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Wu J, Zhang X, Wang L, Zhang P, Guo X, Xie P. Altering optical zone diameter, reverse curve width, and compression factor: impacts on visual performance and axial elongation in orthokeratology. Cont Lens Anterior Eye 2024; 47:102136. [PMID: 38503665 DOI: 10.1016/j.clae.2024.102136] [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: 05/04/2023] [Revised: 02/08/2024] [Accepted: 03/04/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE To investigate the effects of modifications in back optical zone diameter (BOZD), reverse curve width (RCW), and compression factor (CF) on refractive error changes and axial elongation in myopic children undergoing orthokeratology (ortho-k) over a 12-month period. METHOD In this retrospective study, data from 126 myopic children undergoing ortho-k fitting were analyzed. Subjects were categorized into four distinct groups based on lens design parameters: Group A (BOZD 6.0 mm, RCW 0.6 mm, CF 0.75 D); Group B (BOZD 6.0 mm, RCW 0.6 mm, CF 1.25 D); Group C (BOZD 5.4 mm, RCW 0.9 mm, CF 1.25 D); and Group D (BOZD 5.0 mm, RCW 1.1 mm, CF 1.25 D). The study evaluated uncorrected visual acuity (UCVA), corneal topography, and axial length (AL) at intervals, using Linear Mixed Models (LMMs) for time-based changes, and ANOVA or Kruskal-Wallis tests for group differences in AL elongation. A multivariable regression analysis identified factors independently associated with AL elongation. RESULTS Within the first day and week, all four groups displayed significant improvements in UCVA and alterations in corneal curvature, which subsequently stabilized. Although UCVA variations between groups were subtle, Group D had less corneal curvature change than Groups A and B initially and exhibited significantly less AL elongation after one year. No significant difference in corneal curvature change or AL elongation was observed between Group C and the other groups. Multiple regression analysis indicated that older baseline age, greater baseline spherical equivalent refractive error, and smaller BOZD were associated with less AL elongation. CONCLUSION The study reveals a positive correlation between BOZD and axial length growth over the 12-month period. A pure 0.5 D CF increment demonstrates a nonsignificant impact. This study provides new ideas into optimizing the parameters of ortho-k lenses.
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Affiliation(s)
- Jinfang Wu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Xinyu Zhang
- Eye Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Linlin Wang
- Beijing Internet Eyecare Optometry & Ophthalmology Clinic, Beijing, 100027, China
| | - Peipei Zhang
- Eye Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Xi Guo
- Beijing Internet Eyecare Optometry & Ophthalmology Clinic, Beijing, 100027, China.
| | - Peiying Xie
- Beijing Internet Eyecare Optometry & Ophthalmology Clinic, Beijing, 100027, China.
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Batres L, Valdes-Soria G, Romaguera M, Carracedo G. Accommodation response and spherical aberration during 1-Year of orthokeratology lens wear and after discontinuation. Cont Lens Anterior Eye 2024; 47:102133. [PMID: 38467534 DOI: 10.1016/j.clae.2024.102133] [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: 10/11/2023] [Revised: 02/21/2024] [Accepted: 03/01/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND To assess accommodation and spherical aberration changes during one year of orthokeratology lens wear and one month after lens cessation. METHODS A prospective, randomized, longitudinal study was conducted on forty-seven young healthy subjects at the Optometry Clinic of the Complutense University of Madrid (Spain). Non-cycloplegic refraction, high and low uncorrected visual acuity, high and low best corrected visual acuity, accommodative lag, horizontal near phoria, corneal topography, and high-order aberrations were performed at baseline, 1-day, 1-week, 1-, 6- and 12-months of lens wear and after one month of wash out period. p < 0.05 was considered as statistically significant. RESULTS Spherical equivalent refraction (SE) was -3.23 ± 1.57D at baseline and -0.36 ± 0.64D after 12-months of lens wear, while accommodative lag changed from 0.53 ± 0.39D to 0.15 ± 0.29D after one year of lens wear. No significant differences were found when comparing SE at baseline and after one month of lens cessation (p > 0.05). A high correlation was found between the accommodative lag at baseline and after 12 M of lens wear. 22 out of 25 subjects with exophoria at baseline showed a significant reduction in the deviation at 12-months (p < 0.05). Total spherical aberration increased during all visits due to the lens wear (p < 0.05) although internal spherical aberration showed a significant decrease for 1-week, 1-month and 12-month visits (p < 0,05). CONCLUSION Orthokeratology lenses may change the accommodative response of the patient as a reduction on accommodative lag on exophoric patients and an overall increase on the internal spherical aberrations was found during treatment but return to nearly baseline values when cessation.
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Affiliation(s)
- Laura Batres
- Department of Optometry and Vision, Faculty of Optic and Optometry, Complutense University of Madrid, Spain
| | - Gonzalo Valdes-Soria
- Department of Optometry and Vision, Faculty of Optic and Optometry, Complutense University of Madrid, Spain
| | - María Romaguera
- Department of Optometry and Vision, Faculty of Optic and Optometry, Complutense University of Madrid, Spain
| | - Gonzalo Carracedo
- Department of Optometry and Vision, Faculty of Optic and Optometry, Complutense University of Madrid, Spain.
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Ding W, Jiang D, Tian Y, Lu W, Shi L, Ji R, Zhao C, Leng L. The effect of the back optic zone diameter on the treatment zone area and axial elongation in orthokeratology. Cont Lens Anterior Eye 2024; 47:102131. [PMID: 38403480 DOI: 10.1016/j.clae.2024.102131] [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: 07/10/2023] [Revised: 02/17/2024] [Accepted: 02/21/2024] [Indexed: 02/27/2024]
Abstract
PURPOSE To investigate the influence of corneal parameters on the treatment zone area (TZA) after Corneal Refractive Therapy (CRT) with a 5.0-mm back optical zone diameter (BOZD) were worn and to compare changes in the axial length (AL) with traditional 6.0-mm BOZD lenses. METHODS This retrospective study involved 146 subjects (7-12 years) who wore orthokeratology (ortho-K) lenses for one year: 86 subjects were treated with CRT 5.0-mm lenses, and 60 subjects were treated with CRT 6.0-mm lenses. The TZA was measured after one year of ortho-K treatment. Both TZA and AL elongation after wearing the two kinds of lenses was compared. The parameters were recorded in the CRT 5.0 group: flat K, steep K, corneal toricity, e value, and anterior corneal elevation values at the 3-, 4-, and 5-mm chords along the principal meridians of the superior, inferior, nasal, and temporal sides. The relationships between these data and the TZA were analyzed. RESULTS The TZA was 12.90 ± 5.15 mm2 and 20.61 ± 4.54 mm2, and the AL elongation was 0.15 ± 0.18 mm and 0.26 ± 0.18 mm in the CRT 5.0 group and the CRT 6.0 group, respectively (all p < 0.001). The one-year AL elongation was significantly associated with initial age and the TZA (r = - 0.394, 0.393; all p < 0.001) in the CRT 5.0 group. The following corneal parameters were found to have statistically significant correlations with the TZA: the e value, difference in corneal elevation (nasal-temporal at the 3-, 4-, and 5-mm chord), and the absolute value of elevation difference (nasal-temporal at the 3- and 4-mm chord and inferior-superior at the 3-, 4-, and 5-mm chord). The e value was the only relevant factor for the TZA by multiple regression analysis (unstandardized β = 14.219, p = 0.008). In the CRT 6.0 group, the one-year AL elongation was statistically significantly associated only with initial age (r = - 0.605, p = 0.005), but not with the TZA (p = 0.161). CONCLUSIONS A smaller TZA induced by a smaller BOZD may be beneficial for retarding AL elongation in children undergoing ortho-K treatment. The morphology and eccentricity of the cornea may show effects on the TZA.
