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Chen J, Tang Y, Lin Z, Tao Z, Deng H. Effect and safety posterior scleral reinforcement on controlling myopia in children: a meta-analysis. Int Ophthalmol 2024; 44:8. [PMID: 38319543 PMCID: PMC10847067 DOI: 10.1007/s10792-024-02929-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: 04/15/2023] [Accepted: 12/17/2023] [Indexed: 02/07/2024]
Abstract
PURPOSE The aim of this meta-analysis was to assess the efficacy of posterior scleral reinforcement (PSR) on the control of pediatric myopia. Electronic databases were systematically searched. METHODS Standardized mean differences (SMDs) of outcomes were calculated. Eight studies with 357 patients with pediatric myopia were included. The SMD for the increase in mean axial length (AL) in the PSR and control group was - 1.19 (95% CI - 1.71, - 0.68). RESULTS The SMD for decrease of best-corrected visual acuity (BCVA) LogMAR in the PSR and control group was 0.85 (95% CI 0.28, 1.43). The SMD for change in intraocular pressure (IOP) at the time of surgery and at the end of the follow-up period in the PSR group was - 0.01 (95% CI - 0.48, 0.47). CONCLUSION This meta-analysis indicates that PSR surgery may be an effective therapeutic strategy to control the progression of myopia in childhood with acceptable adverse effects.
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Affiliation(s)
- Jing Chen
- Shenzhen Eye Hospital, Shenzhen Eye Institute, Jinan University, No. 18 Zetian Road, Futian District, Shenzhen, 518040, Guangdong, China
| | - Yu Tang
- The Second Clinical Medical College, Jinan University, Shenzhen, China
| | - Zhihong Lin
- The Second Clinical Medical College, Jinan University, Shenzhen, China
| | - Zhengyang Tao
- Shenzhen Eye Hospital, Shenzhen Eye Institute, Jinan University, No. 18 Zetian Road, Futian District, Shenzhen, 518040, Guangdong, China
| | - Hongwei Deng
- Shenzhen Eye Hospital, Shenzhen Eye Institute, Jinan University, No. 18 Zetian Road, Futian District, Shenzhen, 518040, Guangdong, China.
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2
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Abdellah MM, Amer AA, Eldaly ZH, Anber MA. Optical coherence tomography angiography of the macula of high myopia in children and adolescents. Int J Retina Vitreous 2024; 10:17. [PMID: 38317246 PMCID: PMC10845789 DOI: 10.1186/s40942-024-00532-w] [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: 11/30/2023] [Accepted: 01/13/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND High myopia represents a health issue and leads to the development of complications that threaten vision. The study of macular changes in high myopia patients has undergone great advances with updated technology via new spectral optical coherence tomography (OCT) and Optical coherence tomography angiography (OCTA). Most of related studies have focused on the adults and additional studies need to investigate macular changes in children and adolescents. This study aimed to evaluate the changes in the macular structure by OCT and the macular vessel density in high myopia in children and adolescents by OCTA. METHODS A cross-sectional comparative study. The population was divided into two groups: group 1 (4-11 years) and group 2 (12-18 years). The results were comparable to those of control study of the same age group. The two high myopia groups and the control groups were examined by macular OCT and OCTA to evaluate macular thickness and vessel density in the superficial and deep capillary plexuses. RESULTS OCT measurements of patients in group 1 revealed that central macular thickness was significantly lower in high myopia group than in the control group and measured 220.91 ± 27.87 μm and 258.23 ± 17.26 μm, respectively, (P < 0.0001). However, in group 2 the central macular thickness in the high myopia group and control group was 236.32 ± 27.76 μm and 247.09 ± 16.81 μm respectively, and the difference was not statistically significant (P = 0.09). The parafoveal macular thickness and the perifoveal macular quadrants thickness were significantly lower in high myopic children and high myopic adolescents (P < 0.0001) than age matched controls. The parafoveal and perifoveal vessel densities in the superficial and deep capillary plexuses were lower in the high myopia groups than in the age-matched controls in both groups with a few segment exceptions in group 1. The FAZ was significantly wider in group 1 than in the age-matched emmetropes (P = 0.02). The FAZ was wider in group 2 than controls, but the difference was not statistically significant, (P = 0.75). CONCLUSION High myopic children and adolescents have thinner macular thickness than comparable age-matched emmetropes and have less vessel density in superficial and deep capillary plexuses with a wider FAZ.
