and accumulated lysozyme deposition amounts using an Enzyme-Linked ImmunoSorbent Assay were then analyzed. The base curve, central thickness, power, and transmission of visible light, ultraviolet A, and ultraviolet B were analyzed before and after repeated tear film component deposition procedures. The surface roughness using atomic force microscopy was observed and an energy dispersive spectrometer was used to analyze the composition of the deposits. RESULTS The highest levels of lysozyme were adsorbed on both lens materials during the first four days of the procedure and became saturated by day 6. For both lens materials, contamination on the lenses was easily observed by day 30, and the degree of surface roughness was higher. The transmission levels of different light spectrums were reduced showing that the optical characteristics of both lenses were also affected. CONCLUSIONS The results provide in vitro evidence that lysozyme could not be completely removed from orthokeratology lenses. Both surface and optical properties were affected by the deposition of tear film components. However, only one commercial multipurpose care solution was used to clean the lens in this study when the main ingredient was a surfactant, and the results might be different when other care regimens with other key ingredients are used. In addition, whether tear film component deposition might result in increased risks of infection or corneal abrasion will require further investigation.
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Affiliation(s)
- Chen-Ying Su
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology. 1, Sec. 3, Zhongxiao E. Rd., Taipei 10608, Taiwan
| | - Lung-Kun Yeh
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, No. 5, Fuxing St., Taoyuan 333, Taiwan; College of Medicine, Chang Gung University, No. 259, Wenhua 1st Rd., Taoyuan 333, Taiwan
| | - Pin-Hsuan Huang
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology. 1, Sec. 3, Zhongxiao E. Rd., Taipei 10608, Taiwan
| | - Wen-Pin Lin
- Research and Development Center, Brighten Optix Co., 6F-1, No. 150, Sec.4, Chengde Rd., Shilin Dist., Taipei 111, Taiwan; Department of Optometry, University of Kang Ning, No. 137, Alley 75, Sec. 3, Kang Ning Road, Neihu District, Taipei 11485, Taiwan
| | - Hsueh-Fang Huang
- Research and Development Center, Brighten Optix Co., 6F-1, No. 150, Sec.4, Chengde Rd., Shilin Dist., Taipei 111, Taiwan
| | - Chi-Chun Lai
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, No. 5, Fuxing St., Taoyuan 333, Taiwan; College of Medicine, Chang Gung University, No. 259, Wenhua 1st Rd., Taoyuan 333, Taiwan
| | - Hsu-Wei Fang
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology. 1, Sec. 3, Zhongxiao E. Rd., Taipei 10608, Taiwan; Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, No. 35, Keyan Road, Zhunan Town, Miaoli County 35053, Taiwan.
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Saxena R, Dhiman R, Gupta V, Phuljhele S, Mahajan A, Rakheja V, Swaminathan M, Jethani J, Kesarwani S, Kekunnaya R, Sukhija J, Bhave S, Sharma P, Sinha R, Verma L, Sharma N. Prevention and management of childhood progressive myopia: National consensus guidelines. Indian J Ophthalmol 2023; 71:2873-2881. [PMID: 37417137 PMCID: PMC10491088 DOI: 10.4103/ijo.ijo_387_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 05/02/2023] [Accepted: 05/26/2023] [Indexed: 07/08/2023] Open
Abstract
Myopia is a major public health problem worldwide, including India, with the global prevalence of myopia increasing rapidly over decades. The clinical and socioeconomic impact of myopia is also expected to rise with rising prevalence. Therefore, the focus has now been shifted to prevent the incidence and progression of myopia. However, there is lack of any standardized guidelines for myopia management. This document aims to generate a national-level expert consensus statement on the management of childhood myopia in the Indian scenario. The expert panel of pediatric ophthalmologists consisted of 63 members who met in a hybrid meeting. A list of topics deliberating discussion in the meeting was provided to the experts in advance and they were instructed to provide their opinions on the matter during the meet. The panel of experts then gave their views on each of the items presented, deliberated on different aspects of childhood myopia, and reached a consensus regarding the practice patterns in the Indian scenario. In case of opposing views or lack of a clear consensus, we undertook further discussion and evaluated literature to help arrive at a consensus. A written document is prepared based on recommendations explaining definition of myopia, refraction techniques, components and methods of workup, initiation of anti-myopia treatment, type and timing of interventions, follow-up schedule, and indications for revised or combination treatment. This article formulates evidence-based guidelines for progressing myopes and pre-myopes and also establishes uniformity in the management of childhood myopia in the country.
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Affiliation(s)
- Rohit Saxena
- Dr. R. P. Centre for Ophthalmic Sciences, AIIMS New Delhi, India
| | - Rebika Dhiman
- Dr. R. P. Centre for Ophthalmic Sciences, AIIMS New Delhi, India
| | - Vinay Gupta
- Dr. R. P. Centre for Ophthalmic Sciences, AIIMS New Delhi, India
| | - Swati Phuljhele
- Dr. R. P. Centre for Ophthalmic Sciences, AIIMS New Delhi, India
| | - Asmita Mahajan
- Dr. R. P. Centre for Ophthalmic Sciences, AIIMS New Delhi, India
| | - Vaishali Rakheja
- Dr. R. P. Centre for Ophthalmic Sciences, AIIMS New Delhi, India
| | | | - Jitendra Jethani
- Baroda Children Eye Care and Squint Clinic, Vadodara, Gujarat, India
| | | | | | - Jaspreet Sukhija
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Sankaridurg P, Berntsen DA, Bullimore MA, Cho P, Flitcroft I, Gawne TJ, Gifford KL, Jong M, Kang P, Ostrin LA, Santodomingo-Rubido J, Wildsoet C, Wolffsohn JS. IMI 2023 Digest. Invest Ophthalmol Vis Sci 2023; 64:7. [PMID: 37126356 PMCID: PMC10155872 DOI: 10.1167/iovs.64.6.7] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
Myopia is a dynamic and rapidly moving field, with ongoing research providing a better understanding of the etiology leading to novel myopia control strategies. In 2019, the International Myopia Institute (IMI) assembled and published a series of white papers across relevant topics and updated the evidence with a digest in 2021. Here, we summarize findings across key topics from the previous 2 years. Studies in animal models have continued to explore how wavelength and intensity of light influence eye growth and have examined new pharmacologic agents and scleral cross-linking as potential strategies for slowing myopia. In children, the term premyopia is gaining interest with increased attention to early implementation of myopia control. Most studies use the IMI definitions of ≤-0.5 diopters (D) for myopia and ≤-6.0 D for high myopia, although categorization and definitions for structural consequences of high myopia remain an issue. Clinical trials have demonstrated that newer spectacle lens designs incorporating multiple segments, lenslets, or diffusion optics exhibit good efficacy. Clinical considerations and factors influencing efficacy for soft multifocal contact lenses and orthokeratology are discussed. Topical atropine remains the only widely accessible pharmacologic treatment. Rebound observed with higher concentration of atropine is not evident with lower concentrations or optical interventions. Overall, myopia control treatments show little adverse effect on visual function and appear generally safe, with longer wear times and combination therapies maximizing outcomes. An emerging category of light-based therapies for children requires comprehensive safety data to enable risk versus benefit analysis. Given the success of myopia control strategies, the ethics of including a control arm in clinical trials is heavily debated. IMI recommendations for clinical trial protocols are discussed.