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Affiliation(s)
- Wenzhi Ding
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, China; School of Ophthalmology, Shandong First Medical University, China
| | - Dongdong Jiang
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, China; School of Ophthalmology, Shandong First Medical University, China
| | - Yuyin Tian
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, China; School of Ophthalmology, Shandong First Medical University, China
| | - Weicong Lu
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, China; School of Ophthalmology, Shandong First Medical University, China
| | - Lin Shi
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, China; School of Ophthalmology, Shandong First Medical University, China
| | - Rongyuan Ji
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, China; School of Ophthalmology, Shandong First Medical University, China
| | - Chenpei Zhao
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, China; School of Ophthalmology, Shandong First Medical University, China
| | - Lin Leng
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, China; School of Ophthalmology, Shandong First Medical University, China.
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Tang WT, Luo XN, Zhao WJ, Liao J, Xu XY, Zhang HD, Zhang L. One-year results for myopia control of orthokeratology with different back optic zone diameters: a randomized trial using a novel multispectral-based topographer. Int J Ophthalmol 2024; 17:324-330. [PMID: 38371262 PMCID: PMC10827606 DOI: 10.18240/ijo.2024.02.15] [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: 06/25/2023] [Accepted: 09/28/2023] [Indexed: 02/20/2024] Open
Abstract
AIM To present the 1-year results of a prospective cohort study investigating the efficacy, potential mechanism, and safety of orthokeratology (ortho-k) with different back optic zone diameters (BOZD) for myopia control in children. METHODS This randomized clinical study was performed between Dec. 2020 and Dec. 2021. Participants were randomly assigned to three groups wearing ortho-k: 5 mm BOZD (5-MM group), 5.5 mm BOZD (5.5-MM group), and 6 mm BOZD (6-MM group). The 1-year data were recorded, including axial length, relative peripheral refraction (RPR, measured by multispectral refractive topography, MRT), and visual quality. The contrast sensitivity (CS) was evaluated by CSV-1000 instrument with spatial frequencies of 3, 6, 12, and 18 cycles/degree (c/d); the corneal higher-order aberrations (HOAs) were measured by iTrace aberration analyzer. The one-way ANOVA was performed to assess the differences between the three groups. The correlation between the change in AL and RPR was calculated by Pearson's correlation coefficient. RESULTS The 1-year results of 20, 21, and 21 subjects in the 5-MM, 5.5-MM, and 6-MM groups, respectively, were presented. There were no statistical differences in baseline age, sex, or ocular parameters between the three groups (all P>0.05). At the 1-year visit, the 5-MM group had lower axial elongation than the 6-MM group (0.07±0.09 vs 0.18±0.11 mm, P=0.001). The 5-MM group had more myopic total RPR (TRPR, P=0.014), with RPR in the 15°-30° (RPR 15-30, P=0.015), 30°-45° (RPR 30-45, P=0.011), temporal (RPR-T, P=0.008), and nasal area (RPR-N, P<0.001) than the 6-MM group. RPR 15-30 in the 5.5-MM group was more myopic than that in the 6-MM group (P=0.002), and RPR-N in the 5-MM group was more myopic than that in the 5.5-MM group (P<0.001). There were positive correlations between the axial elongation and the change in TRPR (r=0.756, P<0.001), RPR 15-30 (r=0.364, P=0.004), RPR 30-45 (r=0.306, P=0.016), and RPR-N (r=0.253, P=0.047). The CS decreased at 3 c/d (P<0.001), and the corneal HOAs increased in the 5-MM group (P=0.030). CONCLUSION Ortho-k with 5 mm BOZD can control myopia progression more effectively. The mechanism may be associated with greater myopic shifts in RPR.
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Affiliation(s)
- Wen-Ting Tang
- Department of Ophthalmology, the First Affiliated Hospital of Chengdu Medical College, Chengdu Medical College, Chengdu 610500, Sichuan Province, China
| | - Xiang-Ning Luo
- Department of Ophthalmology, the First Affiliated Hospital of Chengdu Medical College, Chengdu Medical College, Chengdu 610500, Sichuan Province, China
| | - Wen-Jing Zhao
- Department of Ophthalmology, the First Affiliated Hospital of Chengdu Medical College, Chengdu Medical College, Chengdu 610500, Sichuan Province, China
| | - Jia Liao
- Department of Ophthalmology, the First Affiliated Hospital of Chengdu Medical College, Chengdu Medical College, Chengdu 610500, Sichuan Province, China
| | - Xin-Yue Xu
- Department of Ophthalmology, the First Affiliated Hospital of Chengdu Medical College, Chengdu Medical College, Chengdu 610500, Sichuan Province, China
| | - Hui-Dan Zhang
- Department of Ophthalmology, the First Affiliated Hospital of Chengdu Medical College, Chengdu Medical College, Chengdu 610500, Sichuan Province, China
| | - Li Zhang
- Department of Ophthalmology, the First Affiliated Hospital of Chengdu Medical College, Chengdu Medical College, Chengdu 610500, Sichuan Province, China
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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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Zhang M, Guo Y, Zhou C, Zhang J, Zhang M, Huang J, Du Y, Ge S, Zhou C, Zhou Y. Deep neural network with self-attention based automated determination system for treatment zone and peripheral steepened zone in Orthokeratology for adolescent myopia. Cont Lens Anterior Eye 2024; 47:102081. [PMID: 37957085 DOI: 10.1016/j.clae.2023.102081] [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: 03/18/2023] [Revised: 10/27/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE The aim of this study is to develop an automatic model based on deep learning techniques for determining the Treatment Zone (TZ) and Peripheral Steepened Zone (PSZ) following Orthokeratology (OK) treatment. METHODS A total of 1346 corneal topography maps were included in the study. A deep neural network based on the Segformer architecture was constructed to automatically detect TZ and PSZ. The model was optimized and trained multiple times, and the areas of TZ, PSZ, and TZ decentration were calculated based on the segmentation results. RESULTS The mean Intersection over Union (mIoU) of the overall segmentation results of the model reached over 97% after multiple training with different optimization methods, and the IoU for the TZ and PSZ segmentation tasks were 98.08% and 94.54% in test set, respectively. Moreover, the model demonstrated high consistency with the expert annotation for the TZ segmentation, while a significant difference was found in the PSZ segmentation and expert annotation due to several interference factors. CONCLUSION This study presents an efficient and repeatable system for clinical research, based on a deep neural network that accurately determines TZ and PSZ after OK treatment using the Segformer architecture. However, further deployment validation may be necessary.
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Affiliation(s)
- Mingxu Zhang
- Eye School of Chengdu University of T.C.M, Shierqiao Road 37(th), Jinniu District, Chengdu, Sichuan Province 610032, China; Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection, Shierqiao Road 37th, Jinniu District, Chengdu, Sichuan Province 610032, China; Beijing Ming Vision & Ophthalmology, Chongwenwai Street16(th), Dongcheng District, Beijing 100062, China.