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Affiliation(s)
- Marwa Mahmoud Abdellah
- Ophthalmology Department, Sohag Faculty of Medicine, Sohag University, Sohag, 82525, Egypt.
| | - Ahmed Ali Amer
- Ophthalmology Department, Qena Faculty of Medicine, South Valley University, Qena, Egypt
| | - Zeiad Hasan Eldaly
- Ophthalmology Department, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt
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3
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Jiang D, Guo N, Lv X, Li Y, Han Y, Yuan M, Zhai C, Zhang W, Zhang F. Association between Fundus Tessellation and Contrast Sensitivity in Myopic Eyes. Curr Eye Res 2024; 49:188-196. [PMID: 37846084 DOI: 10.1080/02713683.2023.2269612] [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: 01/17/2023] [Accepted: 10/07/2023] [Indexed: 10/18/2023]
Abstract
PURPOSE To assess the association of fundus tessellation with contrast sensitivity, Quality of Vision questionnaire, and other factors at five years postcorneal refractive surgery. METHODS This is a cross-sectional study. Both eyes of 98 subjects (196 eyes) who received femtosecond laser in situ keratomileusis (FS-LASIK) or small incision lenticular extraction (SMILE) five years prior were enrolled in this study. Fundus tessellation was imaged using wide-angle fundus photographs and graded into four categories with the assistance of the ETDRS grid. Photopic and mesopic contrast sensitivity were measured under the best correction. The Quality of Vision (QoV) questionnaire was used to assess visual symptoms. RESULTS Fundus tessellation was classified as follows: 19 eyes were grade 0 (9.7%), 28 eyes were grade 1 (14.3%), 59 eyes were grade 2 (30.1%), and 90 eyes were grade 3 (45.9%). Higher degrees of fundus tessellation were associated with lower photopic contrast sensitivity, a significant difference was observed at spatial frequencies of 6cpd (p = 0.030, grade 1 >grade 3 p = 0.011). Higher degrees of fundus tessellation were also associated with lower mesopic contrast sensitivity, a significant difference was observed at spatial frequencies of 18cpd (p = 0.011, grade 0 >grade 3 p = 0.012). The preoperative degree of myopia was positively associated with fundus tessellation grade (p < 0.001). However, in linear mixed-effect model analysis, no significant influence of parameters (contrast sensitivity, preoperative myopia, and QoV scores) upon different tessellation grades was found (p > 0.05). CONCLUSIONS Patients with moderate and high myopia were more likely to have higher grades of fundus tessellation. Higher degree of fundus tessellation associates with lower contrast sensitivity. Patients with moderate and high myopia should be concerned with retinal-choroidal changes. Contrast sensitivity could be a clinical sign for progression of tessellation and used to screen for early retinal-choroidal changes to prevent pathologic myopia.