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Affiliation(s)
- Padmaja Sankaridurg
- Brien Holden Vision Institute, Sydney, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - David A Berntsen
- University of Houston, College of Optometry, Houston, Texas, United States
| | - Mark A Bullimore
- University of Houston, College of Optometry, Houston, Texas, United States
| | - Pauline Cho
- West China Hospital, Sichuan University, Sichuan, China
- Eye & ENT Hospital of Fudan University, Shanghai, China
- Affiliated Eye Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ian Flitcroft
- Centre for Eye Research Ireland, School of Physics and Clinical and Optometric Sciences, Technological University Dublin, Dublin, Ireland
- Department of Ophthalmology, Children's Health Ireland at Temple Street Hospital, Dublin, Ireland
| | - Timothy J Gawne
- Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Kate L Gifford
- Queensland University of Technology, Brisbane, Australia
| | - Monica Jong
- Johnson & Johnson Vision, Jacksonville, Florida, United States
| | - Pauline Kang
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Lisa A Ostrin
- University of Houston, College of Optometry, Houston, Texas, United States
| | | | - Christine Wildsoet
- UC Berkeley Wertheim School Optometry & Vision Science, Berkeley, California, United States
| | - James S Wolffsohn
- College of Health & Life Sciences, Aston University, Birmingham, United Kingdom
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Bullimore MA, Richdale K. Incidence of Corneal Adverse Events in Children Wearing Soft Contact Lenses. Eye Contact Lens 2023; 49:204-211. [PMID: 36877990 PMCID: PMC10503544 DOI: 10.1097/icl.0000000000000976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVES There is increasing interest in fitting children with soft contact lenses, in part due to the increase in prescribing of designs to slow the progression of myopia. This literature review summarizes large prospective and retrospective studies that include data on the incidence of microbial keratitis and corneal infiltrative events (CIEs) in children wearing soft contact lenses. METHODS Peer-reviewed prospective and retrospective studies that report contact lens-related complications in children with at least one year of wear and at least 100 patient years of wear were identified. RESULTS Seven prospective studies published between 2004 and 2022 were identified representing 3,752 patient years of wear in 1,756 children, nearly all of whom were fitted at age 12 years or younger. Collectively, they report one case of microbial keratitis and 53 CIEs, of which 16 were classified as symptomatic. The overall incidence of microbial keratitis was 2.7 per 10,000 patient years (95% CI: 0.5-15), and the incidence of symptomatic CIEs was 42 per 10,000 patient years (95% CI: 26-69). Two retrospective studies were identified representing 2,545 patient years of wear in 1,025 children, fitted at age 12 years or younger. One study reports two cases of microbial keratitis giving an incidence of 9.4 per 10,000 patient years (95% CI: 0.5-15). CONCLUSIONS Accurate classification of CIEs is challenging, particularly in retrospective studies. The incidence of microbial keratitis in children wearing soft lenses is no higher than in adults, and the incidence of CIEs seems to be markedly lower.
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Farassat N, Böhringer D, Küchlin S, Molnár FE, Schwietering A, Seger D, Hug MJ, Knöbel AB, Schneider-Fuchs S, Ihorst G, Wabbels B, Beisse C, Ziemssen F, Schuettauf F, Hedergott A, Ring-Mangold T, Schuart C, Wolf A, Schmickler S, Biermann J, Eberwein P, Hufendiek K, Eckstein A, Gusek-Schneider G, Schittkowski M, Lischka T, Lagrèze WA. Low-dose AtropIne for Myopia Control in Children (AIM): protocol for a randomised, controlled, double-blind, multicentre, clinical trial with two parallel arms. BMJ Open 2023; 13:e068822. [PMID: 37080623 PMCID: PMC10124292 DOI: 10.1136/bmjopen-2022-068822] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
INTRODUCTION Myopia is a major cause of degenerative eye disease and increases the risk of secondary visual impairment. Mitigating its progression therefore has great potential of clinically relevant benefit as shown by using highly diluted atropine eye drops in children of Asian origin. However, limited evidence is available regarding the efficacy and safety of low-dose atropine therapy in non-Asian populations. Hence, the Low-dose AtropIne for Myopia Control in Children (AIM) study will test the efficacy and safety of 0.02% atropine vs placebo in a German population. METHODS AND ANALYSIS AIM is a national, multicentre, prospective, randomised, placebo-controlled, double-blind trial with two parallel arms. The primary objective is to assess the efficacy of atropine 0.02% eyedrops for myopia control in children of Caucasian origin. The primary outcome is the change in cycloplegic refraction after 1 year of treatment (D/year). Secondary and tertiary outcome measures comprise the change in axial length (mm/year) in children treated with 0.02% atropine compared with placebo, the myopic progression of participants treated with 0.01% compared with 0.02% atropine (D/year and mm/year), and the safety profile of both 0.02% and 0.01% atropine. Furthermore, the myopic progression 1 year after cessation of therapy with 0.02% atropine will be evaluated. Inclusion criteria are an age of 8-12 years and myopia of -1 D to -6 D with an estimated annual myopia progression of ≥0.5 D. After randomisation, patients will receive either atropine 0.02% (arm A) or placebo eye drops (arm B) in the first year of treatment. In the second year, they will continue to receive atropine 0.02% (arm A) or switch to atropine 0.01% (arm B). In the third year, they will switch to placebo (arm A) or continue with atropine 0.01% (arm B). To achieve a statistical power of 80%, the calculated sample size is 300. The trial has started in October 2021 with a planned recruitment period of 18 months. ETHICS AND DISSEMINATION AIM has been approved by the Central Ethics Committee of the University Medical Center Freiburg (21-1106), local ethics committees of each participating centre and the German Federal Institute for Drugs and Medical Devices (61-3910-4044659). It complies with the Declaration of Helsinki, local laws and ICH-GCP. Results and underlying data from this trial will be disseminated through peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER NCT03865160.
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Affiliation(s)
- Navid Farassat
- Eye Center, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany
| | - Daniel Böhringer
- Eye Center, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany
| | - Sebastian Küchlin
- Eye Center, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany
| | - Fanni E Molnár
- Eye Center, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany
| | - Anne Schwietering
- Eye Center, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany
| | - Dorina Seger
- Eye Center, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany
| | - Martin J Hug
- Department of Pharmacy, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany
| | - Anja-Birte Knöbel
- Clinical Trials Unit, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany
| | - Sabine Schneider-Fuchs
- Clinical Trials Unit, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany
| | - Gabriele Ihorst
- Clinical Trials Unit, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany
| | - Bettina Wabbels
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
| | - Christina Beisse
- Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Focke Ziemssen
- Department of Ophthalmology, University Hospital Leipzig, Leipzig, Germany
| | - Frank Schuettauf
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andrea Hedergott
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Theresia Ring-Mangold
- Department of Ophthalmology, Ludwig-Maximilians-University (LMU) Munich, Munich, Germany
| | - Claudia Schuart
- Department of Ophthalmology, Medical Faculty of Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Armin Wolf
- Department of Ophthalmology, Ulm University Medical Center, Ulm, Germany
| | | | - Julia Biermann
- Department of Ophthalmology, University of Muenster Medical Center, Muenster, Germany
| | | | | | - Anja Eckstein
- Department of Ophthalmology, University Duisburg Essen, Essen, Germany
| | - Gabriele Gusek-Schneider
- Department of Ophthalmology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Schittkowski
- Department of Ophthalmology, Section for Strabismus and Neuroophthalmology, University Medicine Göttingen, Göttingen, Germany
| | - Thomas Lischka
- Department of Ophthalmology, Carl-von-Ossietzky University Oldenburg, Oldenburg, Germany
| | - Wolf A Lagrèze
- Eye Center, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany
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Skidmore KV, Tomiyama ES, Rickert ME, Richdale K, Kollbaum P. Retrospective review of the effectiveness of orthokeratology versus soft peripheral defocus contact lenses for myopia management in an academic setting. Ophthalmic Physiol Opt 2023; 43:534-543. [PMID: 36919952 DOI: 10.1111/opo.13121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 02/22/2023] [Accepted: 02/24/2023] [Indexed: 03/16/2023]
Abstract
PURPOSE To evaluate the relative efficacy of peripheral defocus contact lenses (PDCLs) and orthokeratology (OK) in a real-world clinical population, and compare these results with previous randomised controlled clinical trials. METHODS Records from a university practice were reviewed to identify children who were treated with OK or PDCLs. The analysed sample contained 273 visits from 77 patients. Annualised rates of axial length (AL) progression were calculated and used as the response variable in both linear mixed-effects (LME) and nonlinear regression models. RESULTS On average, children were 10.7 years of age at baseline (p = 0.14 between treatments), and most patients were female. More Asian children wore OK lenses compared with PDCLs (p < 0.01). At baseline, children had ~3.00 D of myopia and 0.75 D of astigmatism in both treatment groups (p > 0.20 between treatments). LME regression models using only baseline covariates showed no evidence that the annualised change in AL differed between treatments, with or without the inclusion of age, race, sex, baseline AL or spherical equivalent refractive error. Across all possible subsets of models, age at baseline was the best predictor of annualised AL change. There was no statistical difference between parameters of an exponential decay model fitted within treatment using follow-up age as a time-varying predictor, indicating that the rate of annualised change in AL was similar for OK and PDCL. CONCLUSIONS Retrospective analysis of real-world clinical data found no difference in annualised AL growth between PDCL and OK. Importantly, the AL progression from this clinical setting is consistent with that reported in randomised clinical trials. Therefore, continued research of real-world performance is warranted to understand the safety and efficacy of modern myopia control treatments in the broader population.