| | - Yujuan Guo
- Eye School of Chengdu University of T.C.M, Shierqiao Road 37(th), Jinniu District, Chengdu, Sichuan Province 610032, China; Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection, Shierqiao Road 37th, Jinniu District, Chengdu, Sichuan Province 610032, China
| | - Chengwei Zhou
- International School of Beijing, Anhua Street 10(th), Shunyi District, Beijing 101300, China
| | - Jing Zhang
- Beijing Ming Vision & Ophthalmology, Chongwenwai Street16(th), Dongcheng District, Beijing 100062, China
| | - Meimei Zhang
- Eye School of Chengdu University of T.C.M, Shierqiao Road 37(th), Jinniu District, Chengdu, Sichuan Province 610032, China; Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection, Shierqiao Road 37th, Jinniu District, Chengdu, Sichuan Province 610032, China; Beijing Ming Vision & Ophthalmology, Chongwenwai Street16(th), Dongcheng District, Beijing 100062, China
| | - Ju Huang
- Hospital of Chengdu University of T.C.M, Shierqiao Road 41(st), Jinniu District, Chengdu, Sichuan Province 610032, China
| | - Yuqin Du
- Eye School of Chengdu University of T.C.M, Shierqiao Road 37(th), Jinniu District, Chengdu, Sichuan Province 610032, China; Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection, Shierqiao Road 37th, Jinniu District, Chengdu, Sichuan Province 610032, China; Beijing Ming Vision & Ophthalmology, Chongwenwai Street16(th), Dongcheng District, Beijing 100062, China
| | - Shanshan Ge
- Eye School of Chengdu University of T.C.M, Shierqiao Road 37(th), Jinniu District, Chengdu, Sichuan Province 610032, China; Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection, Shierqiao Road 37th, Jinniu District, Chengdu, Sichuan Province 610032, China; Beijing Ming Vision & Ophthalmology, Chongwenwai Street16(th), Dongcheng District, Beijing 100062, China
| | - Chunyang Zhou
- Eye School of Chengdu University of T.C.M, Shierqiao Road 37(th), Jinniu District, Chengdu, Sichuan Province 610032, China; Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection, Shierqiao Road 37th, Jinniu District, Chengdu, Sichuan Province 610032, China
| | - Yuehua Zhou
- Eye School of Chengdu University of T.C.M, Shierqiao Road 37(th), Jinniu District, Chengdu, Sichuan Province 610032, China; Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection, Shierqiao Road 37th, Jinniu District, Chengdu, Sichuan Province 610032, China; Beijing Ming Vision & Ophthalmology, Chongwenwai Street16(th), Dongcheng District, Beijing 100062, China.
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Lin N, Sun Y, Yang M, Chen B, Mao J, Liu Y, Deng R. Metrics of Anterior Sclera in Normal Chinese Adults: Anterior Segment Imaging Using the Swept-Source Optical Coherence Tomography. Eye Contact Lens 2024; 50:23-28. [PMID: 37713630 DOI: 10.1097/icl.0000000000001032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2023] [Indexed: 09/17/2023]
Abstract
PURPOSE To measure the corneoscleral limbus and anterior sclera parameters of normal Chinese adults by swept-source optical coherence tomography (OCT). MATERIALS AND METHODS In this cross-sectional study, a total of 56 Chinese subjects with ametropia were evaluated in the Eye Hospital of Wenzhou Medical University from September 2020 to December 2020, including 26 (46.4%) men, with an average age of 24.7±1.8 years old. The OCT SS-1000 (CASIA, Tomey, Tokyo, Japan) was used to measure the sagittal height, corneoscleral junction (CSJ) angle, and scleral angle. RESULTS The chord was across the corneal center and the line connecting the center of the cornea and the center of the chord was perpendicular to the chord. The mean sagittal height at chord lengths of 10.0, 12.3, and 15.0 mm were 1,756±72, 2,658±110, and 3,676±155 μm, respectively. The absolute values of the differences between horizontal and vertical meridians at three chord lengths were 54±40, 70±67, and 117±95 μm, respectively. One-way analysis of variance showed that the differences of CSJ angles at 12.3-mm chord and scleral angles at 15.0-mm chord in the four segments were statistically significant ( F values were 32.01 and 13.37, respectively, both P <0.001). The CSJ angles from low to high were 176.53±2.14° (nasal), 178.66±1.84° (inferior), 179.13±1.20° (temporal), and 179.31±1.68° (superior), and 87.5% of the nasal angles were less than 179°. The scleral angles from high to low were 38.35±2.47° (temporal), 38.26±3.37° (superior), 35.37±3.10° (nasal), and 35.30±4.71° (inferior). CONCLUSIONS The morphology of corneoscleral limbus and anterior sclera is asymmetrical in normal Chinese adults. The nasal side of the corneoscleral limbus has the largest angle, and the superior and temporal sides of the scleral angle are larger.
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Affiliation(s)
- Na Lin
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University (N.L., Y.S., M.Y., J.M., Y.L., R.D.), Wenzhou ; and Vision X Medical Technology Co., Ltd (B.C.), Shanghai, China
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Kou S, Ren Y, Zhuang X, Chen Y, Zhang X. Study on Related Factors of the Treatment Zone After Wearing Paragon CRT and Euclid Orthokeratology Lenses. Eye Contact Lens 2023; 49:521-527. [PMID: 37707469 PMCID: PMC10659246 DOI: 10.1097/icl.0000000000001035] [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: 08/06/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVE To explore the influence factors of the treatment zone diameter (TZD) and its relationship with axial length growth (ALG) after wearing Paragon CRT and Euclid orthokeratology lenses. METHODS The right eye data of myopic patients wearing Paragon CRT and Euclid orthokeratology in the ophthalmology department of The First Affiliated Hospital of Soochow University were retrospectively reviewed from April 2019 to October 2022. The TZD and ALG were compared between the Paragon CRT and Euclid groups. The correlation factors of TZD after wearing lens for 1 month and the relationship between the overlapping treatment zone-to-pupil area ratio and the ALG after wearing lens for 1 year were analyzed between the two groups. RESULTS There were 160 patients (160 eyes) in the Paragon CRT group and 155 patients (155 eyes) in the Euclid group. After wearing lens for 1 month, the TZD in the Paragon CRT group (3.72±0.37 mm) was larger than that in the Euclid group (3.26±0.37 mm) ( P <0.001). The stepwise multivariate linear regression analysis showed that the eccentricity at the flattest meridians (Em) and the central corneal thickness were correlated with the TZD in both groups ( P <0.05). After wearing lens for 1 year, the ALG in the Paragon CRT group (0.32±0.20 mm) was larger than that in the Euclid group (0.25±0.20 mm) ( P =0.001). The stepwise multivariate linear regression analysis showed that the initial wearing age and the overlapping treatment zone area-to-pupil area ratio were correlated with the ALG in both groups ( P <0.05). CONCLUSION For both the Paragon CRT and Euclid orthokeratology, the wearers with thicker central corneal thickness and smaller Em usually had a smaller TZD. In both groups, the overlapping treatment zone area-to-pupil area ratio was correlated with the ALG.
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Affiliation(s)
- Sasa Kou
- Department of Ophthalmology (S.K., Y.R., Xinyu Zhuang, Xiaofeng Zhang), The First Affiliated Hospital of Soochow University, Suzhou, China; and Department of Ophthalmology (Y.C., Xiaofeng Zhang), Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China
| | - Yaru Ren
- Department of Ophthalmology (S.K., Y.R., Xinyu Zhuang, Xiaofeng Zhang), The First Affiliated Hospital of Soochow University, Suzhou, China; and Department of Ophthalmology (Y.C., Xiaofeng Zhang), Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China
| | - Xinyu Zhuang
- Department of Ophthalmology (S.K., Y.R., Xinyu Zhuang, Xiaofeng Zhang), The First Affiliated Hospital of Soochow University, Suzhou, China; and Department of Ophthalmology (Y.C., Xiaofeng Zhang), Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China
| | - Yingjie Chen
- Department of Ophthalmology (S.K., Y.R., Xinyu Zhuang, Xiaofeng Zhang), The First Affiliated Hospital of Soochow University, Suzhou, China; and Department of Ophthalmology (Y.C., Xiaofeng Zhang), Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China
| | - Xiaofeng Zhang
- Department of Ophthalmology (S.K., Y.R., Xinyu Zhuang, Xiaofeng Zhang), The First Affiliated Hospital of Soochow University, Suzhou, China; and Department of Ophthalmology (Y.C., Xiaofeng Zhang), Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China
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Li X, Zuo L, Zhao H, Hu J, Tang T, Wang K, Li Y, Zhao M. Efficacy of small back optic zone design on myopia control for corneal refractive therapy (CRT): a one-year prospective cohort study. EYE AND VISION (LONDON, ENGLAND) 2023; 10:47. [PMID: 37986014 PMCID: PMC10658859 DOI: 10.1186/s40662-023-00364-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/26/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND To investigate the control effect on the axial length elongation using corneal refractive therapy (CRT) with different optical zone diameters (BOZDs). We also sought to compare the difference in higher-order aberrations (HOAs), treatment zone (TZ) size and Zernike defocus coefficient with different BOZDs and seek the optimal parameter for predicting axial elongation. METHODS This prospective cohort study included 7- to 14-year-olds fitted with orthokeratology (ortho-K) lenses of 5-mm (5-mm group) or 6-mm BOZD (6-mm group). Axial length (AL), corneal topography, HOAs and Zernike defocus coefficient were obtained at baseline, and 1, 3, 6, 9 and 12 months follow-up visits. Multivariate regression analyses were used to explore the association between AL change and ocular biometric parameters. Receiver operating characteristic (ROC) curve analysis was used to determine the best diagnostic value for AL change in ocular biometric parameters. RESULTS In total, 301 participants completed the one-year follow-up. The mean AL change in the 5-mm group (0.13 ± 0.18 mm) was less than that in the 6-mm group (0.27 ± 0.15 mm) at the 12 months visit. The TZ size and decentration were smaller, while the Zernike defocus coefficient and HOAs were higher in the 5-mm group (all P < 0.05). Older age and smaller TZ size were protective factors against AL elongation in multiple regression. In predicting AL elongation, TZ diameter yielded an area under the ROC curve of 0.684 with a cut-off value of 3.82 mm. CONCLUSION The 5-mm group showed 0.14 mm (51.8%) less axial elongation than the 6-mm group. The 5-mm BOZD produced a smaller TZ size, higher Zernike defocus coefficient and higher HOA after reshaping of the cornea. TZ size was the best predictor of AL elongation. TZ diameter less than 3.82 mm may lead to AL elongation less than 0.2 mm in one year.