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Affiliation(s)
- Dianjun Jiang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing, China
| | - Ning Guo
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing, China
| | - Xiaotong Lv
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing, China
| | - Yu Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing, China
| | - Yu Han
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing, China
| | - Mingzhen Yuan
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing, China
| | - Changbin Zhai
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing, China
| | - Wei Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing, China
| | - Fengju Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing, China
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Kaphle D, Varnas SR, Schmid KL, Suheimat M, Leube A, Atchison DA. Accommodation lags are higher in myopia than in emmetropia: Measurement methods and metrics matter. Ophthalmic Physiol Opt 2022; 42:1103-1114. [PMID: 35775299 PMCID: PMC9544228 DOI: 10.1111/opo.13021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 05/31/2022] [Accepted: 05/31/2022] [Indexed: 12/29/2022]
Abstract
Purpose To determine whether accommodative errors in emmetropes and myopes are systematically different, and the effect of using different instruments and metrics. Methods Seventy‐six adults aged 18–27 years comprising 24 emmetropes (spherical equivalent refraction of the dominant eye +0.04 ± 0.03 D) and 52 myopes (−2.73 ± 0.22 D) were included. Accommodation responses were measured with a Grand Seiko WAM‐5500 and a Hartmann–Shack Complete Ophthalmic Analysis System aberrometer, using pupil plane (Zernike and Seidel refraction) and retinal image plane (neural sharpness—NS; and visual Strehl ratio for modulation transfer function—VSMTF) metrics at 40, 33 and 25 cm. Accommodation stimuli were presented to the corrected dominant eye, and responses, referenced to the corneal plane, were determined in the fellow eye. Linear mixed‐effects models were used to determine influence of the refractive group, the measurement method, accommodation stimulus, age, race, parental myopia, gender and binocular measures of heterophoria, accommodative convergence/accommodation and convergence accommodation/convergence ratios. Results Lags of accommodation were affected significantly by the measurement method (p < 0.001), the refractive group (p = 0.003), near heterophoria (p = 0.002) and accommodative stimulus (p < 0.05), with significant interactions between some of these variables. Overall, emmetropes had smaller lags of accommodation than myopes with respective means ± standard errors of 0.31 ± 0.08 D and 0.61 ± 0.06 D (p = 0.003). Lags were largest for the Grand Seiko and Zernike defocus, intermediate for NS and VSMTF, and least for Seidel defocus. Conclusions The mean lag of accommodation in emmetropes is approximately equal to the previously reported depth of focus. Myopes had larger (double) lags than emmetropes. Differences between methods and instruments could be as great as 0.50 D, and this must be considered when comparing studies and outcomes. Accommodative lag increased with the accommodation stimulus, but only for methods using a fixed small pupil diameter.
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Affiliation(s)
- Dinesh Kaphle
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia.,Discipline of Optometry, Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Saulius R Varnas
- Carl Zeiss Vision Australia Holdings Limited, Adelaide, South Australia, Australia
| | - Katrina L Schmid
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Marwan Suheimat
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | | | - David A Atchison
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
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González-Iglesias E, López-Vázquez A, Noval S, Nieves-Moreno M, Granados-Fernández M, Arruti N, Rosa-Pérez I, Pacio-Míguez M, Montaño VEF, Rodríguez-Solana P, del Pozo A, Santos-Simarro F, Vallespín E. Next-Generation Sequencing Screening of 43 Families with Non-Syndromic Early-Onset High Myopia: A Clinical and Genetic Study. Int J Mol Sci 2022; 23:ijms23084233. [PMID: 35457050 PMCID: PMC9031962 DOI: 10.3390/ijms23084233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 04/04/2022] [Indexed: 02/01/2023] Open
Abstract
Early-onset high myopia (EoHM) is a disease that causes a spherical refraction error of ≥-6 diopters before 10 years of age, with potential multiple ocular complications. In this article, we report a clinical and genetic study of 43 families with EoHM recruited in our center. A complete ophthalmological evaluation was performed, and a sample of peripheral blood was obtained from proband and family members. DNA was analyzed using a customized next-generation sequencing panel that included 419 genes related to ophthalmological disorders with a suspected genetic cause, and genes related to EoHM pathogenesis. We detected pathogenic and likely pathogenic variants in 23.9% of the families and detected variants of unknown significance in 76.1%. Of these, 5.7% were found in genes related to non-syndromic EoHM, 48.6% in genes associated with inherited retinal dystrophies that can include a syndromic phenotype, and 45.7% in genes that are not directly related to EoHM or retinal dystrophy. We found no candidate genes in 23% of the patients, which suggests that further studies are needed. We propose a systematic genetic analysis for patients with EoHM because it helps with follow-up, prognosis and genetic counseling.