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Affiliation(s)
| | - Erin S Tomiyama
- University of Houston College of Optometry, Houston, Texas, USA.,Southern California College of Optometry, Marshall B. Ketchum University, Fullerton, California, USA
| | - Martin E Rickert
- Indiana University School of Optometry, Bloomington, Indiana, USA
| | | | - Pete Kollbaum
- Indiana University School of Optometry, Bloomington, Indiana, USA
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Tao Y, Li M, Tan J, Huang J, Cheng X, Xie P, Liu X, Zhou Q, Ouyang J. Effects of atropine and tropicamide on ocular biological parameters in children: a prospective observational study. BMC Ophthalmol 2023; 23:96. [PMID: 36915059 PMCID: PMC10010000 DOI: 10.1186/s12886-023-02840-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 03/03/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND The effectiveness of cycloplegia in delaying the progression of myopia and its application in refractive examination in children have been extensively studied, but there are still few studies on the effects of atropine/tropicamide on ocular biological parameters. Therefore, the purpose of this study was to explore the effects of atropine/tropicamide on children's ocular biological parameters in different age groups and the differences between them. METHODS This was a prospective observational study in which all school children were examined for dioptres and ocular biological parameters in the outpatient clinic, and 1% atropine or tropicamide was used for treatment. After examination, we enrolled the patients grouped by age (age from 2 to 12 years treated by atropine, 55 cases; age from 2 to 10 years treated by tropicamide, 70 cases; age from 14 to 17 years treated by tropicamide, 70 cases). The ocular biological parameters of each patient before and after cycloplegia were measured, and the difference and its absolute value were calculated for statistical analysis using an independent-samples t test. RESULTS We compared the value and the absolute value of the differences in ocular biological parameters before and after cycloplegia in the same age group, and we found that the differences were not statistically significant (P > 0.05). There were significant differences in the corresponding values of AL, K1 and ACD among the different age groups (P < 0.05). Before cycloplegia, there were significant differences in AL, K, K1, K2 and ACD in different age groups (P < 0.05). However, the differences in AL, K, K1, K2 and ACD among different age groups disappeared after cycloplegia (P > 0.05). CONCLUSIONS This study demonstrated that atropine/tropicamide have different effects on cycloplegia in children of different ages. The effects of atropine/tropicamide on ocular biological parameters should be fully considered when evaluating the refractive state before refractive surgery or mydriasis optometry for children of different ages.
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Affiliation(s)
- Yulin Tao
- Department of Ophthalmology, Jiujiang No 1 Peoples Hospital, Affiliated Jiujiang Hospital of Nanchang University, 48 South Taling Road, Jiujiang, 332000, Jiangxi, China.,Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Center of National Ocular Disease Clinical Research Center, 17 Yongwai Main Street, Nanchang, 330006, Jiangxi, China
| | - Mohan Li
- Department of Ophthalmology, The Second Hospital of Anhui Medical University, No.678 Furong Road, Economic Development Zone, Hefei, 230031, Anhui, China
| | - Jian Tan
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Center of National Ocular Disease Clinical Research Center, 17 Yongwai Main Street, Nanchang, 330006, Jiangxi, China
| | - Jing Huang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Center of National Ocular Disease Clinical Research Center, 17 Yongwai Main Street, Nanchang, 330006, Jiangxi, China
| | - Xiaokang Cheng
- Department of Ophthalmology, Jiujiang No 1 Peoples Hospital, Affiliated Jiujiang Hospital of Nanchang University, 48 South Taling Road, Jiujiang, 332000, Jiangxi, China
| | - Ping Xie
- Department of Ophthalmology, Jiujiang No 1 Peoples Hospital, Affiliated Jiujiang Hospital of Nanchang University, 48 South Taling Road, Jiujiang, 332000, Jiangxi, China
| | - Xiansheng Liu
- Department of Ophthalmology, Jiujiang No 1 Peoples Hospital, Affiliated Jiujiang Hospital of Nanchang University, 48 South Taling Road, Jiujiang, 332000, Jiangxi, China
| | - Qiong Zhou
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Center of National Ocular Disease Clinical Research Center, 17 Yongwai Main Street, Nanchang, 330006, Jiangxi, China.
| | - Jun Ouyang
- Department of Ophthalmology, Jiujiang No 1 Peoples Hospital, Affiliated Jiujiang Hospital of Nanchang University, 48 South Taling Road, Jiujiang, 332000, Jiangxi, China.
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Modeling and Prediction of the Immediate and Short-Term Effect of Myopic Orthokeratology. Eye Contact Lens 2023; 49:77-82. [PMID: 36694311 DOI: 10.1097/icl.0000000000000962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2022] [Indexed: 01/26/2023]
Abstract
PURPOSE To characterize the clinical changes occurring in the initial phase of the orthokeratology (OK) treatment for myopia correction, developing a model of prediction of the refractive changes in such phase. METHODS Prospective study enrolling 64 eyes of 32 patients (range, 20-40 years) undergoing myopic OK treatment with the reverse geometry contact lens CRT (Paragon Vision Science). Changes in uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), refraction, corneal topography, ocular aberrations, and corneal epithelial thickness were evaluated during the first hour of OK lens wear and after 1 week of OK treatment. Multiple linear regression analysis was used to obtain a model to predict the short-term refractive effect of OK. RESULTS The UCVA improved at each visit, reaching normal visual acuity values after a week (P<0.001) of OK treatment, which was consistent with the significant spherical equivalent (SE) reduction and central flattening (P<0.001). Multiple linear regression analysis revealed that one night change in refraction (ΔR×1N) could be predicted according to the following expression (P<0.001, R2=0.686): ΔR×1N=1.042+0.028×Age+1.014×BCET (baseline central epithelium thickness)-0.752×BKm (baseline mean keratometry)-1.405×BSE (baseline SE)+1.032×ΔR×1 h (change in SE after 1 hr of OK lens use). Similarly, a statistically relevant linear relationship was obtained for predicting the refractive change after 1 week (ΔR×1W) of OK use (P<0.001, R2=0.928): ΔR×1W=3.470-1.046×BSE-1.552×BBCVA (baseline BCVA)-0.391×BKm+0.450×ΔR×1 h. CONCLUSIONS The immediate and short-term refractive effects of myopic OK with the reverse geometry contact lens CRT can be predicted with enough accuracy from baseline and first trial visits data.