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Affiliation(s)
- Xuewei Li
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, 100044, 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 the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Lili Zuo
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, 100044, 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 the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Heng Zhao
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, 100044, 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 the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Jie Hu
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, 100044, 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 the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Tao Tang
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, 100044, 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 the 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 and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, 100044, 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 the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China.
| | - Yan Li
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, 100044, 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 the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Mingwei Zhao
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, 100044, 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 the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
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10
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Guo B, Cheung SW, Kojima R, Cho P. Variation of Orthokeratology Lens Treatment Zone (VOLTZ) Study: A 2-year randomised clinical trial. Ophthalmic Physiol Opt 2023; 43:1449-1461. [PMID: 37545099 DOI: 10.1111/opo.13208] [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: 01/30/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 08/08/2023]
Abstract
PURPOSE To compare axial elongation (AE) and treatment zone (TZ) characteristics in children wearing 6 mm or 5 mm back optic zone diameter (BOZD) orthokeratology (ortho-k) lenses over 2 years. METHODS Forty-five (6 to <11 years of age) myopic (-4.00 to -0.75 D) children of Chinese ethnicity were randomly assigned to use the two different lens designs (23 and 22 wore the 6 and 5 mm lenses, respectively). Data collection was performed at baseline and every 6-months after commencing lens wear. RESULTS After 24 months, subjects wearing lenses with a 5 mm BOZD achieved smaller TZ diameter (horizontal: 2.69 ± 0.28 vs. 3.84 ± 0.39 mm; vertical: 2.65 ± 0.22 vs. 3.42 ± 0.34 mm, p < 0.001) and less AE (0.15 ± 0.21 vs. 0.35 ± 0.23, p = 0.005) compared to those using the 6 mm design, with no difference in choroidal thickness (ChT) changes (p = 0.93). A significant increase in ChT, using pooled data analysis, was noted at the 6-month (11.8 ± 19.77 μm, p < 0.001) and 12-month (12.0 ± 23.7 μm, p = 0.004) visits, compared to baseline, indicating a transient change in ChT. Significant associations were noted, using linear mixed models, between AE and the TZ diameters (p < 0.003) after adjusting for baseline data. A very weak association was found between ChT changes and AE, with the effect size close to zero. CONCLUSIONS Smaller BOZD ortho-k lenses resulted in a smaller TZ diameter, which was associated with less AE after 2 years of treatment. The changes in ChT played a very weak role, suggesting that other factors may contribute more to the reduced AE in subjects wearing lenses having a smaller BOZD.
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Affiliation(s)
- Biyue Guo
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Sin Wan Cheung
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Randy Kojima
- College of Optometry, Pacific University, Forest Grove, Oregon, USA
| | - Pauline Cho
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
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11
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Gruhl J, Widmer F, Nagl A, Bandlitz S. Factors influencing treatment zone size in orthokeratology. Cont Lens Anterior Eye 2023; 46:101848. [PMID: 37137758 DOI: 10.1016/j.clae.2023.101848] [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: 12/24/2022] [Revised: 04/04/2023] [Accepted: 04/16/2023] [Indexed: 05/05/2023]
Abstract
PURPOSE The aim of this study was to analyze the influence of corneal topography, contact lens parameters and degree of myopia on the treatment zone (TZ) and peripheral plus ring (PPR) size in orthokeratology. METHODS In this retrospective study the topographic zones of the right eyes of 106 patients (73 female, 22.16 ± 8.96 years) were analyzed in the tangential difference map of the Oculus Keratograph 5M (Oculus, Wetzlar, Germany). Using the MB-Ruler Pro 5.4 software (MB-Softwaresolutions, Iffezheim, Germany) the horizontal, vertical, longest, shortest diameters and area of the TZ; horizontal, vertical, total diameters and width of the PPR were measured. Correlations were determined between these zones and the subjects' baseline parameters (myopia; corneal diameter, radii, astigmatism, eccentricity, sagittal height; contact lens radii, toricity and total diameter) for three back optic zone diameter (BOZD) groups (5.5, 6.0 and 6.6 mm). A stepwise linear regression analysis was performed to test for TZ and PPR predictability. RESULTS In the group of BOZD 6.0 correlations were found between the amount of myopia and the short TZ diameter (r = -0.25, p = 0.025); the steep corneal radius and the vertical diameter (r = -0.244, p = 0.029), the longest diameter (r = -0.254, p = 0.023) and the area (r = -0.228, p = 0.042) of the TZ; the amount of astigmatism and PPR width (r = 0.266, p = 0.017); eccentricity of the steep corneal meridian and PPR width (r = -0.222, p = 0.047). BOZD correlated significantly positively with all zones (p < 0.05). The best prediction model (R2 = 0.389) resulted with the TZ area as the outcome variable. CONCLUSION The amount of myopia, topography and contact lens parameters influence TZ and PPR in orthokeratology. Describing the TZ by its area may provide the most accurate representation of its size.
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Affiliation(s)
- Jessica Gruhl
- Hochschule Aalen, Aalen University, Aalen, Germany; Avermann Contactlinsen, Dortmund, Germany.