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Affiliation(s)
- Eva González-Iglesias
- Section of Molecular Ophthalmology, Medical and Molecular Genetics Institute (INGEMM) IdiPaz, La Paz University Hospital, 28046 Madrid, Spain; (E.G.-I.); (V.E.F.M.); (P.R.-S.)
| | - Ana López-Vázquez
- Department of Ophthalmology, La Paz University Hospital, 28046 Madrid, Spain; (A.L.-V.); (S.N.); (M.N.-M.); (M.G.-F.); (N.A.); (I.R.-P.)
| | - Susana Noval
- Department of Ophthalmology, La Paz University Hospital, 28046 Madrid, Spain; (A.L.-V.); (S.N.); (M.N.-M.); (M.G.-F.); (N.A.); (I.R.-P.)
| | - María Nieves-Moreno
- Department of Ophthalmology, La Paz University Hospital, 28046 Madrid, Spain; (A.L.-V.); (S.N.); (M.N.-M.); (M.G.-F.); (N.A.); (I.R.-P.)
| | - María Granados-Fernández
- Department of Ophthalmology, La Paz University Hospital, 28046 Madrid, Spain; (A.L.-V.); (S.N.); (M.N.-M.); (M.G.-F.); (N.A.); (I.R.-P.)
| | - Natalia Arruti
- Department of Ophthalmology, La Paz University Hospital, 28046 Madrid, Spain; (A.L.-V.); (S.N.); (M.N.-M.); (M.G.-F.); (N.A.); (I.R.-P.)
| | - Irene Rosa-Pérez
- Department of Ophthalmology, La Paz University Hospital, 28046 Madrid, Spain; (A.L.-V.); (S.N.); (M.N.-M.); (M.G.-F.); (N.A.); (I.R.-P.)
| | - Marta Pacio-Míguez
- Biomedical Research Center in the Rare Diseases Network (CIBERER), Carlos II Health Institute (ISCIII), 28029 Madrid, Spain; (M.P.-M.); (A.d.P.); (F.S.-S.)
- Section of Neurodevelopmental Disorders, Medical and Molecular Genetics Institute (INGEMM) IdiPaz, La Paz University Hospital, 28046 Madrid, Spain
| | - Victoria E. F. Montaño
- Section of Molecular Ophthalmology, Medical and Molecular Genetics Institute (INGEMM) IdiPaz, La Paz University Hospital, 28046 Madrid, Spain; (E.G.-I.); (V.E.F.M.); (P.R.-S.)
- Biomedical Research Center in the Rare Diseases Network (CIBERER), Carlos II Health Institute (ISCIII), 28029 Madrid, Spain; (M.P.-M.); (A.d.P.); (F.S.-S.)
| | - Patricia Rodríguez-Solana
- Section of Molecular Ophthalmology, Medical and Molecular Genetics Institute (INGEMM) IdiPaz, La Paz University Hospital, 28046 Madrid, Spain; (E.G.-I.); (V.E.F.M.); (P.R.-S.)
| | - Angela del Pozo
- Biomedical Research Center in the Rare Diseases Network (CIBERER), Carlos II Health Institute (ISCIII), 28029 Madrid, Spain; (M.P.-M.); (A.d.P.); (F.S.-S.)
- Section of Clinical Bioinformatics, Medical and Molecular Genetics Institute (INGEMM) IdiPaz, La Paz University Hospital, 28046 Madrid, Spain
| | - Fernando Santos-Simarro
- Biomedical Research Center in the Rare Diseases Network (CIBERER), Carlos II Health Institute (ISCIII), 28029 Madrid, Spain; (M.P.-M.); (A.d.P.); (F.S.-S.)
- Section of Clinical Genetics, Medical and Molecular Genetics Institute (INGEMM) IdiPaz, La Paz University Hospital, 28046 Madrid, Spain
| | - Elena Vallespín
- Section of Molecular Ophthalmology, Medical and Molecular Genetics Institute (INGEMM) IdiPaz, La Paz University Hospital, 28046 Madrid, Spain; (E.G.-I.); (V.E.F.M.); (P.R.-S.)