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Santodomingo-Rubido J. Foreword - Orthokeratology for Myopia Control in everyday practice. Cont Lens Anterior Eye 2023; 46:101798. [PMID: 36539314 DOI: 10.1016/j.clae.2022.101798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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34
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Sayah DN, Lesk MR. Ocular Rigidity and Current Therapy. Curr Eye Res 2023; 48:105-113. [PMID: 35763027 DOI: 10.1080/02713683.2022.2093380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Purpose: Ocular rigidity (OR) is an important biomechanical parameter of the eye accounting for the material and geometrical properties of the corneoscleral shell.Methods: This study used a literature search to review the role of ocular rigidity and the application of potential therapies targeting this parameter in glaucoma and myopia.Conclusion: Biomechanical modeling and improved understanding of the biochemistry, and molecular arrangement of sclera and its constituents have yielded important insights. Recent developments, including that of a non-invasive and direct OR measurement method and improved ocular imaging techniques are helping to elucidate the role of OR in healthy and diseased eyes by facilitating large scale and longitudinal clinical studies. Improved understanding of OR at the initial stages of disease processes and its alterations with disease progression will undoubtedly propel research in the field. Furthermore, a better understanding of the determinants of OR is helping to refine novel therapeutic approaches which target and alter the biomechanical properties of the sclera in sight-threatening conditions such as glaucoma and myopia.
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Affiliation(s)
- Diane N Sayah
- Maisonneuve-Rosemont Hospital Research Center, Montreal, Canada.,School of Optometry, Université de Montréal, Montreal, Canada
| | - Mark R Lesk
- Maisonneuve-Rosemont Hospital Research Center, Montreal, Canada.,Department of Ophthalmology, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Centre Universitaire d'ophtalmologie de l'Université de Montréal de l'Hôpital Maisonneuve-Rosemont, CIUSSS-E, Montreal, Canada
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35
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Huang Y, Li X, Fang W, Luo W, Ye H, Du X, Di Y, Qiao T. Development and Validation of a Simple Nomogram for Predicting Rapid Myopia Progression in Children with Orthokeratology Management. Curr Eye Res 2023; 48:465-473. [PMID: 36622263 DOI: 10.1080/02713683.2023.2167212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
PURPOSE To develop and validate an ideal nomogram and an online calculator for predicting rapid myopia progression risk in children managed with orthokeratology (ortho-k). METHODS Data of children undergoing ortho-k treatment at Shanghai Children's Hospitals between January 2018 and April 2021 were retrospectively assessed. Potential predictors were screened using univariable analyses and a bidirectional stepwise procedure based on Akaike's information criterion. The final model was constructed using multivariable logistic regression and validated using an internal validation cohort. A nomogram and an online calculator were used to present the final model. RESULTS In this retrospective study with 1051 eyes of 560 myopia patients, the training cohort included 735 eyes, and the validation cohort included 316 eyes. Among 11 potential predictors of rapid myopia progression considered, the following four variables identified as independent predictive factors were included in the nomogram: age (odds ratio [OR], 0.69; 95% confidence interval [CI], 0.61-0.79), baseline spherical equivalent (OR, 1.53; 95% CI, 1.31-1.79), pupil diameter (OR, 0.56; 95% CI, 0.32-0.97), and horizontal visible iris diameter (OR, 0.57; 95% CI, 0.33-0.97). The mean concordance statistics for the training and validation cohorts were 0.705 (95% CI 0.664-0.747) and 0.707 (95% CI 0.639-0.774), respectively. The online calculator is publicly available (https://hycalculatoronline.shinyapps.io/dynnomapp/). CONCLUSION This study developed a simple-to-use nomogram and online calculator that predicted rapid myopia progression risk in children treated with ortho-k, who will likely benefit from early intervention and improved surveillance.
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Affiliation(s)
- Ying Huang
- Department of Ophthalmology, Shanghai Children's Hospital, School of medicine, Shanghai Jiaotong University, Shanghai, China
| | - Xinyue Li
- Department of Ophthalmology, Shanghai Children's Hospital, School of medicine, Shanghai Jiaotong University, Shanghai, China
| | - Wangyi Fang
- Department of Ophthalmology, Shanghai Children's Hospital, School of medicine, Shanghai Jiaotong University, Shanghai, China
| | - Wenting Luo
- Department of Ophthalmology, Shanghai Children's Hospital, School of medicine, Shanghai Jiaotong University, Shanghai, China
| | - Han Ye
- Department of Ophthalmology, Shanghai Children's Hospital, School of medicine, Shanghai Jiaotong University, Shanghai, China
| | - Xiaodong Du
- Department of Ophthalmology, Shanghai Children's Hospital, School of medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yue Di
- Department of Ophthalmology, Shanghai Children's Hospital, School of medicine, Shanghai Jiaotong University, Shanghai, China
| | - Tong Qiao
- Department of Ophthalmology, Shanghai Children's Hospital, School of medicine, Shanghai Jiaotong University, Shanghai, China
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Avetisov SE, Musaeva GM, Bubnova IA. [Effect of conventional and orthokeratological hard contact lenses on anatomical and functional characteristics of the cornea]. Vestn Oftalmol 2023; 139:7-15. [PMID: 36924510 DOI: 10.17116/oftalma20231390117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Contact lenses are widely used for correction of myopia due to their accessibility, effectiveness and relative safety. PURPOSE This study evaluated the potential effects of conventional hard contact lenses (HCL) and orthokeratological contact lenses (OKL) on anatomical and functional condition of the cornea in myopia correction. MATERIAL AND METHODS The study included 80 patients (159 eyes) with low, moderate and high myopia. Group 1 consisted of 40 patients (79 eyes) who used conventional HCL; group 2 included 40 patients (80 eyes) who used OKL. All patients underwent topographic keratometry, corneal pachymetry mapping (Pentacam, Oculus, Germany; Visante OCT, Carl Zeiss, Germany), high-order aberrometry (OPD Scan, Nidek, Japan), confocal microscopy (Confoscan 4, Nidek, Japan), evaluation of corneal biomechanical properties (ORA, Reichert Technologies, USA) and corneal light scattering (Pentacam, Oculus, Germany). Examinations were taken before the treatment started and after 8-12 months of contact lens wear. RESULTS Group 1 showed corneal thickness increase in all zones (by 0.9-1.1%), no significant changes in corneal refraction, and increase in corneal hysteresis and corneal resistance factor. OKL wear led to a significant flattening of anterior surface of the cornea and steepening of its paracentral area, decrease in central corneal thickness (by 2.8%) and increase in mid-peripheral thickness (by 2.2%). No significant changes in posterior corneal surface were observed in the study patients. More significant increase in higher-order aberrations and the degree of light scattering was observed in group 2, while changes in subepithelial nerve plexus and stromal structure were more significant in group 1. CONCLUSION Long-term OKL wear shows more significant morphological and functional corneal changes compared to RGP lens.
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Affiliation(s)
- S E Avetisov
- Krasnov Research Institute of Eye Disease, Moscow, Russia.,I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - G M Musaeva
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - I A Bubnova
- Krasnov Research Institute of Eye Disease, Moscow, Russia
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Bullimore MA, Brennan NA. Myopia: An ounce of prevention is worth a pound of cure. Ophthalmic Physiol Opt 2023; 43:116-121. [PMID: 36197452 DOI: 10.1111/opo.13058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 09/08/2022] [Accepted: 09/14/2022] [Indexed: 12/27/2022]
Abstract
PURPOSE Myopia severity has a profound impact on visual impairment in later life. A patient's final level of myopia may be lowered by myopia control, but also by delaying onset. Here, we evaluate the influence of the age of onset on the final recorded level of myopia. METHODS Data were extracted from: (1) Three prospective cohort studies of myopia progression in East Asia and the United States where the final recorded level of myopia is presented as a function of the established age of onset. (2) Four retrospective studies of myopia progression in Finland, India, the Netherlands and China and two cross-sectional studies in Argentina and the UK where the age of onset was based on self-report of age at first spectacle prescription. (3) A cohort study of Finnish subjects originally recruited for a clinical trial and followed into adulthood. Subjects were divided into five groups according to age at recruitment that was used as a surrogate for the age of onset. RESULTS Final recorded level of myopia was plotted as a function of age of onset for all studies. Among the three East Asian studies, the slopes are between 0.68 and 0.97 D/year, meaning that each later year of onset is associated with between 0.68 and 0.97 less myopia at the final recorded refraction. For six of the seven non-East Asian studies, the slopes are substantially flatter, with slopes between 0.23 and 0.50 D/year. By contrast, the slope for the Finnish study was 0.87 D/year. Increasing age of final recorded refraction tended to be associated with higher levels of myopia. CONCLUSION Among East Asians, delaying the onset of myopia by 1 year has the potential to lower the final myopia level by 0.75 D or more-equivalent to 2-3 years of myopia control with existing modalities. The benefit is lower, but meaningful, among non-East Asians.