| | | | - Anna Nagl
- Hochschule Aalen, Aalen University, Aalen, Germany
| | - Stefan Bandlitz
- Höhere Fachschule für Augenoptik Köln, Cologne School of Optometry, Cologne, Germany; College of Health and Life Sciences, Aston University, Birmingham, UK
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Li J, Hu J, Li X, Tang J, Li Y, Wang K, Zhao M. Long-term variations and influential factors of the treatment zone of wearing orthokeratology lenses. Cont Lens Anterior Eye 2023; 46:101867. [PMID: 37286433 DOI: 10.1016/j.clae.2023.101867] [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: 12/01/2022] [Revised: 05/01/2023] [Accepted: 05/23/2023] [Indexed: 06/09/2023]
Abstract
PURPOSE To investigate the variation trend of the treatment zone (TZ) during 12 months of Orthokeratology (Ortho-K) from the perspective of the treatment zone size (TZS), decentration (TZD) and the weighted Zernike defocus coefficient of the treatment zone (Cweighteddefocus). METHODS 94 patients were included in this retrospective study, who were fitted with a 5-curve vision shaping treatment (VST) lens (n = 44) or a 3-zone corneal refractive therapy (CRT) lens (n = 50). The TZS, TZD and Cweighteddefocus up to 12 months were analyzed. RESULTS TZS (F(4,372) = 10.167, P<0.001), TZD (F(4,372) = 8.083, P<0.001) and Cweighteddefocus (F(4,372) = 7.100, P<0.001) were significantly increased with time during overnight Ortho-K treatment. The TZS increased sharply from 1 week to 1 month of overnight Ortho-K (F = 25.479, P <.001) and stayed smooth then. It showed growing tendency from 6 to 12 months (F = 8.407, P =.005). The TZD (F = 16.637, P <.001) and Cweighteddefocus (F = 13.401, P <.001) increased significantly until 1 month and kept stable until 12 months (all P>0.05). The univariant linear regression analysis showed that TZS of the last visit was correlated with baseline myopia (β = 0.219, P =.034). Also, the greater final Cweighteddefocus was correlated with higher baseline myopia (β = -0.589, P<0.001) and higher corneal astigmatism (β = -0.228, P =.007) at the onset of lens wear with the multiple linear regression. CONCLUSION The TZS, TZD and Cweighteddefocus kept stable after 1 month of Ortho-K while the TZS had an increasing trend after 6 months. Children with higher myopic eyes or higher corneal astigmatism at baseline tended to have smaller TZS and greater Cweighteddefocus at 12 months.
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Affiliation(s)
- Jingxin Li
- Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing 100044, China; College of Optometry, Peking University Health Science Center, Beijing, China; Department of Ophthalmology, Eye Disease and Optometry Institute, Peking University People's Hospital, China; Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, China
| | - Jie Hu
- Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing 100044, China; College of Optometry, Peking University Health Science Center, Beijing, China; Department of Ophthalmology, Eye Disease and Optometry Institute, Peking University People's Hospital, China; Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, China
| | - Xuewei Li
- Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing 100044, China; College of Optometry, Peking University Health Science Center, Beijing, China; Department of Ophthalmology, Eye Disease and Optometry Institute, Peking University People's Hospital, China; Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, China; Department of Optometry, Institute of Medical Technology, Peking University Health Science Center, Beijing 100044, China
| | - Jiyang Tang
- Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing 100044, China; College of Optometry, Peking University Health Science Center, Beijing, China; Department of Ophthalmology, Eye Disease and Optometry Institute, Peking University People's Hospital, China; Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, China
| | - Yan Li
- Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing 100044, China; College of Optometry, Peking University Health Science Center, Beijing, China; Department of Ophthalmology, Eye Disease and Optometry Institute, Peking University People's Hospital, China; Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, China; Department of Optometry, Institute of Medical Technology, Peking University Health Science Center, Beijing 100044, China
| | - Kai Wang
- Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing 100044, China; College of Optometry, Peking University Health Science Center, Beijing, China; Department of Ophthalmology, Eye Disease and Optometry Institute, Peking University People's Hospital, China; Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, China; Department of Optometry, Institute of Medical Technology, Peking University Health Science Center, Beijing 100044, China.
| | - Mingwei Zhao
- Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing 100044, China; College of Optometry, Peking University Health Science Center, Beijing, China; Department of Ophthalmology, Eye Disease and Optometry Institute, Peking University People's Hospital, China; Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, China; Department of Optometry, Institute of Medical Technology, Peking University Health Science Center, Beijing 100044, China
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Guo B, Cho P, Cheung SW, Kojima R, Vincent S. Optical changes and association with axial elongation in children wearing orthokeratology lenses of different back optic zone diameter. EYE AND VISION (LONDON, ENGLAND) 2023; 10:25. [PMID: 37391828 DOI: 10.1186/s40662-023-00344-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 04/26/2023] [Indexed: 07/02/2023]
Abstract
PURPOSE To compare changes in ocular aberrations in children wearing orthokeratology (ortho-k) lenses with a back optic zone diameter (BOZD) of 6 mm (6-MM group) or 5 mm (5-MM group) and their associations with axial elongation (AE) over two years. METHODS Seventy Chinese children, aged 6 to < 11 years, with myopia between - 4.00 to - 0.75 D, were randomly allocated to 5-MM and 6-MM groups. Ocular aberrations were measured, rescaled to a 4-mm pupil, and fitted with a 6th order Zernike expansion. Measurements, including axial length, were taken prior to commencing ortho-k treatment and then every six months over two years. RESULTS After two years, the 5-MM group displayed a smaller horizontal treatment zone (TZ) diameter (by 1.14 ± 0.11 mm, P < 0.001) and less AE (by 0.22 ± 0.07 mm, P = 0.002) compared with the 6-MM group. A greater increase in total root mean square (RMS) of higher-order aberrations (HOAs), primary spherical aberration (SA) ([Formula: see text], and coma were also observed in the 5-MM group at all follow-up visits. The horizontal TZ diameter was significantly associated with changes in RMS HOAs, SA (RMS, primary and secondary SA), and RMS coma. After controlling for baseline parameters, RMS HOAs, RMS SA, RMS coma, and primary ([Formula: see text] and secondary ([Formula: see text] SA were significantly associated with AE. CONCLUSIONS Ortho-k lenses with a smaller BOZD created a smaller horizontal TZ diameter and a significant increase in total HOAs, total SA, total coma, and primary SA and a decrease in secondary SA. Of these ocular aberrations, total HOAs, total SA, and primary SA were negatively correlated with AE over two years. TRIAL REGISTRATION ClinicalTrial.gov, NCT03191942. Registered 19 June 2017, https://clinicaltrials.gov/ct2/show/NCT03191942 .
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Affiliation(s)
- Biyue Guo
- Centre for Myopia Research, Optometry Research Clinic, School of Optometry, The Hong Kong Polytechnic University, A136-137, Hung Hum, Kowloon, Hong Kong SAR, China.
| | - Pauline Cho
- Centre for Myopia Research, Optometry Research Clinic, School of Optometry, The Hong Kong Polytechnic University, A136-137, Hung Hum, Kowloon, Hong Kong SAR, China
| | - Sin Wan Cheung
- Centre for Myopia Research, Optometry Research Clinic, School of Optometry, The Hong Kong Polytechnic University, A136-137, Hung Hum, Kowloon, Hong Kong SAR, China
| | - Randy Kojima
- College of Optometry, Pacific University, Oregon, USA
| | - Stephen Vincent
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, QLD, Australia
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Tang T, Li X, Chen S, Xu Q, Zhao H, Wang K, Li Y, Zhao M. Long-term follow-up of changes in ocular biometric parameters in orthokeratology lens wearers with relatively large-scale axial length reduction. EYE AND VISION (LONDON, ENGLAND) 2023; 10:6. [PMID: 36726171 PMCID: PMC9893609 DOI: 10.1186/s40662-022-00324-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 12/26/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND To investigate ocular biological characteristics for myopic children with axial length (AL) reduction during orthokeratology (Ortho-K) treatment and provide clinical clues for better myopia control effects. METHODS Changes in ocular parameters and treatment zone (TZ) in 75 subjects who completed one-year Ortho-K treatment were retrospectively reviewed. The subjects were divided into two groups according to one-year AL change: the AL reduction group (n = 37) and the AL elongation group (n = 38). Univariate and multivariate regression analyses were performed to determine the association between TZ, ocular parameters, and AL change. RESULTS There was no significant difference in baseline between the two groups (all P > 0.05). After one year of Ortho-K treatment, compared with those in the AL elongation group, children in the AL reduction group had a decreased anterior chamber depth (ACD) (P < 0.001), thickened crystalline lens thickness (CLT) (P = 0.002), thinned vitreous chamber depth (VCD) (P < 0.001) and smaller TZ (P = 0.03), but no difference in central corneal thickness (CCT) and pupil diameter (PD). In the multivariable analyses, AL reduction was negatively associated with baseline age (beta: - 0.048; 95% CI: - 0.083 to - 0.013; P = 0.009) and positively associated with the TZ (beta: 0.024; 95% CI: 0.009 to 0.040; P = 0.003). CONCLUSIONS In AL reduction eyes, thickened CLT, decreased ACD and thinned VCD were observed during Ortho-K treatment, which could be suggested as indicators for better myopia control effects in the clinic. Older baseline age and smaller TZ wearing Ortho-K were also associated with AL change. Thickened CLT may be a result of compensation for AL-reduction eyes.