- Biomedical Research Center in the Rare Diseases Network (CIBERER), Carlos II Health Institute (ISCIII), 28029 Madrid, Spain; (M.P.-M.); (A.d.P.); (F.S.-S.)
- Correspondence:
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Xin X, Guo Q, Ming S, Liu C, Wang Z, Lei B. High-Resolution Image Analysis Reveals a Decrease in Lens Thickness and Cone Density in a Cohort of Young Myopic Patients. Front Med (Lausanne) 2022; 8:796778. [PMID: 34977098 PMCID: PMC8716878 DOI: 10.3389/fmed.2021.796778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 11/16/2021] [Indexed: 12/29/2022] Open
Abstract
Purpose: To study the association between axial length (AL) and the thickness of the lens, retina, choroid, and cone density with swept-source optical coherence tomography (SS-OCT) and an adaptive optics (AO) fundus camera. Design: A prospective cross-sectional study. Methods: This study included 136 eyes in 68 subjects. SS-OCT was used to quantify the thickness of the lens, ganglion cell complex (GCC) layer, inner nuclear layer (INL), outer retinal layer (ORL), and choroid layer. Adaptive optics was used to quantify spatial features of the cone photoreceptors, including density, spacing, regularity, and dispersion. The associations among the AL and the thickness of lens, retina, choroid, and cone features were evaluated with linear regression. Results: With the severity of myopia, the increased AL was associated with thinning of the lens (P < 0.001, 95% CI: −100.42 to −49.76). The thickness of the ORL and choroid decreased significantly (all P < 0.001), whereas the thickness of the GCC and INL decreased only in the outer ring (both P < 0.01). There was a significant correlation between the cone density/spacing and AL (both P < 0.001). Although cone density was reduced from 25,160/mm2 to 19,134/mm2 in the inner region and from 17,458/mm2 to 13,896/mm2 in the outer region, the best-corrected visual acuity (BCVA) was 20/20 or greater. Conclusions: We found that the lens thickness (LT), ORL, and cone density decreased in myopia. While decreasing cone density and ORL thickness should be related to axial elongation, decreasing of LT might imply intrinsic physical accommodation. These results provide further morphological changes of myopia.
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Affiliation(s)
- Xiaoyu Xin
- Department of Ophthalmology, Henan University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, China.,Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, Zhengzhou, China
| | - Qingge Guo
- Department of Ophthalmology, Henan University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, China.,Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, Zhengzhou, China
| | - Shuai Ming
- Department of Ophthalmology, Henan University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, China.,Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, Zhengzhou, China
| | - Changgeng Liu
- Department of Ophthalmology, Henan University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, China.,Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, Zhengzhou, China
| | - Zhongfeng Wang
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China
| | - Bo Lei
- Department of Ophthalmology, Henan University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, China.,Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, Zhengzhou, China.,Department of Ophthalmology, Zhengzhou University People's Hospital, Zhengzhou University, Zhengzhou, China
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Zhang L, Liu K, Nie F, Duan X. Research advance in optic disc tilt and rotation in high myopia and its implications for glaucoma and visual field defects. Eur J Ophthalmol 2021; 32:2505-2514. [PMID: 34859716 DOI: 10.1177/11206721211063716] [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: 11/17/2022]
Abstract
High myopia is of worldwide concern due to its high prevalence, and myopia is an independent risk factor for glaucoma. The purpose of this paper is to review the mechanism and clinical manifestations of optic disc tilt and rotation in high myopia and its relationship with glaucoma, to provide clues for monitoring fundus changes in high myopia and the early diagnosis of high myopia with glaucoma.
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Affiliation(s)
- Lurong Zhang
- Department of Ophthalmology, 70566The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ke Liu
- Department of Ophthalmology, 70566The Second Xiangya Hospital of Central South University, Changsha, China
| | - Fen Nie
- Department of Ophthalmology, 70566The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xuanchu Duan
- Department of Ophthalmology, 70566The Second Xiangya Hospital of Central South University, Changsha, China.,159368Central South University, Aier School of Ophthalmology, Aier Eye Hospital, Changsha, China
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