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Affiliation(s)
- Mark A Bullimore
- College of Optometry, University of Houston, Houston, Texas, USA
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Changes in ocular biological parameters after cycloplegia based on dioptre, age and sex. Sci Rep 2022; 12:22470. [PMID: 36577765 PMCID: PMC9797549 DOI: 10.1038/s41598-022-25462-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 11/30/2022] [Indexed: 12/29/2022] Open
Abstract
The effects of cycloplegia on ocular biological parameters in children have been extensively studied, but few studies have compared these parameters between different refractive states, ages, and sexes. Therefore, the purpose of this study was to investigate the changes in ocular biometry before and after cycloplegia in different groups based on dioptre, age and sex. We examined a total of 2049 participants in this cross-sectional study. A comprehensive eye examination was conducted before cycloplegia. Cycloplegia was implemented with the application of atropine or tropicamide. Ocular biological parameters were evaluated after cycloplegia, including axial length (AL), mean keratometry (K), flat keratometry (K1), steep keratometry (K2), central corneal thickness (CCT), anterior chamber depth (ACD) and white-to-white (WTW) distance. All the participants were categorized based on dioptre, age and sex. Statistical analysis was performed with paired t tests and Wilcoxon signed-rank tests. Regarding dioptre, AL was found to be increased significantly in the Fs, Ast and FA (p < 0.05) postcycloplegia groups. We observed significant increases in K, K1, K2 and ACD in the Fs group (p < 0.05) after cycloplegia. Regarding age, we found significant increases in AL, CCT and ACD in group 1 (p < 0.05), but AL decreased significantly in groups 2 and 3 (p < 0.05) postcycloplegia. There were no significant changes found in K, K1 and K2 in the three groups after cycloplegia (p > 0.05). Regarding sex, AL and WTW were found to decrease significantly among males and increase significantly among females (p < 0.05) postcycloplegia, while K, K1 and K2 showed the opposite trends. This study showed that there were differences in some ocular biological parameters after cycloplegia across different groups; in particular, there were significant differences in AL, CCT and ACD. Attention should be devoted to the influence of cycloplegia in clinical work.
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Hui W, Xiao-feng H, Song-guo L, Jing-jing W, Xuan H, Yong T. Application of orthokeratology on myopia control and its effect on ocular surface and meibomian gland function in Chinese myopic adolescents. Front Med (Lausanne) 2022; 9:979334. [PMID: 36569150 PMCID: PMC9772008 DOI: 10.3389/fmed.2022.979334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 11/14/2022] [Indexed: 12/12/2022] Open
Abstract
Purpose This study aimed to investigate the influence of orthokeratology (OK) on myopia control and ocular surface and meibomian gland function in myopic adolescents. Methods A prospective study was conducted over a 12-month period. The subjects were classified into two groups, namely, the OK lens group and the frame glasses control group. Axial length, corneal curvature, ocular surface, and meibomian gland parameters were measured at baseline, 1, 3, 6, and 12 months after wearing OK lenses. Results The axial length growth rate in the OK group was significantly slower than in the control group (P < 0.01). The naked eye vision and the ocular surface disease index (OSDI) scores recorded 1, 3, 6, and 12 months after wearing OK lenses were significantly higher than the scores recorded before wearing OK lenses. There was no significant difference in other ocular parameters at each follow-up time point compared with pre-wearing (P > 0.05). After using the OK lens for 6 months, the OSDI score and corneal fluorescein staining (CFS) score increased significantly (P < 0.001), but there were no significant differences in other parameters among the groups. No infectious keratitis occurred during the study. Conclusion These results provide evidence that the use of OK lenses can control the axial growth and progress rate of myopia compared with frame glasses. During the 12-month follow-up, although wearing OK lenses may have aggravated dry eye symptoms, each patient's ocular surface and meibomian gland function did not change significantly, indicating that the use of OK lenses is a relatively safe modality for the control of myopia in adolescents.
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Affiliation(s)
- Wang Hui
- Department of Ophthalmology, Beijing Chaoyang Hospital, The Third Clinical Medical College of Capital Medical University, Beijing, China
| | - Hu Xiao-feng
- Department of Ophthalmology, Beijing Chaoyang Hospital, The Third Clinical Medical College of Capital Medical University, Beijing, China
| | - Li Song-guo
- Peking University Shougang Hospital, Beijing, China
| | - Wang Jing-jing
- Beijing Tongzhou Maternity and Child Health Care Hospital, Beijing, China
| | - Huang Xuan
- Department of Ophthalmology, Beijing Chaoyang Hospital, The Third Clinical Medical College of Capital Medical University, Beijing, China,*Correspondence: Huang Xuan,
| | - Tao Yong
- Department of Ophthalmology, Beijing Chaoyang Hospital, The Third Clinical Medical College of Capital Medical University, Beijing, China
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Xiong R, Zhu Z, Jiang Y, Kong X, Zhang J, Wang W, Kiburg K, Yuan Y, Chen Y, Zhang S, Xuan M, Zeng J, Morgan IG, He M. Sustained and rebound effect of repeated low‐level red‐light therapy on myopia control: A 2‐year post‐trial follow‐up study. Clin Exp Ophthalmol 2022; 50:1013-1024. [PMID: 36054314 PMCID: PMC10086781 DOI: 10.1111/ceo.14149] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/18/2022] [Accepted: 08/21/2022] [Indexed: 01/16/2023]
Abstract
BACKGROUND To evaluate the long-term efficacy and safety of continued repeated low-level red-light (RLRL) therapy on myopia control over 2 years, and the potential rebound effect after treatment cessation. METHODS The Chinese myopic children who originally completed the one-year randomised controlled trial were enrolled. Children continued RLRL-therapy were defined as RLRL-RLRL group, while those who stopped and switched to single-vision spectacle (SVS) in the second year were RLRL-SVS group. Likewise, those who continued to merely wear SVS or received additional RLRL-therapy were SVS-SVS and SVS-RLRL groups, respectively. RLRL-therapy was provided by an at-home desktop light device emitting red-light of 650 nm and was administered for 3 min at a time, twice a day and 5 days per week. Changes in axial length (AL) and cycloplegic spherical equivalence refraction (SER) were measured. RESULTS Among the 199 children who were eligible, 138 (69.3%) children attended the examination and 114 (57.3%) were analysed (SVS-SVS: n = 41; SVS-RLRL: n = 10; RLRL-SVS: n = 52; RLRL-RLRL: n = 11). The baseline characteristics were balanced among four groups. In the second year, the mean changes in AL were 0.28 ± 0.14 mm, 0.05 ± 0.24 mm, 0.42 ± 0.20 mm and 0.12 ± 0.16 mm in SVS-SVS, SVS-RLRL, RLRL-SVS and RLRL-RLRL group, respectively (p < 0.001). The respective mean SER changes were -0.54 ± 0.39D, -0.09 ± 0.55D, -0.91 ± 0.48D, and -0.20 ± 0.56D (p < 0.001). Over the 2-year period, axial elongation and SER progression were smallest in RLRL-RLRL group (AL: 0.16 ± 0.37 mm; SER: -0.31 ± 0.79D), followed by SVS-RLRL (AL: 0.44 ± 0.37 mm; SER: -0.96 ± 0.70D), RLRL-SVS (AL: 0.50 ± 0.28 mm; SER: -1.07 ± 0.69D) and SVS-SVS group (AL: 0.64 ± 0.29 mm; SER: -1.24 ± 0.63D). No self-reported adverse events, functional or structural damages were noted. CONCLUSIONS Continued RLRL therapy sustained promising efficacy and safety in slowing myopia progression over 2 years. A modest rebound effect was noted after treatment cessation.