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Affiliation(s)
- Tao Tang
- grid.11135.370000 0001 2256 9319Institute of Medical Technology, Peking University Health Science Center, Beijing, China ,grid.411634.50000 0004 0632 4559Department of Ophthalmology and Clinical Centre of Optometry, Peking University People’s Hospital, Beijing, China ,grid.11135.370000 0001 2256 9319College of Optometry, Peking University Health Science Center, Beijing, China ,grid.411634.50000 0004 0632 4559Eye Disease and Optometry Institute, Peking University People’s Hospital, Beijing, China ,Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Xuewei Li
- grid.11135.370000 0001 2256 9319Institute of Medical Technology, Peking University Health Science Center, Beijing, China ,grid.411634.50000 0004 0632 4559Department of Ophthalmology and Clinical Centre of Optometry, Peking University People’s Hospital, Beijing, China ,grid.11135.370000 0001 2256 9319College of Optometry, Peking University Health Science Center, Beijing, China ,grid.411634.50000 0004 0632 4559Eye Disease and Optometry Institute, Peking University People’s Hospital, Beijing, China ,Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Sitong Chen
- grid.11135.370000 0001 2256 9319Institute of Medical Technology, Peking University Health Science Center, Beijing, China ,grid.411634.50000 0004 0632 4559Department of Ophthalmology and Clinical Centre of Optometry, Peking University People’s Hospital, Beijing, China ,grid.11135.370000 0001 2256 9319College of Optometry, Peking University Health Science Center, Beijing, China ,grid.411634.50000 0004 0632 4559Eye Disease and Optometry Institute, Peking University People’s Hospital, Beijing, China ,Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Qiong Xu
- grid.411634.50000 0004 0632 4559Department of Ophthalmology and Clinical Centre of Optometry, Peking University People’s Hospital, Beijing, China ,grid.11135.370000 0001 2256 9319College of Optometry, Peking University Health Science Center, Beijing, China ,grid.411634.50000 0004 0632 4559Eye Disease and Optometry Institute, Peking University People’s Hospital, Beijing, China ,Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Heng Zhao
- grid.11135.370000 0001 2256 9319Institute of Medical Technology, Peking University Health Science Center, Beijing, China ,grid.411634.50000 0004 0632 4559Department of Ophthalmology and Clinical Centre of Optometry, Peking University People’s Hospital, Beijing, China ,grid.11135.370000 0001 2256 9319College of Optometry, Peking University Health Science Center, Beijing, China ,grid.411634.50000 0004 0632 4559Eye Disease and Optometry Institute, Peking University People’s Hospital, Beijing, China ,Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Kai Wang
- grid.11135.370000 0001 2256 9319Institute of Medical Technology, Peking University Health Science Center, Beijing, China ,grid.411634.50000 0004 0632 4559Department of Ophthalmology and Clinical Centre of Optometry, Peking University People’s Hospital, Beijing, China ,grid.11135.370000 0001 2256 9319College of Optometry, Peking University Health Science Center, Beijing, China ,grid.411634.50000 0004 0632 4559Eye Disease and Optometry Institute, Peking University People’s Hospital, Beijing, China ,Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Yan Li
- grid.411634.50000 0004 0632 4559Department of Ophthalmology and Clinical Centre of Optometry, Peking University People’s Hospital, Beijing, China ,grid.11135.370000 0001 2256 9319College of Optometry, Peking University Health Science Center, Beijing, China ,grid.411634.50000 0004 0632 4559Eye Disease and Optometry Institute, Peking University People’s Hospital, Beijing, China ,Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Mingwei Zhao
- grid.11135.370000 0001 2256 9319Institute of Medical Technology, Peking University Health Science Center, Beijing, China ,grid.411634.50000 0004 0632 4559Department of Ophthalmology and Clinical Centre of Optometry, Peking University People’s Hospital, Beijing, China ,grid.11135.370000 0001 2256 9319College of Optometry, Peking University Health Science Center, Beijing, China ,grid.411634.50000 0004 0632 4559Eye Disease and Optometry Institute, Peking University People’s Hospital, Beijing, China ,Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
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Wu LY, Gomes Esporcatte LP, Li WK, Lin WP, Wu R, White L, Salomão MQ, Lopes BT, Ambrósio R, Abass A. Investigation of the relationship between contact lens design parameters and refractive changes in Ortho-K. Heliyon 2022; 8:e11699. [DOI: 10.1016/j.heliyon.2022.e11699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/28/2022] [Accepted: 11/11/2022] [Indexed: 11/21/2022] Open
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Lin W, Gu T, Bi H, Du B, Zhang B, Wei R. The treatment zone decentration and corneal refractive profile changes in children undergoing orthokeratology treatment. BMC Ophthalmol 2022; 22:177. [PMID: 35436922 PMCID: PMC9016930 DOI: 10.1186/s12886-022-02396-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 04/11/2022] [Indexed: 01/21/2023] Open
Abstract
Background To confirm the association between treatment-zone (TZ) decentration and axial length growth (ALG) in children who underwent orthokeratology; and to explore the association between TZ decentration and relative corneal refractive power (RCRP) profile, which was known to be significantly associated with ALG retardation. Methods Four hundred myopic children of age 12 years participated in the study, with 200 wearing orthokeratology lenses and the other 200 wearing single-vision spectacle as the controls. Cycloplegic refraction was performed at baseline. Axial length was measured at baseline and 12 months after initial lens wear, and ALG was defined as the difference. In the ortho-k group, TZ decentration and the RCRP map were calculated from the topography map obtained at the 12-month visit. RCRP were summed within various chord radii from the cornea center, and the association to TZ decentration, spherical equivalent (SE), ALG were analyzed with linear regressions. Results Compared to the controls, children wearing orthokeratology lenses had significantly smaller ALG over 1 year (0.1 ± 0.15 mm vs. 0.32 ± 0.17 mm, p < 0.001). ALG was significantly and negatively associated with summed RCRP within the central cornea of 2 mm in radius. The mean TZ decentration was 0.62 ± 0.25 mm, and the mean direction was 214.26 ± 7.39 degrees. ALG was negatively associated with the TZ decentration magnitude (p < 0.01), but not the direction (p = 0.905). TZ decentration caused an asymmetrical distribution of the RCRP with the nasal side plus power shifting towards the corneal center. For chord radius ranging 1-2 mm, the association between TZ decentration and the summed RCRP were significant, and the proportion of variance accountable increased with chord radius. For chord radius beyond 1.5 mm, the association between baseline spherical equivalent (SE) and summed RCRP was significant. The portion of variance accountable by SE increased and peaked in 2.5 mm chord radius. Conclusions A larger TZ decentration was associated with a larger summed RCRP in the central cornea. It may be one of the possible reasons why TZ decentration is beneficial to retarding myopia progression.
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Affiliation(s)
- Weiping Lin
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, People's Republic of China
| | - Tianpu Gu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, People's Republic of China
| | - Hua Bi
- College of Optometry, Nova Southeastern University, Davie, FL, 33314, USA
| | - Bei Du
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, People's Republic of China
| | - Bin Zhang
- College of Optometry, Nova Southeastern University, Davie, FL, 33314, USA.
| | - Ruihua Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, People's Republic of China.
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Guo B, Wu H, Cheung SW, Cho P. Manual and software-based measurements of treatment zone parameters and characteristics in children with slow and fast axial elongation in orthokeratology. Ophthalmic Physiol Opt 2022; 42:773-785. [PMID: 35366332 DOI: 10.1111/opo.12981] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 03/06/2022] [Accepted: 03/06/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE To compare the treatment zone (TZ) measurements obtained using manual and software-based methods in orthokeratology (ortho-k) subjects and explore the TZ characteristics of children with slow and fast axial elongation after ortho-k. METHODS Data from 69 subjects (aged 7 to <13 years old), who participated in three 24-month longitudinal orthokeratology studies, showing fast (>0.27 mm, n = 38) and slow (<0.09 mm, n = 31) axial elongation, were retrieved. The TZ after ortho-k was defined as the central flattened area enclosed by points with no refractive power change. TZ parameters, including decentration, size, width of the peripheral steepened zone (PSZ), central and peripheral refractive power changes and peripheral rate of power change, were determined manually and using python-based software. TZ parameters were compared between measurement methods and between groups. RESULTS Almost all TZ parameters measured manually and with the aid of software were significantly different (p < 0.05). Differences in decentration, size and the PSZ width were not clinically significant, but differences (0.45 to 0.92 D) in refractive power change in the PSZ were significant, although intraclass coefficients (0.95 to 0.98) indicated excellent agreement between methods. Significantly greater TZ decentration, smaller TZ size and greater inferior rate of power change (relative to the TZ centre) were observed in slow progressors using both methods, suggesting a potential role of TZ in regulating myopia progression in ortho-k. CONCLUSION TZ measurements using manual and software-based methods differed significantly and cannot be used interchangeably. The combination of TZ decentration, TZ size and peripheral rate of power change may affect myopia control effect in ortho-k.
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Affiliation(s)
- Biyue Guo
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Huihuan Wu
- Department of Electrical Engineering, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Sin Wan Cheung
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Pauline Cho
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
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18
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Tang Y, Chen Z, Wang W, Wen L, Zhou L, Wang M, Tang F, Tang H, Lan W, Yang Z. A Deep Learning-Based Framework for Accurate Evaluation of Corneal Treatment Zone After Orthokeratology. Transl Vis Sci Technol 2021; 10:21. [PMID: 34932118 PMCID: PMC8709934 DOI: 10.1167/tvst.10.14.21] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Given the robust effectiveness of inhibiting myopia progression, orthokeratology has gained increasing popularity worldwide. However, identifying the boundary and the center of reshaped corneal area (i.e., treatment zone) is the main challenging task in evaluating the performance of orthokeratology. Here we present automated deep learning algorithms to solve the challenges. Methods A total of 6328 corneal topographical maps, including 2996 axial subtractive maps and 3332 tangential subtractive maps, were collected from 2044 myopic patients who received orthokeratology. The boundary and the center of the treatment zones were annotated by experts as ground truths using axial subtractive maps and tangential subtractive maps, respectively. The algorithms based on neural network structures of fully convolutional networks (FCNs) and convolutional neural networks (CNNs) were developed to automatically identify the boundary and the center of the treatment zone, respectively. Results The algorithm of FCNs identified the treatment zone boundaries with an accuracy intersection over union (IoU) of 0.90 ± 0.06 (mean ± SD; range, 0.60-0.97). The algorithm of CNNs also identified the treatment zone centers with an average deviation of 0.22 ± 0.22 mm (range, 0.01-1.66 mm). Conclusions These results show that a deep learning-based solution is able to provide an automatic and accurate tool to accomplish the two main challenges of orthokeratology. Translational Relevance Deep learning in orthokeratology can shorten the time while maintaining accurate results in clinical practice, which enables clinicians to help more patients daily.
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Affiliation(s)
- Yong Tang
- School of Computer Science and Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhao Chen
- Aier School of Ophthalmology, Central South University, Changsha, China
| | - Weijia Wang
- School of Information and Software Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Longbo Wen
- Aier School of Ophthalmology, Central South University, Changsha, China
| | - Linjing Zhou
- School of Information and Software Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Mao Wang
- Information Center, Aier Eye Hospital Group, Changsha, China
| | - Fan Tang
- Information Center, Aier Eye Hospital Group, Changsha, China
| | - He Tang
- School of Electronic Science and Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Weizhong Lan
- Aier School of Ophthalmology, Central South University, Changsha, China.,Guangzhou Aier Eye Hospital, Jinan University, Guangzhou, China
| | - Zhikuan Yang
- Aier School of Ophthalmology, Central South University, Changsha, China.,Hunan Province Optometry Engineering Technology Research Center, Changsha, China
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19
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Lin W, Li N, Gu T, Tang C, Liu G, Du B, Wei R. The treatment zone size and its decentration influence axial elongation in children with orthokeratology treatment. BMC Ophthalmol 2021; 21:362. [PMID: 34641799 PMCID: PMC8513184 DOI: 10.1186/s12886-021-02123-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 09/30/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND To investigate whether the treatment zone size (TZS) and treatment zone decentration (TZD) will affect the axial elongation in myopic children undergoing orthokeratology treatment. METHODS A self-controlled retrospective study was conducted on 352 children who met the inclusion criteria. Axial length was measured before and at 12 months after the initial lens wear. Corneal topography was measured at baseline and at each follow-up after lens wear. The Corneal topography obtained from the 12-month visit was used to quantify TZS and TZD for each subject. Cycloplegic refraction was required for all children before fitting the orthokeratology lenses. RESULTS Axial elongation was significantly associated with age, baseline spherical equivalent (SE), TZS, and TZD with univariate linear regression. In groups with both small and large TZS, axial elongation was significantly decreased with large TZD (both P < 0.01). In groups with both small and large TZD, axial elongation was significantly decreased with small TZS (P = 0.03 for small TZD, P = 0.01 for large TZD). Age, SE, and TZD were significantly associated with axial elongation in multiple regression (all P < 0.01). CONCLUSION Relatively smaller TZS and larger TZD may be beneficial in slowing myopia progression in children with orthokeratology treatment.
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Affiliation(s)
- Weiping Lin
- Eye Institute and School of Optometry, Tianjin, China.,Tianjin Medical University Eye Hospital, Tianjin, China
| | - Na Li
- Eye Institute and School of Optometry, Tianjin, China.,Tianjin Medical University Eye Hospital, Tianjin, China
| | - Tianpu Gu
- Eye Institute and School of Optometry, Tianjin, China.,Tianjin Medical University Eye Hospital, Tianjin, China
| | - Chunyu Tang
- Eye Institute and School of Optometry, Tianjin, China.,Tianjin Medical University Eye Hospital, Tianjin, China
| | - Guihua Liu
- Eye Institute and School of Optometry, Tianjin, China.,Tianjin Medical University Eye Hospital, Tianjin, China
| | - Bei Du
- Eye Institute and School of Optometry, Tianjin, China.,Tianjin Medical University Eye Hospital, Tianjin, China.,Tianjin Key Laboratory of Retinal Functions and Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Ruihua Wei
- Eye Institute and School of Optometry, Tianjin, China. .,Tianjin Medical University Eye Hospital, Tianjin, China. .,Tianjin Key Laboratory of Retinal Functions and Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China.