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Affiliation(s)
- Ruilin Xiong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat‐sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science Guangdong Provincial Clinical Research Center for Ocular Diseases Guangzhou China
| | - Zhuoting Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat‐sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science Guangdong Provincial Clinical Research Center for Ocular Diseases Guangzhou China
- Centre for Eye Research Australia Royal Victorian Eye and Ear Hospital Melbourne Victoria Australia
- Ophthalmology, Department of Surgery University of Melbourne Melbourne Victoria Australia
| | - Yu Jiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat‐sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science Guangdong Provincial Clinical Research Center for Ocular Diseases Guangzhou China
| | - Xiangbin Kong
- Department of Ophthalmology, Affiliated Foshan Hospital Southern Medical University Foshan China
| | - Jian Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat‐sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science Guangdong Provincial Clinical Research Center for Ocular Diseases Guangzhou China
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat‐sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science Guangdong Provincial Clinical Research Center for Ocular Diseases Guangzhou China
| | - Katerina Kiburg
- Centre for Eye Research Australia Royal Victorian Eye and Ear Hospital Melbourne Victoria Australia
| | - Yixiong Yuan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat‐sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science Guangdong Provincial Clinical Research Center for Ocular Diseases Guangzhou China
| | - Yanping Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat‐sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science Guangdong Provincial Clinical Research Center for Ocular Diseases Guangzhou China
| | - Shiran Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat‐sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science Guangdong Provincial Clinical Research Center for Ocular Diseases Guangzhou China
| | - Meng Xuan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat‐sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science Guangdong Provincial Clinical Research Center for Ocular Diseases Guangzhou China
| | - Junwen Zeng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat‐sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science Guangdong Provincial Clinical Research Center for Ocular Diseases Guangzhou China
| | - Ian G. Morgan
- Research School of Biology Australian National University Canberra Australian Capital Territory Australia
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat‐sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science Guangdong Provincial Clinical Research Center for Ocular Diseases Guangzhou China
- Centre for Eye Research Australia Royal Victorian Eye and Ear Hospital Melbourne Victoria Australia
- Ophthalmology, Department of Surgery University of Melbourne Melbourne Victoria Australia
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Zhu MJ, Ding L, Du LL, Chen J, He XG, Li SS, Zou HD. Photopic pupil size change in myopic orthokeratology and its influence on axial length elongation. Int J Ophthalmol 2022; 15:1322-1330. [PMID: 36017053 DOI: 10.18240/ijo.2022.08.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 02/25/2022] [Indexed: 11/23/2022] Open
Abstract
AIM To explore the photopic pupil size behavior in myopic children undergoing overnight orthokeratology (ortho-k) over 1-year period and its effects on the axial elongation. METHODS A total of 202 Chinese myopic children were enrolled in this prospective clinical trial. Ninety-five subjects in ortho-k group and eighty-eight subjects in spectacle group completed the 1-year study. Axial length (AL) was measured before enrollment and every 6mo after the start of ortho-k. The photopic pupil diameter (PPD) was determined using the Pentacam AXL and measured in an examination room with lighting of 300-310 Lx. Stepwise multiple linear regression analysis was used to identify variables contribution to axial elongation. RESULTS Compared with spectacle group, the average 1-year axial elongation was significantly slower in the ortho-k group (0.25±0.27 vs 0.44±0.23 mm, P<0.0001). In ortho-k group, PPDs significantly decreased from 4.21±0.62 mm to 3.94±0.53 mm after 1mo of lens wear (P=0.001, Bonferroni correction) and the change lasts for 3-month visit. No significantly change during the other follow-up visits was found (P>0.05, Bonferroni correction). The 4.81 mm PPD may be a possible cutoff point in the ortho-k group. Subjects with PPD below or equal to 4.81 mm tended to have smaller axial elongation compared to subjects with PPD above 4.81 mm after 1-year period (t=-3.09, P=0.003). In ortho-k group, univariate analyses indicated that those with older age, greater degree of myopia, longer AL, smaller baseline PPD (PPDbaseline) experienced a smaller change in AL. In multivariate analyses, older age, greater AL and smaller PPDbaseline were associated with smaller increases in AL. In spectacle group, PPD tended to be stable (P>0.05, Bonferroni correction) and did not affect axial growth. CONCLUSION PPDs experience significantly decreases at 1-month and 3-month ortho-k treatment. Children with smaller PPD tend to experience slower axial elongation and may benefit more from ortho-k.
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Affiliation(s)
- Meng-Jun Zhu
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai 200040, China
| | - Li Ding
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai 200040, China
| | - Lin-Lin Du
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai 200040, China
| | - Jun Chen
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai 200040, China
| | - Xian-Gui He
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai 200040, China
| | - Shan-Shan Li
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai 200040, China
| | - Hai-Dong Zou
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai 200040, China.,Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai 200080, China
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Fan Y, Zuo L, Ma J, Peng Z, Li Y, Wang K, Zhao M. An investigation into the causes of abnormal waste of Ortho-K lenses. Front Public Health 2022; 10:981573. [PMID: 36045728 PMCID: PMC9421076 DOI: 10.3389/fpubh.2022.981573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/28/2022] [Indexed: 01/25/2023] Open
Abstract
Purpose To investigate the reasons for wasting orthokeratology (OK) lenses due to breakage or loss, provide more comprehensive guidelines for the clinical care of lenses and minimize time and costs for patients due to excessive broken and lost lenses. Methods A survey was administered to clinic outpatients who had broken or lost their OK lenses before the regularly scheduled replacement cycle (1-1.5 years). The association between the frequency of OK lens breakage and daily care was assessed using Fisher's exact test and multivariable ordered logistic regression analysis. Results A total of 306 valid questionnaires were collected. Among the subjects, 141 were male, and 165 were female, with a mean age of 10.57 ± 2.00 years (range: 6-18 years). In the investigation of the causes of OK lens waste, 81.4% of the patients reported lens breakage, 13.1% lost their lenses, and 5.6% of patients experienced both fragmentation and lens loss. More than half of the patients (52.90%) used incorrect lens cleaning techniques. In further analysis of the relationship between the frequency of OK lens fragmentation within a year and daily care habits, a significant difference was observed between the caregiver (P = 0.03) and whether the lenses were cleaned promptly after removal (P < 0.001). Mothers as daily caregivers of OK lenses had a lower frequency of fragmentation in a year compared to nanny or grandparents (P = 0.014, OR = 0.33, 95% CI = 0.13, 0.80). The failure to clean the lenses according to eye care practitioners' guidance was a risk factor for the frequent breakage of OK lenses (P < 0.001. OR = 5.29, 95% CI = 3.15, 8.89). Conclusions The causes of OK lens waste were mainly attributed to caregivers, care practices and some unexpected situations that can be avoided through optometrists' reminders. Regardless of the reasons for noncompliant behavior leading to breakage or loss of OK lenses, all of the complications can probably be addressed by better and more frequent reinforcement of care procedures by practitioners. Better clinical guidance measures and more frequent reminders could prevent a large proportion of abnormal waste of OK lenses.
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Affiliation(s)
- Yuzhuo Fan
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China,Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing, China,College of Optometry, Peking University Health Science Center, Beijing, China,Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China,Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Lili Zuo
- Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing, China,Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China,Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Jiahui Ma
- Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing, China,Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China,Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Zisu Peng
- Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing, China,Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China,Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Yan Li
- Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing, China,Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China,Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Kai Wang
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China,Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing, China,College of Optometry, Peking University Health Science Center, Beijing, China,Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China,Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China,*Correspondence: Kai Wang
| | - Mingwei Zhao
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China,Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing, China,College of Optometry, Peking University Health Science Center, Beijing, China,Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China,Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
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Fitting of Orthokeratology in the United States: A Survey of the Current State of Orthokeratology. Optom Vis Sci 2022; 99:568-579. [PMID: 35657355 DOI: 10.1097/opx.0000000000001911] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
SIGNIFICANCE The Fitting of Orthokeratology in the United States (FOKUS) survey provides information about the United States (US) OrthoK market. This independent survey is the first to attain detailed assessment of the OrthoK market. PURPOSE Develop and administer a survey to eye care providers (ECP's) in the US who are managing orthokeratology patients and those who are not to determine a profile of prescribers, patients and overall market. METHODS The FOKUS survey was administered and distributed online. Outcome measures of the FOKUS survey involved general categories of 1) practice and practitioner profiles, 2) clinical prescribing patterns, 3) patient profile, 4) products and marketing, 5) fees and 6) market size and growth. RESULTS The number of ECP's who are actively fitting and managing OrthoK patients in the US is approximately 3,000. 545 responded to the survey, 283 reported they were actively fitting orthokeratology. Orthokeratology is prescribed with the intent of managing myopia by 68% of respondents, 53% monitor axial length, and 61% start OrthoK patients at age 13 years old or under. The mean number of years a patient wears OrthoK is 7.8. A commonly reported complication with orthokeratology is corneal staining. Microbial keratitis (MK) is rarely or never seen by 86% of respondents. Of those currently fitting, 56% anticipate growth of orthokeratology fitting over the next twelve months. Of those not currently fitting orthokeratology, 46% plan to start within two years. CONCLUSIONS Orthokeratology represents a small but growing segment of the US contact lens market. The number of practitioners actively prescribing and fitting orthokeratology in the US is approximately 3,000 with high potential for growth within the next two years. Results of the FOKUS survey are relevant to practitioners currently fitting or considering orthokeratology, manufacturers, educators and researchers as baseline for future orthokeratology market assessment.
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Chen X, Xiong Y, Liu F, Wang J, Yang B, Liu L. Factors determining the myopia control effect of an orthokeratology lens: A two‐year multi‐level model. Ophthalmic Physiol Opt 2022; 42:786-796. [PMID: 35499112 DOI: 10.1111/opo.12990] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 03/28/2022] [Indexed: 02/05/2023]
Affiliation(s)
- Xiaohang Chen
- Department of Optometry and Visual Science, West China School of Medicine Sichuan University Chengdu China
- Laboratory of Optometry and Vision Sciences, West China Hospital Sichuan University Chengdu China
- Department of Ophthalmology, West China Hospital Sichuan University Chengdu China
| | - Yan Xiong
- Department of Pediatrics Affiliated Hospital of North Sichuan Medical University Nanchong China
| | - Fengyang Liu
- Department of Optometry Guizhou Provincial People's Hospital Guiyang China
| | - Jianglan Wang
- Department of Optometry and Visual Science, West China School of Medicine Sichuan University Chengdu China
- Laboratory of Optometry and Vision Sciences, West China Hospital Sichuan University Chengdu China
- Department of Ophthalmology, West China Hospital Sichuan University Chengdu China
| | - Bi Yang
- Department of Optometry and Visual Science, West China School of Medicine Sichuan University Chengdu China
- Laboratory of Optometry and Vision Sciences, West China Hospital Sichuan University Chengdu China
- Department of Ophthalmology, West China Hospital Sichuan University Chengdu China
| | - Longqian Liu
- Department of Optometry and Visual Science, West China School of Medicine Sichuan University Chengdu China
- Laboratory of Optometry and Vision Sciences, West China Hospital Sichuan University Chengdu China
- Department of Ophthalmology, West China Hospital Sichuan University Chengdu China
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Lipson MJ. The Role of Orthokeratology in Myopia Management. Eye Contact Lens 2022; 48:189-193. [PMID: 35333801 DOI: 10.1097/icl.0000000000000890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2021] [Indexed: 11/04/2022]
Abstract
ABSTRACT Intervention to slow axial elongation and progressing degree of myopia has become an important public health issue. Although orthokeratology (OrthoK) has been prescribed to temporarily reduce or eliminate refractive error, myopic children undergoing OrthoK have shown significant slowing of axial elongation and myopic progression. This review presents data on the efficacy, benefits, and risks of the use of OrthoK to slow axial elongation in myopic children. It also discusses how OrthoK fits into an overall strategy of myopia management in practice compared with alternative prescribed interventions to slow myopic progression. Other factors discussed are patient candidacy, impact on vision-related quality of life, and use of OrthoK in combination with pharmaceutical agents. With precise fitting, careful follow-up, and patient compliance with recommended lens cleaning and disinfection, OrthoK is a safe and effective method to slow axial elongation in children.
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Affiliation(s)
- Michael J Lipson
- Kellogg Eye Center, Department of Ophthalmology and Visual Science, University of Michigan, Commerce Twp, MI
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Overview on Defocus Incorporated Multiple Segments Lenses: A Novel Perspective in Myopia Progression Management. Vision (Basel) 2022; 6:vision6020020. [PMID: 35466272 PMCID: PMC9036268 DOI: 10.3390/vision6020020] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/09/2022] [Accepted: 03/30/2022] [Indexed: 11/16/2022] Open
Abstract
Myopia is becoming more common across the world, affecting approximately two billion people and rising. Different kinds of therapies (optical, pharmaceutical, environmental, or behavioral) have been proposed to decrease myopia progression, but with variable results and a lack of standardization. The evidence that targeted myopic defocus inhibits eye length growth has paved the way for several contact and spectacle lense designs to induce a peripheral defocus, thus slowing myopia progression, but the perfect configuration has yet to be defined. One of the newest and more promising approaches in this field is the use of Defocus Incorporated Multiple Segments (DIMS) lenses. These lenses are built from the assumption that targeted myopic defocus, produced by 396 mid-peripheral lenslets with positive power, inhibits eye length growth. Recent studies have highlighted the effectiveness of these lenses compared to children who had worn single vision spectacle lenses, in terms of myopia control and tolerability. Despite the evidence that these lenses can help slow down the progression of myopia, the occasional mid-peripheral aberrations they can induce, as well as the overall eye strain that comes with wearing them, should not be overlooked. The aim of this review is to give attention to the advantages and the shortfalls of this new approach and to evaluate its effectiveness in clinical practice.
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Sun L, Li ZX, Chen Y, He ZQ, Song HX. The effect of orthokeratology treatment zone decentration on myopia progression. BMC Ophthalmol 2022; 22:76. [PMID: 35164702 PMCID: PMC8845411 DOI: 10.1186/s12886-022-02310-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 02/10/2022] [Indexed: 12/18/2022] Open
Abstract
Background This study aimed to compare the changes in the axial length (AL) in myopic children that wear centered and decentered orthokeratology (Ortho-K). Methods This retrospective study included 217 subjects who were treated with an Ortho-K lens for >12 months. The subjects were divided into three groups based on the magnitude of the Ortho-K lens treatment zone decentration: mildly, moderately, and severely decentered groups. Distance and direction of treatment zone decentration were calculated using software that was developed in-house. The AL changes in different groups were compared. Results Based on the distance of the treatment zone decentration, 65 children (65 eyes) were included in the mildly decentered group, 114 children (114 eyes) in the moderately decentered group, and 38 children (38 eyes) in the severely decentered group. The mean decentration distance in the three groups was 0.35 ± 0.11 mm, 0.71 ± 0.13 mm, and 1.21 ± 0.22 mm, respectively. The mean AL increase in the three groups after 12 months of Ortho-K lens wear was 0.24 ± 0.21 mm, 0.23 ± 0.18 mm, and 0.19 ± 0.20 mm, respectively. There were no significant differences in AL changes among the three groups. Conclusions Ortho-K lens decentration is common in clinical practice. The AL change after Ortho-K lens wear was not significantly different in subjects with different magnitudes of Ortho-K lens decentration. Fitting the Ortho-K lens in the properly centered zone is recommended to ensure the safety of Ortho-K lens wear and to maintain visual quality.