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20
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He Y, Liu L, Vincent SJ. Compression Factor and Visual Performance in Adults Treated With Orthokeratology. Eye Contact Lens 2021; 47:413-419. [PMID: 33974574 DOI: 10.1097/icl.0000000000000796] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To investigate the effect of compression factor on visual performance in orthokeratology (ortho-k). METHODS Myopic adults were fitted with ortho-k lenses with either a 0.75 diopter (D) or 1.75 D compression factor. Higher-order aberrations (HOAs), corneal topography, and responses to the National Eye Institute/Refractive Error Quality of Life Instrument-42 questionnaire were measured at baseline and 6-month and 12-month follow-up along with a satisfaction questionnaire. Subjective refraction, high-contrast, and low-contrast visual acuity were measured at baseline and 1-day, 1-week, 6-month, and 12-month follow-up. RESULTS Forty-four myopic (mean spherical equivalent refraction: -3.66±0.84 D) adults (median age 25 years) completed the 12-month follow-up. After ortho-k lens wear, levels of satisfaction of vision after waking were significantly higher than vision before sleep for both compression factors (both P<0.01). The increased compression factor (ICF) resulted in less myopia at the 1-week visit (P=0.04) and better high-contrast unaided visual acuity at the 1-day visit (P=0.03) compared with the conventional compression factor (CCF). No other significant differences were observed for the compression factor for treatment zone diameter, lens decentration, or any subjective measurements. Individual HOA terms , , , and were significantly higher in the CCF group (0.75 D) (all P<0.05). The HOA visual Strehl ratio decreased significantly after lens wear (P<0.001) but did not vary with the compression factor. CONCLUSIONS An ICF did not result in clinically significant differences in subjective refraction, visual acuity, unaided vision, or the total ocular HOA profile compared with a CCF (0.75 D) in myopic adults after long-term ortho-k lens wear.
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Affiliation(s)
- Yuanhao He
- Department of Optometry and Visual Science (Y.H.), West China School of Medicine, Sichuan University, Chengdu, China; Department of Ophthalmology (L.L.), West China Hospital, Sichuan University, Chengdu, China; and Contact Lens and Visual Optics Laboratory (S.J.V.), Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
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21
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Guo B, Cheung SW, Kojima R, Cho P. One-year results of the Variation of Orthokeratology Lens Treatment Zone (VOLTZ) Study: a prospective randomised clinical trial. Ophthalmic Physiol Opt 2021; 41:702-714. [PMID: 33991112 PMCID: PMC8251614 DOI: 10.1111/opo.12834] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 12/11/2022]
Abstract
Purpose To present the 1‐year results of the Variation of Orthokeratology Lens Treatment Zone (VOLTZ) Study, which aims to investigate the myopia control effect of orthokeratology (ortho‐k) lenses with different back optic zone diameters (BOZD). Method Children, aged 6 to <11 years, having myopia −4.00 D to −0.75 D, were randomly assigned to wear ortho‐k lenses with 6 mm (6‐MM group) or 5 mm (5‐MM group) BOZD. Data collection included changes in refraction, vision, lens performance and binding, ocular health conditions, axial length and characteristics of the treatment zone (TZ) area. Results The 1‐year results of 34 and 36 subjects (right eye only) in the 6‐MM and 5‐MM groups, respectively, are presented. No significant differences in baseline demographics were found between the groups (p > 0.05). The first‐fit success rates, based on satisfactory centration at the 1‐month visit, were 100% and 94% respectively. Horizontal TZ size was 0.92 mm and 0.72 mm smaller in the 5‐MM group at the 6‐month and 12‐month visits, respectively (p < 0.05). At the 12‐month visit, no significant between‐group differences were found in the incidence of corneal staining (low grade only), lens binding and visual performance (all p > 0.05). Axial elongation was slower in the 5‐MM group (0.04 ± 0.15 mm) than the 6‐MM group (0.17 ± 0.13 mm) (p = 0.001). A significant positive correlation was observed between the horizontal TZ size and axial elongation (r = 0.36, p = 0.006). Conclusion Clinical performance of the two ortho‐k lenses was similar, indicating that a smaller BOZD (5 mm) did not affect lens performance or ocular integrity. However, a smaller BOZD led to a reduced TZ, with retardation of axial elongation by 0.13 mm compared to conventional 6 mm BOZD ortho‐k lenses after one year of lens wear.
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Affiliation(s)
- Biyue Guo
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region, China
| | - Sin Wan Cheung
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region, China
| | - Randy Kojima
- College of Optometry, Pacific University, Oregon, USA
| | - Pauline Cho
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region, China
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22
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Vincent SJ, Cho P, Chan KY, Fadel D, Ghorbani-Mojarrad N, González-Méijome JM, Johnson L, Kang P, Michaud L, Simard P, Jones L. CLEAR - Orthokeratology. Cont Lens Anterior Eye 2021; 44:240-269. [DOI: 10.1016/j.clae.2021.02.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 02/01/2021] [Indexed: 12/25/2022]
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23
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The Role of Back Optic Zone Diameter in Myopia Control with Orthokeratology Lenses. J Clin Med 2021; 10:jcm10020336. [PMID: 33477514 PMCID: PMC7831104 DOI: 10.3390/jcm10020336] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 01/08/2021] [Accepted: 01/14/2021] [Indexed: 12/14/2022] Open
Abstract
We compared the efficacy of controlling the annual increase in axial length (AL) in myopic Caucasian children based on two parameters: the back optic zone diameter (BOZD) of the orthokeratology (OK) lens and plus power ring diameter (PPRD) or mid-peripheral annular ring of corneal steepening. Data from 71 myopic patients (mean age, 13.34 ± 1.38 years; range, 10-15 years; 64% male) corrected with different BOZD OK lenses (DRL, Precilens) were collected retrospectively from a Spanish optometric clinic. The sample was divided into groups with BOZDs above or below 5.00 mm and the induced PPRD above or below 4.5 mm, and the relation to AL and refractive progression at 12 months was analyzed. Three subgroups were analyzed, i.e., plus power ring (PPR) inside, outside, or matching the pupil. The mean baseline myopia was -3.11 ± 1.46 D and the AL 24.65 ± 0.88 mm. Significant (p < 0.001) differences were found after 12 months of treatment in the refractive error and AL for the BOZD and PPRD. AL changes in subjects with smaller BOZDs decreased significantly regarding larger diameters (0.09 ± 0.12 and 0.15 ± 0.11 mm, respectively); in subjects with a horizontal sector of PPRD falling inside the pupil, the AL increased less (p = 0.035) than matching or outside the pupil groups by 0.04 ± 0.10 mm, 0.10 ± 0.11 mm, and 0.17 ± 0.12 mm, respectively. This means a 76% lesser AL growth or 0.13 mm/year in absolute reduction. OK corneal parameters can be modified by changing the OK lens designs, which affects myopia progression and AL elongation. Smaller BOZD induces a reduced PPRDs that slows AL elongation better than standard OK lenses. Further investigations should elucidate the effect of pupillary diameter, PPRD, and power change on myopia control.
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Cho WH, Fang PC, Yu HJ, Lin PW, Huang HM, Kuo MT. Analysis of tear film spatial instability for pediatric myopia under treatment. Sci Rep 2020; 10:14789. [PMID: 32901095 PMCID: PMC7478966 DOI: 10.1038/s41598-020-71710-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 08/19/2020] [Indexed: 02/08/2023] Open
Abstract
In Taiwan, the prevalence of myopia in children between 6 and 18 years old is over 80%, and high myopia accounts for over 20%, which turned out to be in the leading place worldwide. Orthokeratology and low-dose atropine are proven treatments to reduce myopia progression, though the potential corneal disturbances remain an issue in young populations. The alteration of the tear film is widely discussed but there is no consensus to date, so we aim to investigate the tear film spatial instability in children with myopia control using atropine or orthokeratology. Thirty-eight treatment-naïve participants and 126 myopic children under treatments were enrolled. The ocular surface homeostasis, spatial distribution of tear break-up, and high-order aberrations (HOAs) of the corneal surface were assessed. We found out that myopic children treated with either atropine or orthokeratology showed ocular surface homeostasis similar to that in treatment-naïve children. Nevertheless, children treated with orthokeratology presented higher HOAs (p < 0.00001) and a tendency of the first tear break-up zone at the inner half of the cornea (p = 0.04). This unique spatial instability of the tear film associated with myopia treatment might provide a more focused way of monitoring the pediatric tear film instability.
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Affiliation(s)
- Wan-Hua Cho
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Po-Chiung Fang
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hun-Ju Yu
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Pei-Wen Lin
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hsiu-Mei Huang
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ming-Tse Kuo
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
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