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Affiliation(s)
- Lu Sun
- Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and visual Sciences, National Engineering Research Center for Ophthalmology, #1 Dong Jiao Min Xiang, Beijing, 100730, China
| | - Zheng-Xuan Li
- Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and visual Sciences, National Engineering Research Center for Ophthalmology, #1 Dong Jiao Min Xiang, Beijing, 100730, China
| | - Yun Chen
- Key Laboratory of Universal Wireless Communications, Ministry of Education, Beijing University of Posts and Telecommunications, Beijing, 100876, China
| | - Zhi-Qiang He
- Key Laboratory of Universal Wireless Communications, Ministry of Education, Beijing University of Posts and Telecommunications, Beijing, 100876, China
| | - Hong-Xin Song
- Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and visual Sciences, National Engineering Research Center for Ophthalmology, #1 Dong Jiao Min Xiang, Beijing, 100730, China.
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Zhao L, Jing L, Li J, Du X. Changes in corneal densitometry after long-term orthokeratology for myopia and short-term discontinuation. PLoS One 2022; 17:e0263121. [PMID: 35120161 PMCID: PMC8815901 DOI: 10.1371/journal.pone.0263121] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 01/12/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose
To quantify changes in corneal densitometry after long-term orthokeratology treatment in myopic children and to analyze the reversibility one month after discontinuation.
Methods
Seventy-four myopic subjects aged 8–16 years, who wore orthokeratology lenses for two years, were divided into relatively steep- (lens movement within 1.0–1.5 mm, thirty-six participants) and flat-fitting groups (lens movement within 1.5–2.0 mm, thirty-eight participants). Based on refractive errors, they were divided into low and moderate myopia groups (thirty-seven participants in each group). Corneal densitometry was performed using Pentacam (Oculus Optikgeräte GmbH, Wetzlar, Germany) at each follow-up timepoint. Repeated-measures analysis of variance was used to compare the parameters before and after orthokeratology.
Results
The corneal densitometry values over the 0–10 mm diameter area increased from 12.84±1.38 grayscale units (GSU) at baseline to 13.59±1.42 GSU after three-month orthokeratology (P = .001) and reached 14.92±1.45 GSU at two years (P < .001). An increase in densitometry began at one month (P = .001) over the 0–2 mm annulus compared with that at three months over the 2–6 mm and 6–10 mm zones (P = .002,.014). The densitometry values significantly increased at three months in the relatively steep-fitting group (P = .003) and at one year in the relatively flat-fitting group (P = .001). After discontinuation of orthokeratology for one month, the values showed no significant decrease.
Conclusions
Long-term orthokeratology treatment causes a small but statistically significant increase in corneal densitometry values. During the first year, the onset of these changes was related to the fitting mode. Corneal densitometry values showed no significant reduction after one-month discontinuation.
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Affiliation(s)
- Lianghui Zhao
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
- Weifang Medical University, Weifang, China
| | - Lili Jing
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Jie Li
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Xianli Du
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
- * E-mail:
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Chen X, Xiong Y, Qi X, Liu L. Nasal-temporal asymmetric changes in retinal peripheral refractive error in myopic adolescents induced by overnight orthokeratology lenses. Front Neurol 2022; 13:1006112. [PMID: 36938370 PMCID: PMC10017440 DOI: 10.3389/fneur.2022.1006112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/07/2022] [Indexed: 03/06/2023] Open
Abstract
Objective To observe the changes in peripheral refraction in myopic adolescents after overnight orthokeratology and its influencing factors. Methods This was a prospective study among young myopic adolescents aged 8-14 years (n = 21). The peripheral refraction of the subjects was measured at 5, 10, 15, 20, 25, and 30° from the nasal and temporal side to the central fixation by WAM-5500 Open-field refractometer. The axial length, baseline spherical equivalent refraction, and other parameters were measured. The data were measured at baseline and 1, 3, and 12 months after wearing orthokeratology lenses. Results The relative peripheral refraction at the nasal and temporal side from central to 30° eccentricity revealed relative hyperopic defocus in all subjects at baseline measurement. One month after wearing the orthokeratology lenses, the relative peripheral refraction changed to myopic defocus, the nasal-temporal relative peripheral refraction was asymmetric, and the observed difference was statistically significant. Positive correlations were found between the change amount of nasal relative peripheral refraction and baseline spherical equivalent refraction, the baseline nasal relative peripheral refraction was higher than that on the temporal side, and after orthokeratology, the value of nasal relative peripheral refraction was lower than that on the temporal side. The changes at 30° on both sides were correlated to the axial elongation (rNasal = 0.565, rTemporal = 0.526, p < 0.05). Conclusion This study demonstrated that after orthokeratology, relative peripheral hyperopia in the myopic patients turned into relative peripheral myopia, and the nasal-temporal asymmetry changed significantly after orthokeratology, which was correlated with the baseline refractive state.
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Affiliation(s)
- Xiaohang Chen
- Laboratory of Optometry and Visual Science, Sichuan University, Chengdu, Sichuan, China
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yan Xiong
- Department of Pediatrics, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Xinzhou Qi
- School of Management, Fudan University, Shanghai, China
| | - Longqian Liu
- Laboratory of Optometry and Visual Science, Sichuan University, Chengdu, Sichuan, China
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- *Correspondence: Longqian Liu ;
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London N, Erdinest N, Lavy I, Levinger N, Pras E, Morad Y. Original article: Myopia control utilizing low-dose atropine as an isolated therapy or in combination with other optical measures: A retrospective cohort study. Taiwan J Ophthalmol 2022. [PMID: 37484626 PMCID: PMC10361442 DOI: 10.4103/tjo.tjo_31_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
PURPOSE To assess the additive potency of low-dose atropine combined with optical measures designed to decrease myopia progression. MATERIALS AND METHODS This retrospective study included 104 myopic children aged 5-12 over 4 years, divided into five groups: daily instillation of 0.01% atropine and distance single-vision spectacles (A), 0.01% atropine and progressive addition lenses (A + PAL), 0.01% atropine and soft contact lens with peripheral blur (A + CL). Two control groups were included, prescribed bifocal spectacles or single vision (SV) spectacles. Cycloplegic spherical equivalence refraction was measured biannually, including 1 year after cessation of treatment. RESULTS A significant decrease in myopia progression was noted during the 2nd and 3rd years of atropine treatment: A -0.55 ± 0.55D, -0.15 ± 0.15, -0.12 ± 0.12D were 1st, 2nd, 3rd years, respectively, A + PAL -0.47 ± 0.37D, -0.10 ± 0.25D, and -0.11 ± 0.25D were 1st, 2nd, 3rd years, respectively, A + CL -0.36 ± 0.43D, -0.13 ± 0.29D, and -0.10 ± 0.27D were 1st, 2nd, 3rd years, respectively. Myopia progression over 3 years, respectively, was -0.82 ± 0.50D, -0.70 ± 0.69D, -0.59 ± 0.66D in the bifocal group and -1.20 ± 1.28D, -0.72 ± 0.62D, -0.65 ± 0.47D in the SV group. One year after cessation of atropine treatment, myopia progression was - 0.32 ± 0.31D in A, -0.23 ± 0.28D in A + PAL, and -0.18 ± 0.35D in A + CL. CONCLUSION Atropine 0.01% presented as effective at decelerating myopia progression, more prominent in the 2nd and 3rd years of treatment. Combining atropine 0.01% with optical modalities exhibited a trend for added efficacy over monotherapy. A + CL exhibited the least rebound effect 1 year after cessation of treatment.
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